scholarly journals Cigarette Smoking and Minority Stress Across Age Cohorts in a National Sample of Sexual Minorities: Results From the Generations Study

Author(s):  
Allegra R Gordon ◽  
Jessica N Fish ◽  
Wouter J Kiekens ◽  
Marguerita Lightfoot ◽  
David M Frost ◽  
...  

Abstract Background Sexual minority populations in the United States have persistently higher rates of cigarette use than heterosexuals, partially driven by exposure to minority stressors (e.g., discrimination and victimization). Little is known about cigarette use across cohorts of sexual minority adults who came of age in distinctly different sociopolitical environments. Purpose To examine cigarette use and minority stressors across three age cohorts of U.S. sexual minority adults. Methods We used data from the Generations Study, a nationally representative sample (N = 1,500) of White, Black, and Latino/a sexual minority adults in three age cohorts (younger: 18–25 years; middle: 34–41 years; and older: 52–59 years). Survey data were collected from March 2016 to March 2017. We used sex-stratified logistic regression models to estimate adjusted odds ratios (aORs) and 95% confidence intervals (CIs) for associations between age cohort, minority stressors (discrimination and victimization), and two indicators of cigarette smoking (lifetime use and current use). Results Prevalence of current cigarette use in each age cohort was high (younger: 20%; middle: 33%; and older: 29%). Relative to the younger cohort, men and women in the middle- and older-age cohorts had significantly higher odds of lifetime and current smoking (e.g., men, current, aOR [95% CI]: middle = 2.47 [1.34, 4.52], older = 2.85 [1.66, 4.93]). Minority stressors were independently associated with higher odds of current smoking; when victimization was included, the magnitude of the association between age cohort and current smoking was diminished but remained significant. Conclusions Smoking cessation interventions must consider the role of minority stress and the unique needs of sexual minority people across the life course.

2021 ◽  
Vol 12 ◽  
Author(s):  
Jeremy T. Goldbach ◽  
Sheree M. Schrager ◽  
Mary Rose Mamey ◽  
Harmony Rhoades

Objective: Sexual minority adolescents (SMA) experience numerous behavioral health disparities, including depression, anxiety, substance use, non-suicidal self-injury, and suicidality. The primary framework to understand these disparities is minority stress theory, which frames this disproportionate burden as the result of discrimination, violence, and victimization in a homophobic culture. Empirical examinations of minority stress among SMA have been limited by lack of diverse samples or validated measures. This study engaged a national community sample of SMA to confirm reliability and validity of the Sexual Minority Adolescent Stress Inventory (SMASI).Method: A national sample of 2,310 SMA aged 14–17 was recruited in the United States through a hybrid social media and respondent-driven sampling approach. Item response theory and confirmatory factor analysis established the psychometric properties of the SMASI in this sample; minority stress was modeled as a latent variable in several regression models to verify criterion and divergent validity.Results: In this national sample (M age = 15.9; 64% female and 60% White), the factor structure of the SMASI and its 11 subscales was confirmed and shown to be invariant by demographic characteristics. Minority stress as measured by the SMASI was significantly associated with all mental and behavioral health outcomes.Conclusions: This study provides evidence that SMASI is a reliable, valid, and important tool for better understanding minority stress and subsequent health and mental health consequences among SMA.


Author(s):  
Andrea H Weinberger ◽  
Jiaqi Zhu ◽  
Joun Lee ◽  
Shu Xu ◽  
Renee D Goodwin

Abstract Introduction Cigarette use is declining among youth in the United States, whereas cannabis use and e-cigarette use are increasing. Cannabis use has been linked with increased uptake and persistence of cigarette smoking among adults. The goal of this study was to examine whether cannabis use is associated with the prevalence and incidence of cigarette, e-cigarette, and dual product use among U.S. youth. Methods Data included U.S. youth ages 12–17 from two waves of the Population Assessment of Tobacco and Health (PATH) Study (Wave 1 youth, n = 13 651; Wave 1 tobacco-naive youth, n = 10 081). Weighted logistic regression models were used to examine the association between Wave 1 cannabis use and (1) Wave 1 prevalence of cigarette/e-cigarette use among Wave 1 youth and (2) Wave 2 incidence of cigarette/e-cigarette use among Wave 1 tobacco-naive youth. Analyses were run unadjusted and adjusted for demographics and internalizing/externalizing problem symptoms. Results Wave 1 cigarette and e-cigarette use were significantly more common among youth who used versus did not use cannabis. Among Wave 1 tobacco-naive youth, Wave 1 cannabis use was associated with significantly increased incidence of cigarette and e-cigarette use by Wave 2. Conclusions Youth who use cannabis are more likely to report cigarette and e-cigarette use, and cannabis use is associated with increased risk of initiation of cigarette and e-cigarette use over 1 year. Continued success in tobacco control—specifically toward reducing smoking among adolescents—may require focusing on cannabis, e-cigarette, and cigarette use in public health education, outreach, and intervention efforts. Implications These data extend our knowledge of cigarette and e-cigarette use among youth by showing that cannabis use is associated with increased prevalence and incidence of cigarette and e-cigarette use among youth, relative to youth who do not use cannabis. The increasing popularity of cannabis use among youth and diminished perceptions of risk, coupled with the strong link between cannabis use and tobacco use, may have unintended consequences for cigarette control efforts among youth.


