Lee Juhan, Tan Andy S L
Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA.
Annenberg School for Communication, University of Pennsylvania, Philadelphia, PA, USA.
Nicotine Tob Res. 2025 Aug 28. doi: 10.1093/ntr/ntaf176.
Understanding e-cigarette use among those with multiple intersecting marginalized identities is important since those individuals might experience intersectional minority stress, which is associated with tobacco use. This study examined the prevalence of e-cigarette use at the intersection of race/ethnicity and sexual identity among US adults.
We analyzed the pooled 2021 to 2023 National Health Interview Survey (NHIS) dataset adult samples (N=86655). We conducted an adjusted binomial logistic regression analysis to predict past-30-day e-cigarette use with sexual identity (straight, gay/lesbian/bisexual/something else [LGB+]), race/ethnicity (Non-Hispanic White, Non-Hispanic Black/African American, Non-Hispanic Asian, Non-Hispanic American Indian and Alaska Native, Hispanic, Other races) and an interaction term between sexual identity and race/ethnicity in one model, adjusted for age, education, cigarette smoking, and diagnoses of chronic diseases. The results were stratified by sex and the adjusted predicted margins were estimated.
Among total respondents, 5.5% (weighted) reported past-30-day e-cigarette use, 5.3% were LGB+, 11.8% were non-Hispanic Black, 6.1% were non-Hispanic Asian, 1.4% were non-Hispanic American Indian and Alaska Native, and 17.2% were Hispanic. The overall interaction effect between sexual identity and race/ethnicity on outcome was significant among total respondents (p=0.004) and females (p<0.001), but not males. Among females, the adjusted predicted margins for current e-cigarette use between LGB+ individuals and heterosexual individuals in Hispanic groups (4.0% vs. 1.0%) were significantly different from those in the NH White group (4.4% vs. 3.4%).
Sexual minority adults in Hispanic groups, particularly Hispanic sexual minority females, may be at increased risk for e-cigarette use than Hispanic heterosexual females.
This study highlights the risk of e-cigarette use among sexual minority adults in non-White racial/ethnic groups, particularly Hispanic sexual minority females. These findings underscore the need for future research to understand the unique drivers of e-cigarette use among Hispanic sexual minority females.
了解具有多重交叉边缘化身份的人群中电子烟的使用情况很重要，因为这些个体可能会经历交叉性少数群体压力，而这与烟草使用有关。本研究调查了美国成年人中按种族/族裔和性取向交叉分类的电子烟使用流行情况。
我们分析了2021年至2023年全国健康访谈调查（NHIS）汇总数据集的成年样本（N = 86655）。我们进行了调整后的二项式逻辑回归分析，在一个模型中预测过去30天内电子烟的使用情况，该模型纳入了性取向（异性恋、同性恋/女同性恋/双性恋/其他[LGB+]）、种族/族裔（非西班牙裔白人、非西班牙裔黑人/非裔美国人、非西班牙裔亚洲人、非西班牙裔美国印第安人和阿拉斯加原住民、西班牙裔、其他种族）以及性取向和种族/族裔之间的交互项，并对年龄、教育程度、吸烟情况和慢性病诊断进行了调整。结果按性别分层，并估计了调整后的预测边际。
在所有受访者中，5.5%（加权）报告在过去30天内使用过电子烟，5.3%为LGB+，11.8%为非西班牙裔黑人，6.1%为非西班牙裔亚洲人，1.4%为非西班牙裔美国印第安人和阿拉斯加原住民，17.2%为西班牙裔。性取向和种族/族裔对结果的总体交互作用在所有受访者（p = 0.004）和女性（p < 0.001）中显著，但在男性中不显著。在女性中，西班牙裔群体中LGB+个体和异性恋个体当前电子烟使用的调整后预测边际（4.0%对1.0%）与非西班牙裔白人组（4.4%对3.4%）有显著差异。
西班牙裔群体中的性少数成年人，尤其是西班牙裔性少数女性，使用电子烟的风险可能高于西班牙裔异性恋女性。
本研究强调了非白人种族/族裔群体中性少数成年人使用电子烟的风险，尤其是西班牙裔性少数女性。这些发现强调了未来研究了解西班牙裔性少数女性中电子烟使用独特驱动因素的必要性。
