ArticleLGBT health2018
The Relationship Between Tobacco Use and Legal Document Gender-Marker Change, Hormone Use, and Gender-Affirming Surgery in a United States Sample of Trans-Feminine and Trans-Masculine Individuals: Implications for Cardiovascular Health.
Article in LGBT health, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
29 citing papers in PubMed, 1 synthesis or guideline pooled it, 66 citations in OpenAlex.
- Correlates of Tobacco and Nicotine Use Among Transgender and Gender Diverse People: A Systematic Review Guided by the Minority Stress Model.Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2022Pooled it
- Does gender expression matter in tailoring anti-smoking messages for sexual and gender minority young adults?Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2026Trial
- Long-Term Smoking Cessation Outcomes for Sexual Minority Versus Nonminority Smokers in a Large Randomized Controlled Trial of Two Web-Based Interventions.Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2020Trial
- Heterogeneity in Protective Factors as a Buffer for Unique Risk Factors and Daily Smoking Among Transgender Adults.Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2025Article
- Forms of transphobia and their influence on health outcomes among transgender, nonbinary, and gender diverse individuals: a global systematic review.International journal of transgender health · 2025Article
- Medical gender affirmation appears protective against problematic substance use among transgender women and transfeminine adults: Findings from The LITE Study.Drug and alcohol dependence · 2025Article
- Understanding biopsychosocial factors influencing cigarette smoking among transgender and gender diverse individuals living in Argentina: a qualitative study.International journal for equity in health · 2025Article
- E-cigarette use among gender and sexuality diverse (LGBTQA+) adolescents in Australia: The case for LGBTQA+ affirmative harm reduction.Drug and alcohol review · 2025Article
- Design and pilot evaluation of a brief intervention to reduce transphobia and improve attitudes of government officials to address legal gender affirmation needs of transgender people in Peru.Global health action · 2024Article
- A Qualitative Examination of Tobacco Use and Smoking Cessation Among Gender Minority Adults.Annals of behavioral medicine : a publication of the Society of Behavioral Medicine · 2023Article
- Stressors Associated with Tobacco Use Among Trans Women.Transgender health · 2023Article
- Sociodemographics of Patient Populations Undergoing Gender-Affirming Surgery: A Systematic Review of All Cohort Studies.Transgender health · 2023Review
- Exploring the Association Between Gender Affirmation and PrEP use Among Transgender Women in New York City.AIDS and behavior · 2023Article
- Cardiovascular Risk in Transgender People With Gender-Affirming Hormone Treatment.Circulation reports · 2023Review
- Systems of Care Implications in Hawai'i: Sexual and Gender Minorities.Hawai'i journal of health & social welfare · 2022Article
- Nicotine/tobacco use disparities among transgender and gender diverse adults: Findings from wave 4 PATH data.Drug and alcohol dependence · 2022Article
- A scoping review of alcohol, tobacco, and other drug use treatment interventions for sexual and gender minority populations.Journal of substance abuse treatment · 2022Article
- Standards of Care for the Health of Transgender and Gender Diverse People, Version 8.International journal of transgender health · 2022Article
- Diet, Food Insecurity, and CVD Risk in Sexual and Gender Minority Adults.Current atherosclerosis reports · 2022Review
- Smoking Protective and Risk Factors Among Transgender and Gender-Expansive Individuals (Project SPRING): Qualitative Study Using Digital Photovoice.JMIR public health and surveillance · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 1 institution in 3 countries.
Funding
Abstract
purposeTransgender individuals smoke tobacco at disproportionately higher rates than the general U.S. population, and concurrent use of gender-affirming hormones (estrogen or testosterone) and tobacco confers greater cardiovascular (CV) risk. This study examines the relationship between tobacco use and legal document gender-marker change, and medical/surgical interventions for gender transition.
methodsData came from an Internet-based survey of U.S. trans-feminine (n = 631) and trans-masculine (n = 473) individuals. We used multivariable logistic regression to investigate the relationship between past 3-month tobacco use and legal document gender-marker change, hormone use, and gender-affirming surgery controlling for demographic covariates and enacted and felt stigma.
resultsCompared to trans-feminine participants, trans-masculine individuals reported significantly higher rates of lifetime (74.4% vs. 63.5%) and past 3-month tobacco use (47.8% vs. 36.1%), and began smoking at an earlier age (14.5 vs. 15.5 years). Trans-feminine smokers reported significantly more frequent and heavier use. Adjusting for demographic covariates and enacted and felt stigma, legal document gender-marker change was associated with lower tobacco-use odds among trans-feminine individuals, whereas gender-affirming surgery predicted lower smoking odds among trans-masculine individuals. There were no significant differences in tobacco use by hormone use status.
conclusionIn this study, trans-masculine individuals were more likely to smoke and trans-feminine individuals reported heavier use. It is concerning that individuals receiving hormones did not report lower smoking rates, given the elevated CV risk of this combination. This is a missed opportunity to intervene on a major public health issue and highlights the need for smoking cessation interventions in this population.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.