Department of Psychology, Reed College, Portland, OR, USA.
Oregon Social Learning Center, Eugene, OR, USA.
Nicotine Tob Res. 2023 Jan 1;25(1):19-27. doi: 10.1093/ntr/ntac180.
Poly-tobacco use (PTU), or the concomitant use of two or more nicotine and tobacco products, are a growing public health concern. Adults reporting increased psychological distress (PD) experience profound nicotine and tobacco health-related disparities. Sexual minority (SM) adults report more PTU and higher levels of PD than heterosexuals, yet little is known about patterns of nicotine and tobacco use and its relationship to PD in SM populations.
The purpose of this study was to investigate sexual identity differences in PD and PTU. Data were drawn from the 2016-2018 National Health Interview Survey (N = 83 017), an annual cross-sectional survey of a nationally representative sample of U.S. adults. PD was assessed using the Kessler Psychological Distress Scale (K6). We fit sex-stratified, weighted, adjusted logistic models to compare PTU and PD by sexual identity.
PTU was more prevalent in adults with higher K6 scores. Female adults and SM adults had significantly higher K6 scores and were significantly more likely to experience serious PD when compared to their male and heterosexual counterparts.
The current study provides a snapshot of trends in PTU in relation to PD, gender, and sexual identity. Findings suggest higher rates of both PD and PTU in SM adults. Further research examining the mechanisms underlying this disparity is critical to the development of effective intervention and prevention strategies.
Little is known about sex and sexual identity differences in the relations between patterns of tobacco product use and PD. This study is the first to examine the effect of gender and sexual identity on both PD and PTU. SMs reported higher rates of PD and were more likely to be poly-tobacco users. As new ways of engaging nicotine/tobacco continue to proliferate, health risks will endure especially for marginalized populations. An increased understanding of the psychological and social correlates of PTU in SMs is warranted.
多烟草制品使用（PTU），即同时使用两种或两种以上尼古丁和烟草制品，是一个日益严重的公共卫生问题。报告心理困扰（PD）增加的成年人经历了深刻的尼古丁和烟草相关健康差异。性少数群体（SM）成年人报告的 PTU 更多，PD 水平更高，比异性恋者高，但人们对 SM 人群中尼古丁和烟草使用模式及其与 PD 的关系知之甚少。
本研究旨在调查 PD 和 PTU 中的性认同差异。数据来自 2016-2018 年全国健康访谈调查（N = 83017），这是一项对美国成年人进行的全国代表性样本的年度横断面调查。PD 使用 Kessler 心理困扰量表（K6）进行评估。我们采用性别分层、加权、调整后的逻辑模型，比较了不同性认同者的 PTU 和 PD。
PTU 在 K6 得分较高的成年人中更为普遍。与男性和异性恋者相比，女性成年人和 SM 成年人的 K6 得分明显更高，且更有可能经历严重 PD。
本研究提供了与 PD、性别和性认同相关的 PTU 趋势的快照。研究结果表明，SM 成年人中 PD 和 PTU 的发生率更高。进一步研究检查这种差异背后的机制对于制定有效的干预和预防策略至关重要。
关于性别和性认同差异在烟草制品使用模式与 PD 之间的关系方面知之甚少。本研究首次研究了性别和性认同对 PD 和 PTU 的影响。SM 报告的 PD 发生率更高，且更有可能同时使用多种烟草制品。随着新的尼古丁/烟草使用方式不断涌现，健康风险将持续存在，尤其是对边缘化人群而言。有必要更深入地了解 SM 人群中 PTU 的心理和社会相关因素。
