Department of Health Policy and Behavioral Sciences, School of Public Health, Georgia State University, Atlanta.
Milken Institute School of Public Health, George Washington University, Washington, DC.
JAMA Netw Open. 2022 May 2;5(5):e2211060. doi: 10.1001/jamanetworkopen.2022.11060.
Significant disparities exist in smoking behaviors by sexual minority status in the US.
To examine potential differences in the associations between exposure to the Tips From Former Smokers (Tips) campaign and intentions and attempts to quit smoking by sexual minority status.
DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional study used data from the wave 5 survey of the Population Assessment of Tobacco and Health study. Data from 8072 adults who were currently established cigarette smokers were collected from December 2018 to November 2019 and analyzed in August 2021. The Population Assessment of Tobacco and Health study is an ongoing cohort study representative of the noninstitutionalized US population. Sample weights were applied to account for the complex sampling strategies.
Dichotomized self-reported frequent Tips exposure (often and very often) and infrequent exposure (never, rarely, and sometimes).
Outcomes were intention to quit within 12 months, any serious quit attempts in the past 12 months, and number of serious quit attempts in the past 12 months. Multivariate logistic and ordinal logistic regressions were used to estimate the weighted associations between exposure and each outcome. Interactions between Tips exposure and sexual minority status were examined to explore potential differences.
A total of 8072 participants (mean [SD] age, 44.7 [14.8] years; 3888 [53.2%] male; 4962 [67.4%] non-Hispanic White; and 915 [9.5%] sexual minoritized individuals [ie, those who identified as lesbian, gay, bisexual, or another minoritized sexual identity]) were included. Frequent Tips exposure was associated with higher odds of quit intentions and attempts overall (adjusted odds ratio [aOR], 1.25; 95% CI, 1.07-1.46 for intention to quit within 12 months; aOR, 1.26; 95% CI, 1.08-1.47 for serious quit attempts in the past 12 months; and aOR, 1.24; 95% CI, 1.06-1.44 for number of serious quit attempts in the past 12 months). These associations were significantly stronger for heterosexual smokers than sexual minoritized smokers, as indicated by the significant interaction terms (aOR, 0.58; 95% CI, 0.36-0.96 for intention to quit within 12 months; aOR, 0.41; 95% CI, 0.24-0.70 for serious quit attempts in the past 12 months; and aOR, 0.40; 95% CI, 0.24-0.67 for number of serious quit attempts in the past 12 months). Subgroup analysis showed that heterosexual smokers who reported frequent Tips exposure were more likely to intend to quit within 12 months (aOR, 1.29; 95% CI, 1.10-1.53), have had any serious quit attempts in the past 12 months (aOR, 1.34; 95% CI, 1.13-1.58), and have had more serious quit attempts (aOR, 1.32; 95% CI, 1.12-1.54) than heterosexual smokers who reported infrequent exposure. In contrast, there was no association for sexual minoritized smokers (aOR, 0.82; 95% CI, 0.52-1.30 for intention to quit within 12 months; aOR, 0.65; 95% CI, 0.39-1.07 for serious quit attempts in the past 12 months; and aOR, 0.62; 95% CI, 0.38-1.00 for number of serious quit attempts in the past 12 months).
These findings suggest that significant differences exist in the associations between Tips exposure and quit intentions or attempts by sexual minority status. More targeted campaign content for sexual minoritized smokers may be needed to increase quit intentions and attempts among this group.
在美国，性少数群体的吸烟行为存在显著差异。
研究接触“前吸烟者提示”（Tips）活动与性少数群体吸烟状况与戒烟意图和尝试之间的潜在关联的差异。
设计、地点和参与者：本横断面研究使用了人口烟草和健康评估研究第 5 波调查的数据。2018 年 12 月至 2019 年 11 月期间收集了 8072 名当前固定吸烟成年人的数据，并于 2021 年 8 月进行了分析。人口烟草和健康评估研究是一项具有代表性的非机构化美国人口的正在进行的队列研究。应用样本权重来考虑复杂的抽样策略。
自我报告的频繁接触（经常和非常经常）和不频繁接触（从不、很少和有时）的二分法。
结果是在 12 个月内戒烟的意图、过去 12 个月内任何严重的戒烟尝试以及过去 12 个月内严重戒烟尝试的次数。使用多元逻辑回归和有序逻辑回归来估计暴露与每个结果之间的加权关联。检查了提示暴露与性少数群体地位之间的相互作用，以探讨潜在的差异。
共有 8072 名参与者（平均[SD]年龄 44.7[14.8]岁；3888[53.2%]为男性；4962[67.4%]为非西班牙裔白人；915[9.5%]为性少数群体个体[即那些认为自己是女同性恋、男同性恋、双性恋或其他少数性身份的个体]）被纳入研究。频繁接触提示与总体戒烟意图和尝试的可能性更高相关（调整后的优势比[OR]，1.25；95%CI，1.07-1.46 用于 12 个月内戒烟的意图；调整后的 OR，1.26；95%CI，1.08-1.47 用于过去 12 个月内严重戒烟尝试；调整后的 OR，1.24；95%CI，1.06-1.44 用于过去 12 个月内严重戒烟尝试的次数）。与性少数群体吸烟者相比，异性恋吸烟者的这些关联要强得多，这表明交互项具有统计学意义（调整后的 OR，0.58；95%CI，0.36-0.96 用于 12 个月内戒烟的意图；调整后的 OR，0.41；95%CI，0.24-0.70 用于过去 12 个月内严重戒烟尝试；调整后的 OR，0.40；95%CI，0.24-0.67 用于过去 12 个月内严重戒烟尝试的次数）。亚组分析表明，报告频繁接触提示的异性恋吸烟者更有可能在 12 个月内戒烟（调整后的 OR，1.29；95%CI，1.10-1.53），过去 12 个月内有过任何严重戒烟尝试（调整后的 OR，1.34；95%CI，1.13-1.58），并且有过更多的严重戒烟尝试（调整后的 OR，1.32；95%CI，1.12-1.54），而报告不频繁接触提示的异性恋吸烟者则没有这种关联（调整后的 OR，0.82；95%CI，0.52-1.30 用于 12 个月内戒烟的意图；调整后的 OR，0.65；95%CI，0.39-1.07 用于过去 12 个月内严重戒烟尝试；调整后的 OR，0.62；95%CI，0.38-1.00 用于过去 12 个月内严重戒烟尝试的次数）。
这些发现表明，接触提示与性少数群体的戒烟意图或尝试之间的关联存在显著差异。可能需要针对性少数群体吸烟者提供更有针对性的活动内容，以增加该群体的戒烟意图和尝试。
