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Determinants of smoking among gay & lesbian youth

Institution: University of California, San Francisco
Investigator(s): Jay Paul, Ph.D.
Award Cycle: 2000 (Cycle 9) Grant #: 9RT-0218 Award: $509,771
Subject Area: Epidemiology
Award Type: Research Project Awards
Abstracts

Initial Award Abstract
After years of steady declines in rates of use, cigarette smoking appears to be on the rise among adolescents and young adults. Tobacco use is one behavior that both starts early and shows a more stable pattern of consumption over the lifespan than the use of other substances. For these reasons, it is vital to understand the antecedents of smoking tobacco among the young to plan effective and appropriate prevention and treatment programs. As one might expect, different subgroups of youth show greater risk for regular cigarette use. Prior work by our team and others has demonstrated that tobacco use is more prevalent among gay and bisexual men than among the general male population. Other research findings suggest that this is also true for lesbians and bisexual women, in comparison to their general population counterparts. One important area of research on vulnerability among adolescents to tobacco use has been the notion of "deviance proneness." This theoretical construct seems to potentially dovetail with our prior research findings, which suggest that there may be gay-specific factors that lead to higher rates of smoking. However, we have little information on the determinants of smoking behavior and the specific appeal of cigarettes for gay youth. This study will address this gap in knowledge.

As significant work needs to be done in furthering our understanding of any gay-specific predictors of initiation of tobacco use among gay, lesbian and bisexual youth, we have proposed a qualitative study that will allow us to explore this phenomenon in depth. Open-ended interviews (both using focus groups and individual interviews) will allow us to ask participants about their history of smoking, possible factors that may be associated with their initiation of tobacco use (for example, asking about family members who smoked tobacco, peer use of tobacco, situations that were going on in their lives concurrent to the onset of regular smoking), and considerations that may be relevant to smoking cessation programs targeting these youth (for example, asking about any quit attempts, and how they currently view their smoking behavior). We will attempt to examine both those variables that prior research has shown to be important, as well as to identify any gay-specific variables that may have influenced the use of tobacco. We anticipate that there may very well be gender-related differences in the factors described by study participants.

To ensure diversity of respondents, we will select respondents (in both Los Angeles and San Francisco) who vary on several dimensions (gender, educational attainment, smoking level, and race/ethnicity). Individual interviews will provide an opportunity to gain more in-depth information on the smoking histories of younger gay and lesbian smokers, as the narratives of these interviews can provide a rich picture of the pathway from experimentation to regular use of tobacco, and the factors associated with smoking. Having an open-ended structure for these interviews permits us to explore newly emerging ideas about linkages between smoking behaviors and other life experiences or issues.

We anticipate that the results of this study will provide helpful information for the development of gay/lesbian/bisexual-specific interventions to a) reduce the numbers of such youth who initiate smoking, b) address the contexts in which those who have initiated smoking may progress to regular smoking (and addiction), and c) facilitate smoking cessation in this population. The opportunity to collaborate with community service providers enables us to translate our research findings into anti-smoking campaigns and smoking cessation programs for this population in a timely fashion.