Guillory Jamie, Crankshaw Erik, Alam Ishrat Z, Curry Laurel, Saunders McKinley, Malterud Andie, Budenz Alex, Hoffman Leah, Ganz Ollie, Alexander Allison
RTI International, Dublin 6, Republic of Ireland.
RTI International, Research Triangle Park, NC, USA.
Nicotine Tob Res. 2025 Jun 23;27(7):1247-1255. doi: 10.1093/ntr/ntae252.
LGBTQ+ populations and people who smoke face stigma. This may lead to distancing oneself from smoking-related stigma by becoming a phantom smoker (i.e., reporting smoking, but not identifying as a smoker).
We explored correlates of phantom cigarette smoking among LGBTQ+ young adults. Participants were US young adults (18-24 years) who identified as LGBTQ+, reported any past 30-day cigarette smoking, and had a valid response for smoker self-identification (unique N = 5545). We incorporated data from participants who completed one or more of the seven surveys from the FDA's This Free Life campaign evaluation (February 2016-July 2019). Multivariable panel regression models with unweighted data examined phantom smoking correlates.
Over 60% of the sample were phantom smokers. Compared with self-identified smokers, phantom smokers were younger, more likely to be gay men than lesbian/gay women, and more likely to be non-Hispanic White than non-Hispanic Black, Hispanic, or non-Hispanic people of other races/ethnicities. Phantom smokers were more likely to have a college plus education (vs. high school or less) and report past 30-day alcohol use. Phantom smokers smoked on fewer of the past 30 days and were less likely to report positive cessation attitudes, nicotine dependence, and current e-cigarette or other tobacco product use.
This is the first known study to explore factors associated with phantom smoking among LGBTQ+ young adults. Over half of young adult smokers were phantom smokers. Tobacco education for LGBTQ+ populations should consider phantom smoking and cessation implications to tailor content for phantom and self-identified smokers.
We examined predictors of phantom smoking (current smoking but denying smoker identity) among LGBTQ+ young adult smokers, which has not yet been explored among this population. Phantom (vs. self-identified) smokers were less likely to be lesbian/gay women (vs. gay men) or from a racial/ethnic minority group and more likely to report past 30-day alcohol use. Phantom smokers reported less tobacco use, lower nicotine dependence, and less favorable cessation attitudes. Phantom smokers comprised most smokers in our sample. Findings suggest the importance of addressing this unique aspect of LGBTQ+ smoking in research, clinical settings, and tailored tobacco public education messages.
LGBTQ+群体和吸烟者都面临着污名化。这可能导致通过成为“幻影吸烟者”（即报告吸烟，但不认同自己是吸烟者）来使自己远离与吸烟相关的污名。
我们探讨了LGBTQ+青年成年人中幻影吸烟的相关因素。参与者是美国18至24岁的青年成年人，他们认同自己为LGBTQ+，报告在过去30天内有过吸烟行为，并且对吸烟者自我认同有有效回答（唯一N = 5545）。我们纳入了来自完成美国食品药品监督管理局“自由生活”运动评估的七项调查中的一项或多项调查的参与者的数据（2016年2月至2019年7月）。使用未加权数据的多变量面板回归模型检验了幻影吸烟的相关因素。
超过60%的样本是幻影吸烟者。与自我认同的吸烟者相比，幻影吸烟者更年轻，男性同性恋者比女同性恋者/男同性恋者更有可能是幻影吸烟者，非西班牙裔白人比非西班牙裔黑人、西班牙裔或其他种族/族裔的非西班牙裔人更有可能是幻影吸烟者。幻影吸烟者更有可能拥有大学及以上学历（相对于高中或以下学历），并报告在过去30天内饮酒。幻影吸烟者在过去30天内吸烟的天数较少，并且不太可能报告有积极的戒烟态度、尼古丁依赖以及当前使用电子烟或其他烟草制品。
这是第一项探索LGBTQ+青年成年人中与幻影吸烟相关因素的已知研究。超过一半的青年成年吸烟者是幻影吸烟者。针对LGBTQ+群体的烟草教育应考虑幻影吸烟及其戒烟影响，以便为幻影吸烟者和自我认同的吸烟者量身定制内容。
我们研究了LGBTQ+青年成年吸烟者中幻影吸烟（当前吸烟但否认吸烟者身份）的预测因素，该群体尚未对此进行过探索。幻影吸烟者（相对于自我认同的吸烟者）不太可能是女同性恋者/男同性恋者（相对于男同性恋者）或来自少数种族/族裔群体，并且更有可能报告在过去30天内饮酒。幻影吸烟者报告的烟草使用较少、尼古丁依赖较低且戒烟态度不太积极。在我们的样本中，幻影吸烟者占大多数吸烟者。研究结果表明在研究、临床环境以及量身定制的烟草公共教育信息中解决LGBTQ+吸烟这一独特方面的重要性。
