Sexual minority status, school-based violence, and current tobacco use among youth

• Published in: Tobacco prevention & cessation Vol. 8; no. December; pp. 46 - 11
• Main Authors: Duangchan, Cherdsak, Matthews, Alicia K, Smith, Ariel U, Steffen, Alana D
• Format: Journal Article
• Language: English
• Published: Greece European Publishing on behalf of the European Network for Smoking and Tobacco Prevention (ENSP) 15-12-2022
• Subjects: Research Paper; sexual and gender minorities; LGBTQ; tobacco use; youth; school-based violence
• ISSN: 2459-3087; 2459-3087
• DOI: 10.18332/tpc/156110

Sexual minority individuals experience elevated risk for smoking and violence due to a combination of general and unique identity-based risk factors. This study examined associations among sexual minority status, school-based violence, and tobacco use, among youth.
Data for this secondary data analysis consisted of Chicago-specific data from the 2019 Youth Risk Behavior Surveillance System (n=1562). Current use (≥1 day during the previous 30 days) of any tobacco product (cigarettes, e-cigarettes, smokeless tobacco, and cigars) and school-based violence (avoided school because they felt unsafe, were threatened/injured with a weapon, were in a physical fight, and were bullied) were estimated by sexual orientation (heterosexual vs gay, lesbian, bisexual, and unsure). A chi-squared test was used to investigate associations among the variables. Path analysis was employed to examine possible mediation effects of school-based violence.
Thirty percent of sexual minority youth and 11.5% of heterosexual youth reported current tobacco use (χ
=55.91; p<0.001). Nearly one-third (31.8%) of youth reported school-based violence, with a higher rate (41.2%) reported by sexual minority youth compared to heterosexual youth (28.1%; χ
=19.48; p<0.001). Path analysis confirmed these associations, controlling for sex, age, and race/ethnicity. The model showed that sexual minority status increased odds of current tobacco use by a factor of 1.8 (95% CI: 1.3-2.6) via its relationship with school-based violence, explaining 33.8% of the total association between sexual minority status and tobacco use.
Tobacco use was higher among sexual minority youth. School-based violence partially mediated the association between sexual minority status and tobacco use. Findings highlight the need for tobacco prevention and treatment efforts for sexual minority youth and school-based interventions to reduce exposure to violence.