Ross and Carol Nese College of Nursing, The Pennsylvania State University, University Park, PA 16802, USA.
Division of Biostatistics, College of Public Health, The Ohio State University, Columbus, OH 43210, USA.
Int J Environ Res Public Health. 2021 Aug 26;18(17):9000. doi: 10.3390/ijerph18179000.
There is evidence of higher tobacco use among lesbian or gay and bisexual (LGB) populations. However, a limited number of studies have examined whether there are differences in potential indicators of future tobacco cessation behaviors between LGB and non-LGB populations. This study examined whether sexual identity is associated with craving, nicotine dependence, and quit intentions among high school students. Data were drawn from the 2020 National Youth Tobacco Survey ( = 1642). A propensity score matching (PSM) technique was used to address covariate imbalance among sexual identity groups. Additionally, subgroup analyses were performed for both males and females. The PSM results showed higher odds of craving among students who were gay or lesbian (aOR, 1.70; 95% CI = 1.13-2.55) and bisexual (aOR, 1.89; 95% CI = 1.23-2.92) compared to heterosexual (straight) students. In the sex-based subgroup analyses, we found that gay or lesbian (aOR, 1.92; 95% CI = 1.10-3.34) and bisexual (aOR, 3.12; 95% CI, 1.46-6.66) male students had significantly higher odds of craving when compared to heterosexual/straight male adolescents. However, the association was not significant in female students. Additionally, female bisexuals had significantly lower odds for quit intention (aOR, 0.48; 95% CI = 0.29-0.81) when compared to heterosexual/straight female adolescents. Results also showed no significant differences between LGB and non-LGB students for nicotine dependence. Sexual minority adolescents, especially male adolescents, were more likely to have tobacco cravings and bisexual females had lower odds of quit intention than heterosexual peers. Prevention efforts targeting this subpopulation may be beneficial.
有证据表明，同性恋、双性恋和跨性别（LGB）人群的烟草使用率更高。然而，仅有少数研究探讨了 LGB 和非 LGB 人群在未来戒烟行为的潜在指标上是否存在差异。本研究检验了性身份是否与高中生的烟瘾、尼古丁依赖和戒烟意愿有关。数据来自 2020 年全国青少年烟草调查（=1642）。采用倾向评分匹配（PSM）技术来解决性认同群体之间的协变量不平衡问题。此外，还对男性和女性进行了亚组分析。PSM 结果显示，与异性恋（直人）学生相比，同性恋（OR，1.70；95%CI=1.13-2.55）和双性恋（OR，1.89；95%CI=1.23-2.92）学生更有可能有烟瘾。在按性别划分的亚组分析中，我们发现与异性恋/直人男青少年相比，同性恋（OR，1.92；95%CI=1.10-3.34）和双性恋（OR，3.12；95%CI=1.46-6.66）男学生有更高的烟瘾可能性。然而，这种关联在女学生中并不显著。此外，与异性恋/直人女青少年相比，女双性恋者戒烟意愿的可能性显著降低（OR，0.48；95%CI=0.29-0.81）。结果还表明，LGB 和非 LGB 学生在尼古丁依赖方面没有显著差异。性少数群体青少年，尤其是男青少年，更有可能有烟草成瘾，而双性恋女性戒烟意愿的可能性低于异性恋同龄人。针对这一亚群体的预防工作可能会有所帮助。
