Romm Katelyn F, Vogel Erin A, Cavazos-Rehg Patricia A, Berg Carla J
TSET Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences, Oklahoma City, Oklahoma, USA.
Department of Pediatrics, College of Medicine, University of Oklahoma Health Sciences, Oklahoma City, Oklahoma, USA.
J Rural Health. 2025 Jan;41(1):e70016. doi: 10.1111/jrh.70016.
Sexual minority young adults (SMYAs) residing in rural (vs. urban) areas report higher tobacco use rates. Less work has assessed associations of rural-urban residential movement/stability with SMYAs' tobacco use and factors driving these associations.
We analyzed 2023 survey data from 1082 US SMYAs (aged 18-34). Multivariable regressions controlling for sociodemographics examined associations of: (1) rural-urban movement/stability (urban stability, rural-urban movement, rural stability [REF]) with minority stress-related factors (mental health symptoms, internalized stigma), perceived tobacco norms (peer tobacco use, social acceptability of tobacco use), and tobacco use (past-month cigarette, e-cigarette, any tobacco use, number of products used); and (2) minority stress-related factors and tobacco norms with tobacco use.
Relative to SMYAs reporting rural stability, those reporting rural-urban movement and urban stability displayed lower odds of any tobacco use and mental health symptoms, and less peer tobacco use. Those reporting rural-urban movement also reported lower odds of cigarette use and less internalized stigma. Peer tobacco use was associated with higher odds of cigarette and any tobacco use; reporting ≥ moderate mental health symptoms and greater internalized stigma and social acceptability was associated with higher odds of cigarette use.
These novel findings provide preliminary evidence that, relative to their SM peers who reside in rural areas, SMYAs who move from rural to urban areas may experience less minority stress-related factors and lower tobacco use norms, which may reduce risk for cigarette and other tobacco use. Findings highlight the need for public health messaging interventions targeting SMYAs in rural communities.
居住在农村（与城市相比）地区的性少数青年成年人（SMYAs）报告的烟草使用率更高。较少有研究评估农村 - 城市居住迁移/稳定性与SMYAs烟草使用之间的关联以及驱动这些关联的因素。
我们分析了来自1082名美国SMYAs（年龄在18 - 34岁之间）的2023年调查数据。控制社会人口统计学因素的多变量回归分析了以下关联：（1）农村 - 城市迁移/稳定性（城市稳定性、农村 - 城市迁移、农村稳定性[参考组]）与少数群体压力相关因素（心理健康症状、内化耻辱感）、感知烟草规范（同伴烟草使用、烟草使用的社会可接受性）以及烟草使用（过去一个月的香烟、电子烟、任何烟草使用、使用的产品数量）；（2）少数群体压力相关因素和烟草规范与烟草使用之间的关联。
与报告农村稳定性的SMYAs相比，报告农村 - 城市迁移和城市稳定性的人任何烟草使用和心理健康症状的几率较低，同伴烟草使用也较少。报告农村 - 城市迁移的人香烟使用几率也较低，内化耻辱感也较少。同伴烟草使用与香烟和任何烟草使用的较高几率相关；报告有≥中度心理健康症状、更大内化耻辱感和社会可接受性与香烟使用的较高几率相关。
这些新发现提供了初步证据，即与居住在农村地区的SM同龄人相比，从农村迁移到城市地区的SMYAs可能经历较少的少数群体压力相关因素和较低的烟草使用规范，这可能降低香烟和其他烟草使用的风险。研究结果强调了针对农村社区SMYAs的公共卫生信息干预的必要性。
