Transgender Use of Cigarettes, Cigars, and E-Cigarettes in a National Study

Am J Prev Med. 2017 Jul;53(1):e1-e7. doi: 10.1016/j.amepre.2016.11.022. Epub 2017 Jan 13.

Abstract

Introduction: Tobacco use among transgender adults continues to be an area of research with few reported findings. The limited literature indicates higher cigarette use among transgender adults, compared with the general population. This national study is the first to report on cigarettes, cigars, and e-cigarettes by examining differences in transgender tobacco use independent of sexual orientation.

Methods: Data were collected in 2013 using a nationally cross-sectional online survey of U.S. adults (cisgender, n=17,164; transgender, n=168) and analyzed in 2015. Past 30-day tobacco use point estimates and adjusted logistic regression while controlling for false discovery rate were reported for transgender and cisgender respondents.

Results: Transgender adults reported higher past 30-day use of any cigarette/cigar/e-cigarette product (39.7% vs 25.1%) and current use of cigarettes (35.5% vs 20.7%), cigars (26.8% vs 9.3%), and e-cigarettes (21.3% vs 5.0%) compared with cisgender adults (all p-values ≤0.003). Transgender respondents had significantly higher odds of past 30-day tobacco product use for any cigarette/cigar/e-cigarette product (OR=1.97, 95% CI=1.25, 3.1), e-cigarettes (OR=5.15, 95% CI=3.36, 7.88), cigars (OR=3.56, 95% CI=2.27, 5.59), and cigarettes (OR=2.10, 95% CI=1.35, 3.28) versus cisgender respondents (all p-values ≤0.0035).

Conclusions: Transgender adults are at higher risk for tobacco use than cisgender adults and risk of specific product use varies by gender. This is the first U.S. national study to assess differences in use of various tobacco products using questions that specifically ask for gender identity separately from sexual orientation. This study provides data that can inform targeted interventions to promote transgender health.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Cross-Sectional Studies
  • Electronic Nicotine Delivery Systems / statistics & numerical data*
  • Female
  • Health Surveys / statistics & numerical data
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Prevalence
  • Risk Factors
  • Smoking / epidemiology*
  • Tobacco Products / statistics & numerical data*
  • Tobacco Use / epidemiology*
  • Tobacco Use Disorder / epidemiology*
  • Tobacco Use Disorder / prevention & control
  • Transgender Persons / statistics & numerical data*