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Sexual and gender minority (SGM) people are more likely to use tobacco compared to their heterosexual and cisgender peers. Limited research shows marked disparities in cigarette smoking, especially among emerging adults (ages 18-24). Less is known about the use of alternative tobacco products (e.g., e-cigarettes) and cannabis use, which stand to become more prevalent throughout the State when Proposition 64 is enacted in January, 2018. Furthermore, the multi-level factors (i.e., individual, interpersonal, and societal/policy-related) that influence decisions to use tobacco products and cannabis by specific lesbian, gay, bisexual and transgender (LGBT) subgroups remain largely unknown. In response to this knowledge gap, we propose an exploratory study guided by Minority Stress Theory. In Phase 1, we will recruit SGM daily tobacco users (ages 18-29) in Los Angeles to participate in life-history calendar interviews (N=100; 25 per LGBT subgroup). These semi-structured qualitative interviews will elucidate key factors driving tobacco use from participants’ perspectives. In Phase 2, we will recruit emerging adult LGBT tobacco users across California to participate in a quantitative online survey (N=1,000; 250 per LGBT subgroup) and compare tobacco use frequency and quantity to appropriate heterosexual, cisgender comparison groups (N=500; 250 heterosexual, cisgender women; 250 heterosexual, cisgender men). This quantitative assessment will leverage information learned during Phase 1 and will also incorporate multi-level factors known to influence tobacco use, including SGM community connection, minority stress, and exposure to tobacco marketing. Building on our preliminary data and extensive experience in SGM health disparities research, the specific aims are to: (1) Compare tobacco and alternative tobacco product use among SGM emerging adults in California to their heterosexual, cisgender counterparts; (2) Examine the factors associated with tobacco and alternative tobacco product use among SGM emerging adults in California; and (3) Understand how factors associated with tobacco and alternative tobacco product use differ by SGM emerging adult subgroup in California. The proposed research is an academic-community collaboration between the UCLA, the Los Angeles LGBT Center, and APLA Health. The research will be guided by community-based participatory research principles to ensure community engagement from the inception of the project through results dissemination. Upon completion of the proposed research we plan to leverage our findings to apply for an intervention development grant on tobacco prevention and cessation for SGM people. |