Author(s):  
Funmilola M. OlaOlorun ◽  
Wen Shen

Menopause is the natural senescence of ovarian hormonal production, and it eventually occurs in every woman. The age at which menopause occurs varies between cultures and ethnicities. Menopause can also be the result of medical or surgical interventions, in which case it can occur at a much younger age. Primary symptoms, as well as attitudes toward menopause, also vary between cultures. Presently, the gold standard for treatment of menopause symptoms is hormone therapy; however, many other options have also been shown to be efficacious, and active research is ongoing to develop better and safer treatments. In a high-resource setting, the sequelae/physiologic changes associated with menopause can impact a woman’s physical and mental health for the rest of her life. In addition to “hot flashes,” other less well-known conditions include heart disease, osteoporosis, metabolic syndrome, depression, and cognitive decline. In the United States, cardiac disease is the leading cause of mortality in women over the age of 65. The growing understanding of the physiology of menopause is beginning to inform strategies either to prevent or to attenuate these common health conditions. As the baby boomers age, the distribution of age cohorts will increase the burden of disease toward post-reproductive women. In addition to providing appropriate medical care, public health efforts must focus on this population due to the financial impact of this age cohort of women.


2020 ◽  
Vol 7 (6) ◽  
pp. 543-562
Author(s):  
Russell L. Spiker

This study examines whether health disparities between same-sex and different-sex cohabitors differ depending on socioeconomic status (SES). Previous research showed that SES mediates health disparities between different-sex and same-sex cohabitors, but less is known about its role as a potential moderator. Using data on cohabitors from the Integrated Public Use Microdata Series (IPUMS) National Health Interview Surveys (2007–2018), this study examines how the SES-health gradient shapes health disparities for same-sex and different-sex cohabitors. Average adjusted predictions from multinomial logistic regression models show that higher income-to-needs ratio is associated with improvements in self-rated health for same-sex cohabiting women relative to different-sex cohabiting women. However, results are mixed for men. As income-to-needs ratio increases, same-sex cohabiting men have higher probabilities of “excellent” or “very good” health than different-sex cohabitors; however, their risk of “poor” health increases significantly with higher income-to-needs ratios. Potential explanations related to minority stress, stress proliferation, gendered meanings of self-rated health, and selection are explored. Overall, disparities between same-sex and different-sex cohabitors differ by gender and SES, suggesting socioeconomic diversity should be considered in the study of sexual minority health.


2021 ◽  
pp. LGBTQ-2020-0052
Author(s):  
Gilbert Gonzales ◽  
Emilio Loret de Mola

The 2019 coronavirus (COVID-19) pandemic has led to more than 235,000 deaths and 9 million reported positive cases in the United States. Most of the country implemented stay-at-home orders to prevent the spread of COVID-19, which has led to job losses and more than 40 million claims for unemployment insurance. The objective of this study was to estimate the potential impact of COVID-19-related closures in employment and healthcare access by sexual orientation. We used data from the 2015 to 2018 National Health Interview Survey and employment industry codes to describe the working adult population who may be vulnerable to COVID-19 job losses by sexual orientation. Multivariable logistic regression models identified the risk factors for working in a COVID-19-sensitive industry and differences in healthcare access by sexual orientation. We estimate that there may be approximately 1.7 million sexual minorities and 36.6 million heterosexual adults employed in industries that make them vulnerable to unemployment, uninsurance, and limited access to care. Nearly two-thirds of working adults—regardless of sexual orientation—are at risk of severe illness should they become infected with COVID-19. Almost half of the sexual minority and heterosexual adults in industries sensitive to COVID-19 may remain or become uninsured during the pandemic. Approximately 60% of sexual minorities and 40% of heterosexual adults in COVID-19-sensitive industries are renting their home or apartment (rather than owning their home). Because sexual minority adults vulnerable to the COVID-19 pandemic are renting or within family income ranges for premium tax credits in the individual insurance marketplaces, policymakers should consider expanding protections for renters and broadening special enrollment periods for people seeking coverage in the federal and state-based marketplaces.


