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Nicotine Tob Res. 2019 Jul 9. pii: ntz112. doi: 10.1093/ntr/ntz112. [Epub ahead of print]

Long-term smoking cessation outcomes for sexual minority vs. non-minority smokers in a large randomized, controlled trial of two web-based interventions.

Author information

1
Fred Hutchinson Cancer Research Center, Division of Public Health Sciences, Seattle, WA.
2
Kaiser Permanente Washington Health Research Institute (formerly Group Health Research Institute), Seattle, WA.
3
University of Washington, Department of Psychology, Seattle, WA.

Abstract

INTRODUCTION:

Despite greater smoking prevalence among sexual minority (SM) individuals relative to non-SM individuals, minimal research has examined whether SM smokers have differential success at quitting, and no prior treatment studies have examined differences within SM subgroups. There is also limited knowledge of the psychosocial characteristics of treatment-seeking SM smokers, which could inform targeted treatments. To address these gaps, we compared treatment outcomes and baseline characteristics for SM and non-SM smokers and for bisexual vs. lesbian or gay smokers in a large randomized, controlled trial of two web-based cessation treatments.

METHODS:

Trial participants completed a survey to assess baseline characteristics, including self-identification as either SM (n=253; lesbian/gay, n=122; bisexual, n=131) or non-SM (n=2,384). The primary cessation outcome was complete-case self-reported 30-day abstinence at 12 months post-randomization.

RESULTS:

Cessation outcomes did not differ significantly for SM vs. non-SM smokers (24% vs. 25%, adjusted OR=0.91, 95% CI=0.65-1.28) or across SM subgroups (24% for bisexual vs. 23% for lesbian/gay, adjusted OR=1.01, 95% CI=0.51-2.00), and there were no interactions with treatment group assignment. At baseline, SM smokers differed from non-SM smokers on most demographics, were more likely to screen positive for all mental health conditions assessed, and had greater exposure to other smokers in the home.

CONCLUSIONS:

Substantial differences in baseline characteristics of SM vs. non-SM smokers and bisexual vs. lesbian/gay smokers did not translate into differential treatment outcomes. Nonetheless, SM smokers' willingness or ability to quit smoking could be enhanced by taking their unique psychosocial profile into account when designing targeted interventions.

IMPLICATIONS:

The findings of this study, which included the largest sample of sexual minority (SM) smokers in a prospective intervention trial to date, support those of a small extant body of literature showing no differences in treatment-assisted cessation outcomes between sexual minority (SM) and non-SM smokers. Regardless of their quit rates relative to non-SM smokers, SM smokers' willingness or ability to quit smoking could potentially be enhanced by taking their unique psychosocial profile into account in intervention design, including their younger age, lower socioeconomic status, greater likelihood of being racial or ethnic minorities, and greater prevalence of mental health symptoms.

KEYWORDS:

LGBT; nicotine dependence; smoking cessation; tobacco use disorder

PMID:
31290550
DOI:
10.1093/ntr/ntz112

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