Evidence for the Confluence of Cigarette Smoking, Other Substance Use, and Psychosocial and Mental Health in a Sample of Urban Sexual Minority Young Adults: The P18 Cohort Study.
BACKGROUND
Sexual minority men (SMM) and transgender women (TW) are more likely to smoke cigarettes than heterosexual and cisgender peers, which may exacerbate existing disparities in mental and psychosocial health and substance use.


PURPOSE
As few existing studies have examined the confluence of these factors, we sought to examine tobacco use in a diverse sample of SMM and TW and describe its relationship with other substance use and health.


METHODS
Data were drawn from a study of syndemic conditions among SMM and TW, which included measures assessing tobacco use, substance use, and mental, psychosocial, and general health.


RESULTS
A majority of the racially/ethnically and socioeconomically diverse sample (n = 665) reported ever smoking a cigarette, and more than half of them were current smokers. Current smoking was associated with more frequent recent substance use and poorer mental, psychosocial, and general health. In multivariable analyses, current smoking was predicted by more frequent substance use and more severe anxiety, when adjusting for demographic, substance use, and health factors.


CONCLUSIONS
A syndemic approach to health conditions such as substance use, mental health, and psychosocial burden dictates a framework of interrelation and mutual exacerbation. In doing so, we found that current cigarette use was associated with more frequent alcohol and marijuana use and more severe anxiety, suggesting a confluence of cigarette smoking, other substance use, and mental health burden. We recommend a holistic approach to treating tobacco use in sexual and gender minority populations that addresses both substance use and the myriad psychosocial burdens that sexual and gender minority communities experience.
['LoSchiavo|Caleb|C|', 'Acuna|Nicholas|N|', 'Halkitis|Perry N|PN|']
D000428:Alcohol Drinking D000073865:Cigarette Smoking D015331:Cohort Studies D003430:Cross-Sectional Studies D006801:Humans D008297:Male D008385:Marijuana Smoking D008603:Mental Health D000072339:Sexual and Gender Minorities D012907:Smoking D000076603:Syndemic D014481:United States D055815:Young Adult
Substance use Mental health Tobacco use Syndemics LGBT health disparities