Kcomt Luisa, Evans-Polce Rebecca J, Engstrom Curtiss W, West Brady T, Boyd Carol J, McCabe Sean Esteban
Center for the Study of Drugs, Alcohol, Smoking and Health, Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, Ann Arbor, USA.
Institute for Social Research, University of Michigan, Ann Arbor, USA.
J Gerontol B Psychol Sci Soc Sci. 2021 Aug 13;76(7):1400-1407. doi: 10.1093/geronb/gbab067.
The dearth of research on age-related differences in risk factors for tobacco use disorder (TUD) among sexual minorities, particularly among older adults, can obscure the differential needs of sexual minority age groups for tobacco prevention and cessation. We examined the association of cumulative ethnic/racial discrimination and sexual orientation discrimination with moderate-to-severe TUD among U.S. sexual minority adults aged 50 years and older.
We analyzed cross-sectional data from the National Epidemiologic Survey of Alcohol and Related Conditions-III (n = 36,309 U.S. adults). Our sample consisted of 1,258 adults (lesbian/gay-, bisexual-, and heterosexual-identified adults with same-sex attraction/behavior) aged ≥50 years. Multivariable logistic regression analyses estimated the association of cumulative lifetime ethnic/racial discrimination and sexual orientation discrimination with past-year moderate-to-severe TUD and tested whether the association differed for adults aged 50-64 years versus those aged ≥65 years.
An estimated 8.1% of the sample met criteria for moderate-to-severe TUD. Lifetime ethnic/racial discrimination and sexual orientation discrimination was not significantly associated with moderate-to-severe TUD for adults aged ≥50 years. However, a significant 2-way interaction was found between discrimination and age. In age-stratified analyses, greater discrimination was significantly associated with greater risk for moderate-to-severe TUD for adults aged ≥65 years, but not adults aged 50-64 years.
Greater cumulative discrimination based on ethnicity/race and sexual orientation was associated with increased risk for moderate-to-severe TUD among sexual minority adults aged ≥65 years. Our findings underscore the importance of age considerations in understanding the role of discrimination in the assessment and treatment of TUD.
关于性少数群体（尤其是老年人）中烟草使用障碍（TUD）风险因素的年龄差异研究匮乏，这可能掩盖了性少数群体不同年龄组在烟草预防和戒烟方面的不同需求。我们研究了美国50岁及以上性少数成年人中累积的种族/民族歧视和性取向歧视与中度至重度TUD之间的关联。
我们分析了来自《酒精及相关疾病全国流行病学调查-III》（n = 36,309名美国成年人）的横断面数据。我们的样本包括1258名年龄≥50岁的成年人（自我认同为女同性恋/男同性恋、双性恋以及有同性吸引/行为的异性恋成年人）。多变量逻辑回归分析估计了累积一生的种族/民族歧视和性取向歧视与过去一年中度至重度TUD之间的关联，并检验了50 - 64岁成年人与65岁及以上成年人之间的关联是否存在差异。
估计有8.1%的样本符合中度至重度TUD的标准。对于年龄≥50岁的成年人，一生的种族/民族歧视和性取向歧视与中度至重度TUD无显著关联。然而，发现歧视与年龄之间存在显著的双向交互作用。在按年龄分层的分析中，更大程度的歧视与65岁及以上成年人中度至重度TUD的更高风险显著相关，但与50 - 64岁成年人无关。
基于种族/民族和性取向的更大累积歧视与65岁及以上性少数成年人中度至重度TUD的风险增加相关。我们的研究结果强调了在理解歧视在TUD评估和治疗中的作用时考虑年龄因素的重要性。
