Perceived Mental Health, Cigarettes Per Day and Time to First Cigarette Among Female Sexual Minority Smokers
Abstract
Abstract
Objective:
This study explores how mental health and socio-demographic factors influence smoking behaviors and nicotine dependence among sexual minority females (SMF).
Methods:
Data from Wave 5 of the Population Assessment of Tobacco and Health (PATH) study, with 34,309 adults, were analyzed. Participants reported sexual orientation, smoking habits, and perceived mental health. Conditional process analysis assessed how mental health mediates the relationship between sexual minority status and smoking.
Results:
SMF had a higher smoking prevalence (28.2%) compared to heterosexual women (24.5%), but smoked fewer cigarettes per day (12.90 vs. 13.67) and had lower nicotine dependence, as indicated by a longer time to first cigarette (139.94 vs. 95.88 minutes). Mental health fully mediated the association between sexual minority status and smoking frequency. Lower income was linked to poorer mental health and higher smoking frequency, but not nicotine dependence.
Conclusions:
SMF smoke more frequently but are less nicotine-dependent than heterosexual women. Mental health challenges and socio-economic factors drive smoking behaviors in SMF. Addressing these factors may reduce smoking in this population.
References
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24. Branstetter SA, Mercincavage M, Muscat JE. Predictors of the nicotine dependence behavior time to the first cigarette in a multiracial cohort. Nicotine & Tobacco Research. 2015;17(7):819-824. doi:10.1093/ntr/ntu236
25. Hayes AF. Introduction to Mediation, Moderation, and Conditional Process Analysis: A Regression-Based Approach. Guilford Press; 2013:xvii, 507.
26. McCabe SE, Hughes TL, Bostwick WB, West BT, Boyd CJ. Sexual orientation, substance use behaviors and substance dependence in the United States. Addiction. 2009;104(8):1333-1345. doi:10.1111/j.1360-0443.2009.02596.x
27. Meyer IH. Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: conceptual issues and research evidence. Psychol Bull. 2003;129(5):674-697. doi:10.1037/0033-2909.129.5.674
28. Lehavot K, Simoni JM. The Impact of Minority Stress on Mental Health and Substance Use Among Sexual Minority Women. Journal of consulting and clinical psychology. 2011;79(2):159. doi:10.1037/a0022839
29. Siahpush M, McNeill A, Borland R, Fong GT. Socioeconomic variations in nicotine dependence, self-efficacy, and intention to quit across four countries: findings from the International Tobacco Control (ITC) Four Country Survey. Tob Control. 2006;15 Suppl 3(Suppl 3):iii71-75. doi:10.1136/tc.2004.008763
30. Cano MT, Pennington DL, Reyes S, et al. Factors associated with smoking in low-income persons with and without chronic illness. Tobacco Induced Diseases. 2021;19:59. doi:10.18332/tid/138241
31. Lawrence D, Hafekost J, Hull P, Mitrou F, Zubrick SR. Smoking, mental illness and socioeconomic disadvantage: analysis of the Australian National Survey of Mental Health and Wellbeing. BMC Public Health. 2013;13(1):462. doi:10.1186/1471-2458-13-462
2. Jennings L, Barcelos C, McWilliams C, Malecki K. Inequalities in lesbian, gay, bisexual, and transgender (LGBT) health and health care access and utilization in Wisconsin. Prev Med Rep. 2019;14:100864. doi:10.1016/j.pmedr.2019.100864
3. Frost DM, Lehavot K, Meyer IH. Minority stress and physical health among sexual minority individuals. J Behav Med. 2015;38(1):1-8. doi:10.1007/s10865-013-9523-8
4. Barker M. Gay and Lesbian Health Disparities: Evidence and Recommendations for Elimination. Journal of Health Disparities Research and Practice. 2012;2(2). https://digitalscholarship.unlv.edu/jhdrp/vol2/iss2/6
5. Gonzales G, Henning-Smith C. Health Disparities by Sexual Orientation: Results and Implications from the Behavioral Risk Factor Surveillance System. J Community Health. 2017;42(6):1163-1172. doi:10.1007/s10900-017-0366-z
6. Laughney CI, Eliason EL. Mortality Disparities Among Sexual Minority Adults in the United States. LGBT Health. 2022;9(1):27-33. doi:10.1089/lgbt.2020.0482
7. Operario D, Gamarel KE, Grin BM, et al. Sexual Minority Health Disparities in Adult Men and Women in the United States: National Health and Nutrition Examination Survey, 2001–2010. Am J Public Health. 2015;105(10):e27-e34. doi:10.2105/AJPH.2015.302762
8. Jamal A, King BA, Neff LJ, Whitmill J, Babb SD, Graffunder CM. Current Cigarette Smoking Among Adults - United States, 2005-2015. MMWR Morb Mortal Wkly Rep. 2016;65(44):1205-1211. doi:10.15585/mmwr.mm6544a2
9. Johnson SE, Holder-Hayes E, Tessman GK, King BA, Alexander T, Zhao X. Tobacco Product Use Among Sexual Minority Adults. Am J Prev Med. 2016;50(4):e91-e100. doi:10.1016/j.amepre.2015.07.041
10. Ehlke SJ, Ganz O, Kendzor DE, Cohn AM. Differences between adult sexual minority females and heterosexual females on menthol smoking and other smoking behaviors: Findings from Wave 4 (2016–2018) of the population assessment of tobacco and health study. Addict Behav. 2022;129:107265. doi:10.1016/j.addbeh.2022.107265
