Lee Juhan, Harlow Alyssa F
Department of Epidemiology and Population Health, Albert Einstein College of Medicine.
Department of Epidemiology and Population Health, Montefiore Einstein Comprehensive Cancer Center.
Nicotine Tob Res. 2025 Feb 20. doi: 10.1093/ntr/ntaf044.
Incorporating sexual identity fluidity and stability into the understanding of tobacco use patterns by sexual minority populations is particularly important, but less is known about how changes and stability in sexual identity relate to e-cigarette initiation.
Using three waves of the United States (US) Population Assessment of Tobacco Health (PATH) Study (Waves 4-6 [2016-2021]), we examined the association of sexual identity change and stability with e-cigarette initiation among adults who never vaped at Wave 4 (N=11,554). Changes in sexual identity were defined based on identity at Waves 4-6: (1) Consistently heterosexual; (2) Consistently Lesbian, Gay, Bisexual, or something else (LGB+); (3) Heterosexual at Wave 4 and LGB+ at Wave 6; (4) All other identity changes. The outcome was ever e-cigarette use at Wave 6.
Among adults who never vaped at Wave 4, N=1,022 (4.0%, weighted) initiated e-cigarettes by Wave 6. Overall, N=10,166 (93.1%) reported consistently heterosexual identities, N=513 (2.7%) consistently LGB+, N=316 (1.8%) reported heterosexual identity at Wave 4 and LGB+ identity at Wave 6, and N=298 (2.4%) reported all other identities. Among adults who never used e-cigarettes at Wave 4, those who reported heterosexual at Wave 4 and LGB+ identity at Wave 6 (vs. those who reported consistently heterosexual identity) were more likely to report e-cigarette initiation at Wave 6 (aOR=1.78, 95% CI=1.05, 3.01), after adjusting for covariates.
This study found an increased risk of e-cigarette use initiation and continued use among US adults who changed their self-reported sexual identity from heterosexual identity to LGB+ identity.
This study found an increased risk of e-cigarette use initiation and continued use among US adults who changed their self-reported sexual identity from heterosexual identity to LGB+ identity. Findings may inform the development of tailored interventions and clinical practices, capitalizing on the coming out phase as a teaching moment to communicate the potentially harmful effects of e-cigarette use among sexual minority individuals.
将性取向的流动性和稳定性纳入对性少数群体烟草使用模式的理解中尤为重要，但关于性取向的变化和稳定性如何与电子烟的开始使用相关，我们所知甚少。
利用美国烟草健康人口评估（PATH）研究的三个阶段（第4 - 6阶段[2016 - 2021年]），我们研究了性取向变化和稳定性与第4阶段从未使用过电子烟的成年人（N = 11,554）开始使用电子烟之间的关联。性取向的变化是根据第4 - 6阶段的性取向来定义的：（1）始终为异性恋；（2）始终为女同性恋、男同性恋、双性恋或其他性取向（LGB +）；（3）第4阶段为异性恋，第6阶段为LGB +；（4）所有其他性取向变化。结果变量是在第6阶段曾经使用过电子烟。
在第4阶段从未使用过电子烟的成年人中，到第6阶段有1,022人（加权后为4.0%）开始使用电子烟。总体而言，有10,166人（93.1%）报告始终为异性恋身份，513人（2.7%）始终为LGB +身份，316人（1.8%）报告第4阶段为异性恋身份，第6阶段为LGB +身份，298人（2.4%）报告了所有其他身份。在第4阶段从未使用过电子烟的成年人中，那些报告第4阶段为异性恋身份且第6阶段为LGB +身份的人（与那些报告始终为异性恋身份的人相比）在调整协变量后，在第6阶段更有可能报告开始使用电子烟（调整后的比值比 = 1.78，95%置信区间 = 1.05，3.01）。
本研究发现，在美国成年人中，那些将自我报告的性取向从异性恋身份转变为LGB +身份的人，开始使用电子烟和持续使用电子烟的风险增加。
本研究发现，在美国成年人中，那些将自我报告的性取向从异性恋身份转变为LGB +身份的人，开始使用电子烟和持续使用电子烟的风险增加。研究结果可能为制定针对性的干预措施和临床实践提供信息，利用出柜阶段作为一个教育契机，告知性少数群体个体电子烟使用的潜在有害影响。
