Office of Scholarship and Research, Columbia University School of Nursing, New York, New York; and.
Department of Sociology, University of Utah, Salt Lake City, Utah.
Ann Am Thorac Soc. 2021 Feb;18(2):273-280. doi: 10.1513/AnnalsATS.202001-062OC.
Minority sexual identity appears to confer asthma risks. Although associations between inhaled substances and asthma are established, these have not been examined among sexual minority youths. Given sexual minority adolescents' disproportionately high rates of substance use, research is needed to fill this important gap. Using a representative sample of adolescents from the United States, we ) examined associations among asthma, sexual identity, and inhaled substance use and tested ) whether sexual identity moderates relationships between asthma and inhaled substance use and ) whether inhaled substance use mediates associations between sexual identity and asthma. Data are from the 2015 and 2017 Youth Risk Behavior Surveillance Survey. Adolescents ( = 30,113) reported if they were ever diagnosed with asthma, current use of cigarettes, cigars and/or cigarillos, marijuana, and electronic vapor products and if they ever used inhalants or synthetic marijuana. We used logistic regression to examine associations between asthma, sexual identity, and inhaled substance use controlling for age, race or ethnicity, and body mass index percentile, stratified by sex. Lesbian, gay, and bisexual respondents had higher relative risks for asthma than heterosexual youth. Sexual minority female youths had significantly higher relative risks than heterosexual female youths for use of every inhaled substance. There were few sexual identity differences in inhaled substance use among male youths. Inhaled substance use was significantly associated with higher risks for asthma. In general, associations between each individual inhaled substance and asthma did not differ between sexual minority and heterosexual youths. However, when all inhaled substances were added into the models concurrently, inhaled substance use appeared to mediate associations with asthma among lesbian and bisexual female youths, and partially mediated these associations among sexual minority male youths. Sexual identity and inhaled substance use appear to play important roles in asthma risk. However, these variables do not fully explain the risk, suggesting that other unmeasured variables (e.g., stress and victimization) may be implicated in risks for both inhaled substance use and asthma. It is important that clinicians providing care to adolescents ask about sexual identity and inhaled substance use. Effective approaches to reducing inhaled substance use among adolescents, especially sexual minorities, are needed.
少数群体的性认同似乎会带来哮喘风险。虽然已经确定了吸入物质与哮喘之间的关联，但这些关联在性少数青年群体中尚未得到研究。鉴于性少数青少年的物质使用比例过高，需要开展研究来填补这一重要空白。本研究使用来自美国的代表性青少年样本，研究了哮喘、性认同与吸入性物质使用之间的关联，并检验了性认同是否调节了哮喘与吸入性物质使用之间的关系，以及吸入性物质使用是否在性认同与哮喘之间的关联中起中介作用。数据来自于 2015 年和 2017 年的青少年风险行为监测调查。青少年（ = 30,113）报告了他们是否曾被诊断出患有哮喘、当前是否使用香烟、雪茄和/或小雪茄、大麻和电子烟，以及他们是否曾使用吸入剂或合成大麻。我们使用逻辑回归来检验哮喘、性认同和吸入性物质使用之间的关联，同时控制年龄、种族或族裔以及体重指数百分位数，按性别分层。女同性恋、男同性恋和双性恋受访者患哮喘的相对风险高于异性恋青年。性少数女性青年使用每种吸入性物质的相对风险明显高于异性恋女性青年。男性青年之间在吸入性物质使用方面的性认同差异较小。吸入性物质使用与哮喘风险显著相关。总体而言，在性少数和异性恋青年中，每种单独的吸入性物质与哮喘之间的关联没有差异。然而，当将所有吸入性物质同时纳入模型时，吸入性物质使用似乎在女同性恋和双性恋女性青年的哮喘关联中起中介作用，在性少数男性青年的哮喘关联中起部分中介作用。性认同和吸入性物质使用在哮喘风险中起着重要作用。然而，这些变量并不能完全解释风险，这表明其他未测量的变量（例如，压力和受害）可能与吸入性物质使用和哮喘风险都有关联。为青少年提供护理的临床医生询问性认同和吸入性物质使用情况非常重要。需要采取有效的方法来减少青少年，特别是性少数群体的吸入性物质使用。
