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Participants were 4252 young adult college students involved in the third wave of the Marketing and Promotions across Colleges in Texas project (Project M-PACT). Additionally, we hypothesized that SGM young adults who reported currently using the five examined tobacco products would report a younger age of initiation than current users in the heterosexual majority. In the current study, we expand upon existing research by examining the use of a wide range of tobacco products among 18- to 29-year-old SGM young adults, particularly those who self-identify as gay, lesbian, bisexual, transgender, queer, or “other.” Based on the extant literature, we hypothesized that SGM young adults would have greater odds of being current users of cigarettes, e-cigarettes, cigars, hookah, and smokeless tobacco than their heterosexual peers. 6, 10, 11 Although scarce, other research highlights notable differences in cigarette smoking among less-studied SGM subgroups, including those who identify as queer or pansexual. 3, 16 Some studies conduct intragroup comparisons, notably among bisexual individuals, 6, 8, 10, 11, 17 where a growing body of research identifies bisexual women as the subgroup with the highest prevalence of cigarette and cigar smoking in the SGM community. 5, 12, 14, 15 Less is known about the use of alternative tobacco or nicotine products (hereafter referred to as tobacco products), such as electronic cigarettes (e-cigarettes) or hookah, or about the heterogeneity in use among various SGM populations of young adults, the group reporting the highest prevalence of alternative tobacco use. Many studies examine the tobacco product use of LGB individuals as one group compared to their heterosexual peers. 6, 11, 12 Only a few studies show no differences in tobacco product use between SGM and non-SGM populations or lower prevalence among SGM populations.
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3 These national estimates align with the majority of research, which indicates that SGM adults report higher levels of cigarette use than their non-SGM counterparts 4–10 and younger ages of cigarette initiation among SGM adolescents. National estimates from 2013 to 2014 indicate that cigarette smoking prevalence is 27.1% among LGB adults compared to 16.4% among heterosexual adults. Questions regarding sexual orientation and gender identity have only recently or sporadically been implemented in state- and national-level survey instruments 2 and are often limited primarily to examination of cigarette use among adults who identify as lesbian, gay, and bisexual.
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Research examining the tobacco use behaviors of sexual and gender minority (SGM) populations is relatively new to public health. 1 Sexual minority individuals include those who identify as lesbian, gay, and bisexual (LGB), as well as the identities claimed by queer, and pansexual people, among others. This includes, but is not limited to, gender nonconforming, genderqueer, and transgender individuals.
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Broadly speaking, someone whose sense of self differs from social expectations based on their biological sex assigned at birth is considered part of the gender minority.