Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Emory, USA.
Department of Preventive Medicine, School of Health Sciences, Wuhan University, 185 Donghu Road, Wuhan, 430071, Hubei, People's Republic of China.
BMC Public Health. 2021 Jul 9;21(1):1358. doi: 10.1186/s12889-021-10888-5.
Literature in the West suggested that bisexual men have a higher smoking rate compared to gay men. Data on patterns of smoking among gay and bisexual men are limited in Eastern Asian countries like China. This study examined the cigarette smoking prevalence for gay versus bisexual men in China and their unique minority stress - smoking pathways.
Between September 2017 and November 2018, we surveyed a convenience sample of 538 gay men and 138 bisexual men recruited from local sexual minority organizations in four metropolitan cities in China (i.e., Beijing, Wuhan, Nanchang, and Changsha). Measures included sexual orientation, sociodemographics, theory-based minority stressors, depressive symptoms, and past 30-day cigarette smoking. Two-group (gay men vs. bisexual men) structural equation modeling (SEM) was used to test possible distinct mechanisms between theory-based stressors, depressive symptoms, and cigarette smoking among gay men and bisexual men, respectively.
The mean age of participants was 26.51 (SD = 8.41) years old and 76.3% of them had at least a college degree. Bisexual men reported a higher rate of cigarette smoking compared to gay men (39.9% vs. 27.3%). Two-group SEM indicated that the pathways for cigarette smoking were not different between gay and bisexual men. Higher rejection anticipation was associated with greater depressive symptoms (standardized β = 0.32, p < .001), and depressive symptoms were not associated with cigarette smoking.
Minority stress, specifically rejection anticipation, may be critical considerations in addressing depressive symptoms, but not smoking, among both gay and bisexual men in China.
西方文献表明，双性恋男性的吸烟率高于同性恋男性。在中国等东亚国家，有关同性恋和双性恋男性吸烟模式的数据有限。本研究调查了中国同性恋男性和双性恋男性的吸烟流行率及其独特的少数群体压力与吸烟之间的关系。
2017 年 9 月至 2018 年 11 月，我们从中国四个大城市（北京、武汉、南昌和长沙）的当地少数群体组织中招募了 538 名同性恋男性和 138 名双性恋男性，对他们进行了便利抽样调查。研究工具包括性取向、社会人口学特征、基于理论的少数群体压力源、抑郁症状和过去 30 天的吸烟情况。采用两组（同性恋男性与双性恋男性）结构方程模型（SEM）分别检验了同性恋男性和双性恋男性中基于理论的压力源、抑郁症状和吸烟之间可能存在的不同机制。
参与者的平均年龄为 26.51 岁（SD=8.41），其中 76.3%的人至少拥有大学学历。双性恋男性的吸烟率高于同性恋男性（39.9%比 27.3%）。两组 SEM 表明，同性恋男性和双性恋男性的吸烟途径没有差异。更高的拒绝预期与更大的抑郁症状相关（标准化β=0.32，p<0.001），而抑郁症状与吸烟无关。
少数群体压力，特别是拒绝预期，可能是解决中国同性恋和双性恋男性抑郁症状但不是吸烟问题的关键因素。
