Examining sexual identity stability and change over time and associations with tobacco use in a nationally representative US sample. (June 2023)

• Record Type: Journal Article
• Authors: Evans-Polce, Rebecca J.; Veliz, Philip; Kcomt, Luisa; Boyd, Carol J.; Esteban McCabe, Sean
• Is Part Of: Addictive behaviors. Volume 141(2023)
• Publication Date: 2023-06
• Subjects: Sexual identity -- Disparities -- Tobacco use -- Tobacco use disorder -- Sexual minority health; Substance abuse -- Periodicals; Alcoholism -- Periodicals; Drug addiction -- Periodicals; Nicotine addiction -- Periodicals; Smoking -- Periodicals; Gambling -- Psychological aspects -- Periodicals; Electronic journals; 362.29
• DOI: 10.1016/j.addbeh.2023.107661
• Languages: English
• ISSNs: 0306-4603

Abstract

Highlights: This study examined change in sexual identity over three years. Individuals coming out as a sexual minority had greater odds of tobacco outcomes. Those with multiple changes in sexual identity had greater odds of tobacco outcomes. Gay-stable men had lower odds of increasing tobacco use disorder symptoms. Coming out as a sexual minority may be a particularly vulnerable period for tobacco use. Abstract: Background: Epidemiologic research has found sexual minority identifying individuals are disproportionately burdened by tobacco use and tobacco use disorder (TUD). However, these studies often conceptualize sexual identity as time-invariant. This study examined sexual identity over time and whether a transition to a sexual minority identity was associated with tobacco outcomes. Methods: This study used data from Waves 1–4 of the Population Assessment of Tobacco and Health (2013/14–2016/18) study (adolescents and adults aged ≥ 14 years; n = 26, 553). We examined associations of sexual identity stability and change with changes in the number of tobacco products used and TUD symptoms. Results: Males and females who experienced two or more changes in sexual identity and females who changed from a heterosexual to a sexual minority identity were more likely to have an increase in two or more tobacco products and increase TUD symptoms compared to heterosexual-stable males and females. Gay-stable males were less likely to increase TUD symptoms compared to heterosexual-stable males. Conclusions: Experiencing a change in sexual identity may be a particularly vulnerable period for increases in tobacco products used and TUD. It may be important to provide tobacco use intervention and support resources to individuals coming out as a sexual minority and those fluid in their sexual identity.