2016 ◽  
Vol 31 (5) ◽  
pp. 413-416 ◽  
Author(s):  
Matthew C. Farrelly ◽  
Paul R. Shafer

Purpose: Previous studies have shown that cigarette smoking is associated with higher rates and severity of food insecurity but do not address how population-level smoking rates change in response to changes in food security. Design: Trend analysis of serial cross-sectional data. Setting: Data from a representative survey of US households. Participants: Adults within households participating in both the Food Security Supplement and Tobacco Use Supplement of the Current Population Survey during 5 overlapping administrations from 1998 to 2011. Measures: A “current smoker” is defined as someone who indicated that they currently smoke on “some days” or “every day.” A household’s food security is coded as “secure” or “insecure,” according to responses to a food security scale, interpreted using a US Department of Agriculture standard. Analysis: Descriptive comparison of the roughly triennial trends in the prevalence of food insecurity and current smoking from 1998 to 2011. Results: The prevalence of food insecurity increased by 30% among adults overall versus 54% among current smokers, with most of the changes occurring following the economic recession of 2008 and 2009. Over this same period, the prevalence of current smoking declined by 33% among food-secure adults and only 14% among food-insecure adults. Conclusion: Food insecurity increased more markedly among adult smokers than nonsmokers, and the prevalence of smoking declined more slowly in food-insecure households, indicating that more low-income smokers are facing hunger, which may at least partly be due to buying cigarettes.


Author(s):  
Allison M Glasser ◽  
Mahathi Vojjala ◽  
Jennifer Cantrell ◽  
David T Levy ◽  
Daniel P Giovenco ◽  
...  

Abstract Introduction Understanding the population impact of e-cigarettes requires determining their effect on cigarette smoking cessation. Methods Using the US Population Assessment of Tobacco and Health cohort, we examined smoking cessation among adult current cigarette smokers at Wave 1 with follow-up data at Waves 2 and 3 (n = 9724). Results By Wave 3 (2015/2016), 17.3% of smokers had quit smoking. Smokers using e-cigarettes daily or who increased to daily use over the three waves were two to four times more likely to have quit in the short term (<1 year) and long term (1+ years) compared with never e-cigarette users (p < .001). E-cigarette use in the last quit attempt was associated with a higher likelihood of short-term (<1 year) quitting at Wave 3 (adjusted relative risk ratio: 1.33; 95% confidence interval: 1.04, 1.71) compared with smokers who did not use an e-cigarette in their last quit attempt. Noncurrent (no use in any wave) e-cigarette users and users who were unstable in use frequency were 33% and 47% less likely to quit in the short-term, respectively (p < .001). Flavored (vs nonflavored) and using a rechargeable (vs disposable) e-cigarette device was associated with an increased likelihood of both short- and long-term quitting. Conclusion Smoking cessation was more likely among frequent e-cigarette users, users of e-cigarettes in last quit attempt, and users of flavored and rechargeable devices. Less frequent, unstable, past, or never e-cigarette users were less likely to quit smoking. Monitoring the relationship between patterns of e-cigarette and cigarette use is complex but critical for gauging the potential of e-cigarettes as a harm reduction tool. Implications This study suggests that consistent and frequent e-cigarette use over time is associated with cigarette smoking cessation among adults in the United States. In addition, findings suggest that flavored e-cigarette use and use of rechargeable e-cigarette devices can facilitate smoking cessation. These results underscore the importance of carefully defining and characterizing e-cigarette exposure patterns, potential confounders, and use of e-cigarettes to quit smoking, as well as variations in length of the smoking cessation.


2013 ◽  
Vol 2013 ◽  
pp. 1-9 ◽  
Author(s):  
Hugh Klein ◽  
Claire E. Sterk ◽  
Kirk W. Elifson

Purpose. We examine early-onset cigarette smoking and how, if at all, it is related to subsequent smoking practices.Methods. From 2004 to 2007, face-to-face interviews were conducted with 485 adult cigarette smokers residing in the Atlanta metropolitan area. Data analysis involved a multivariate analysis to determine whether age of smoking onset was related to current smoking practices when the effects of gender, age, race, marital/relationship status, income, and educational attainment were taken into account.Results. The mean age for smoking onset was 14.8, and more than one-half of all smokers had their first cigarette between the ages of 12 and 16. Most people reported an interval of less than one month between their first and second time using tobacco. Earlier onset cigarette smoking was related to more cigarette use and worse tobacco-related health outcomes in adulthood.Conclusions. Early prevention and intervention are needed to avoid early-onset smoking behaviors. Intervening after initial experimentation but before patterned smoking practices are established will be challenging, as the interval between initial and subsequent use tends to be short.


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