Sex and sexual orientation in relation to tobacco use among young adult college students in the US: a cross-sectional study

Abstract

Abstract Background Sexual minority young adults represent a high-risk population for tobacco use. This study examined cigarette and alternative tobacco product (ATP) use prevalence across sexual orientation (heterosexual, gay/lesbian, and bisexual) among college-attending young adult men and women, respectively. Methods Baseline data from a two-year longitudinal study of 3386 young adult college students aged 18–25 in Georgia were analyzed. Correlates examined included sociodemographics (age, sex, sexual orientation, race/ethnicity, college type, and parental education). Outcomes included past 30-day use of tobacco (cigarette, little cigars/cigarillos [LCCs], e-cigarettes, hookah, any tobacco product used, and number of tobacco products used, respectively). Two-group, multivariate multiple regression models were used to examine predictors of tobacco use among men and women, respectively. Results Among men (N = 1207), 34.7% used any tobacco product; 18.6% cigarettes; 12.3% LCCs; 16.8% e-cigarettes; and 14.7% hookah. Controlling for sociodemographics, gay sexual orientation (OR = 1.62, p = 0.012) was associated with higher odds of cigarette use; no other significant associations were found between sexual orientation and tobacco use. Among women (N = 2179), 25.3% used any tobacco product; 10.4% cigarettes; 10.6% LCCs; 7.6% e-cigarettes; and 10.8% hookah. Being bisexual was associated with cigarette (p < 0.001), LCC (p < 0.001), and e-cigarette use (p = 0.006). Lesbian sexual orientation was associated with cigarette (p = 0.032) and LCC use (p < 0.001). Being bisexual predicted any tobacco product used (p = 0.002), as well as number of tobacco products used (p = 0.004). Group comparisons showed that the effect of sexual minority status on LCC use was significantly different for men versus women. Conclusion Sexual minority women, especially bisexual women, are at higher risk for using specific tobacco products compared to heterosexual women; homosexual men are at increased risk of cigarette use compared to heterosexual men. These nuances in tobacco use should inform interventions targeting sexual minorities.

Keywords

• Tobacco use
• Alternative tobacco product
• Sexual orientation
• Sex differences
• Young adults
• College students