11. McCabe SE, West BT, Matthews AK, et al. Sexual orientation, tobacco use, and tobacco cessation treatment-seeking: Results from a national U.S. survey. Behav Med. 2021;47(2):120-130. doi:10.1080/08964289.2019.1676191
12. Branstetter SA. COVID-Related Mental Health and Smoking in Sexual Minority Women. Advanced Journal of Social Science. 2023;12(1):53-58. doi:10.21467/ajss.12.1.53-58
13. Evans-Polce RJ, Veliz P, Kcomt L, Boyd CJ, McCabe SE. Nicotine and Tobacco Product Use and Dependence Symptoms Among US Adolescents and Adults: Differences by Age, Sex, and Sexual Identity. Nicotine Tob Res. 2021;23(12):2065-2074. doi:10.1093/ntr/ntab127
14. Smith PH, Mazure CM, McKee SA. Smoking and mental illness in the U.S. population. Tob Control. 2014;23(e2):e147-153. doi:10.1136/tobaccocontrol-2013-051466
15. Trosclair A, Dube SR. Smoking among adults reporting lifetime depression, anxiety, anxiety with depression, and major depressive episode, United States, 2005-2006. Addict Behav. 2010;35(5):438-443. doi:10.1016/j.addbeh.2009.12.011
16. Prochaska JJ, Das S, Young-Wolff KC. Smoking, Mental Illness, and Public Health. Annu Rev Public Health. 2017;38:165-185. doi:10.1146/annurev-publhealth-031816-044618
17. Lawrence D, Mitrou F, Zubrick SR. Smoking and mental illness: results from population surveys in Australia and the United States. BMC Public Health. 2009;9:285. doi:10.1186/1471-2458-9-285
18. Snell M, Harless D, Shin S, Cunningham P, Barnes A. A longitudinal assessment of nicotine dependence, mental health, and attempts to quit Smoking: Evidence from waves 1-4 of the Population Assessment of Tobacco and Health (PATH) study. Addict Behav. 2021;115:106787. doi:10.1016/j.addbeh.2020.106787
19. Lipari RN, Van Horn S. Smoking and Mental Illness Among Adults in the United States. In: The CBHSQ Report. Substance Abuse and Mental Health Services Administration (US); 2013. Accessed July 8, 2024. http://www.ncbi.nlm.nih.gov/books/NBK430654/
20. Salway T, Delgado-Ron JA, Rich AJ, Dharma C, Baams L, Fish J. Trends in mental health and smoking disparities between sexual minority and heterosexual adults in Canada, 2003–2020. SSM - Population Health. 2024;27:101697. doi:10.1016/j.ssmph.2024.101697
21. Hyland A, Ambrose BK, Conway KP, et al. Design and methods of the Population Assessment of Tobacco and Health (PATH) Study. Tob Control. 2017;26(4):371-378. doi:10.1136/tobaccocontrol-2016-052934
22. Branstetter SA, Muscat JE. Time to First Cigarette and 4-(Methylnitrosamino)-1-(3-Pyridyl)-1-Butanol (NNAL) Levels in Adult Smokers; National Health and Nutrition Examination Survey (NHANES), 2007–2010. Cancer Epidemiology, Biomarkers & Prevention. 2013;22(4):615-622. doi:10.1158/1055-9965.EPI-12-0842
23. Branstetter SA, Muscat JE, Mercincavage M. Time to First Cigarette: A Potential Clinical Screening Tool for Nicotine Dependence. Journal of Addiction Medicine. 2020;14(5):409-414. doi:10.1097/ADM.0000000000000610
24. Branstetter SA, Mercincavage M, Muscat JE. Predictors of the nicotine dependence behavior time to the first cigarette in a multiracial cohort. Nicotine & Tobacco Research. 2015;17(7):819-824. doi:10.1093/ntr/ntu236
25. Hayes AF. Introduction to Mediation, Moderation, and Conditional Process Analysis: A Regression-Based Approach. Guilford Press; 2013:xvii, 507.
26. McCabe SE, Hughes TL, Bostwick WB, West BT, Boyd CJ. Sexual orientation, substance use behaviors and substance dependence in the United States. Addiction. 2009;104(8):1333-1345. doi:10.1111/j.1360-0443.2009.02596.x
27. Meyer IH. Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: conceptual issues and research evidence. Psychol Bull. 2003;129(5):674-697. doi:10.1037/0033-2909.129.5.674
28. Lehavot K, Simoni JM. The Impact of Minority Stress on Mental Health and Substance Use Among Sexual Minority Women. Journal of consulting and clinical psychology. 2011;79(2):159. doi:10.1037/a0022839
29. Siahpush M, McNeill A, Borland R, Fong GT. Socioeconomic variations in nicotine dependence, self-efficacy, and intention to quit across four countries: findings from the International Tobacco Control (ITC) Four Country Survey. Tob Control. 2006;15 Suppl 3(Suppl 3):iii71-75. doi:10.1136/tc.2004.008763
30. Cano MT, Pennington DL, Reyes S, et al. Factors associated with smoking in low-income persons with and without chronic illness. Tobacco Induced Diseases. 2021;19:59. doi:10.18332/tid/138241
31. Lawrence D, Hafekost J, Hull P, Mitrou F, Zubrick SR. Smoking, mental illness and socioeconomic disadvantage: analysis of the Australian National Survey of Mental Health and Wellbeing. BMC Public Health. 2013;13(1):462. doi:10.1186/1471-2458-13-462
Authors
[1]
“Perceived Mental Health, Cigarettes Per Day and Time to First Cigarette Among Female Sexual Minority Smokers”, Soc. sci. humanities j., vol. 8, no. 11, pp. 5893–5901, Nov. 2024, doi: 10.18535/sshj.v8i11.1467.
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