Lee Juhan, Evans-Polce Rebecca J, Parker Maria A
Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, United States of America.
Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, University of Michigan, Ann Arbor, MI, United States of America.
Prev Med Rep. 2025 Apr 10;54:103069. doi: 10.1016/j.pmedr.2025.103069. eCollection 2025 Jun.
Understanding tobacco product use among sexual minority youth is important due to the exposure to nicotine and toxicants, which worsens tobacco-related health disparities. We used recent US national data to characterize tobacco product use by sexual identity.
Data were drawn from the 2023 National Youth Tobacco Survey (NYTS), a nationally representative survey of US middle and high school students ( = 20,503). Sexual identity categories included "heterosexual", "gay/lesbian", "bisexual/pansexual/queer", "asexual", "questioning", "I do not know what this question means", "something else", and "decline to answer." Outcomes were past-30-day (1) multiple tobacco product use (number of products) and (2) frequent tobacco product use (≥20 days). Weighted Poisson regression models examined associations between sexual identity and tobacco use, adjusting for covariates.
In 2023, there was more tobacco product use (adjusted prevalence ratio[aPR] = 2.35, 95 % CI = 1.15, 4.79) and more frequent tobacco product use among gay/lesbian (aPR = 2.89, 95 % CI = 1.42, 5.87) and asexual youths (aPR = 2.92, 95 % CI = 1.41, 6.04) (vs. heterosexual youth) in the past 30 days. Compared to heterosexual youth, gay/lesbian and asexual youth were more likely to report combustible tobacco use, while bisexual, pansexual, queer, and questioning youth were more likely to use non-combustible products, such as e-cigarettes and nicotine pouches.
This study observed more multiple and frequent tobacco product use among US sexual minority youth than heterosexual youth. These disparities by sexual identity emphasize the need for targeted tobacco prevention and cessation programs. Public health interventions should address unique stressors and risk factors contributing to tobacco use among sexual minority youth.
鉴于性少数青年接触尼古丁和有毒物质，了解他们的烟草制品使用情况很重要，因为这会加剧与烟草相关的健康差距。我们利用美国近期的全国数据，按性取向特征描述烟草制品的使用情况。
数据取自2023年全国青少年烟草调查（NYTS），这是一项针对美国初高中学生的具有全国代表性的调查（n = 20,503）。性取向类别包括“异性恋”、“男同性恋/女同性恋”、“双性恋/泛性恋/酷儿”、“无性恋”、“存疑”、“我不知道这个问题是什么意思”、“其他”以及“拒绝回答”。结果指标为过去30天内：（1）多种烟草制品使用情况（使用的制品数量）以及（2）频繁烟草制品使用情况（≥20天）。加权泊松回归模型检验了性取向与烟草使用之间的关联，并对协变量进行了调整。
2023年，男同性恋/女同性恋青年（调整患病率比[aPR]=2.89，95%置信区间[CI]=1.42，5.87）和无性恋青年（aPR = 2.92，95% CI = 1.41，6.04）在过去30天内的烟草制品使用情况（aPR = 2.35，95% CI = 1.15，4.79）以及频繁烟草制品使用情况均多于异性恋青年。与异性恋青年相比，男同性恋/女同性恋和无性恋青年更有可能报告使用可燃烟草，而双性恋、泛性恋、酷儿和存疑青年更有可能使用不可燃制品，如电子烟和尼古丁袋。
本研究观察到，美国性少数青年的多种和频繁烟草制品使用情况多于异性恋青年。这些因性取向产生的差异凸显了针对性烟草预防和戒烟项目的必要性。公共卫生干预措施应解决导致性少数青年使用烟草的独特压力源和风险因素。
