ArticleAmerican journal of preventive medicine2023
Sexual Identity Differences in Tobacco (Re)Uptake: Testing Mediation by Internalizing and Externalizing Symptoms.
Article in American journal of preventive medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
What it found
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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
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Who cites it
3 citing papers in PubMed, 4 citations in OpenAlex.
- Attention-Deficit/Hyperactivity Disorder Symptoms and Later E-Cigarette and Tobacco Use in US Youths.JAMA network open · 2025Article
- "Do all bisexuals have this power?": An exploratory study of "crippling nicotine addiction," identity, and other emergent themes in vaping messages on QueerTok.SSM. Qualitative research in health · 2024Article
- How a "Something Else" Response Option for Sexual Identity Affects National Survey Estimates of Associations Between Sexual Identity, Reproductive Health, and Substance Use.Archives of sexual behavior · 2024Article
Corrections and comments
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Authors and funding
5 authors at 4 institutions in 2 countries.
Funding
Abstract
introductionTobacco use among gay, lesbian, and bisexual individuals is disproportionately higher than among heterosexual individuals. Identifying the mechanisms behind these differences can inform prevention and cessation efforts aimed at advancing health equity. Internalizing and externalizing symptoms as mediators of tobacco (re)uptake among sexual minority individuals was examined.
methodsWaves 4 and 5 of the Population Assessment of Tobacco and Health (2016-2019) study were analyzed in 2022. Adolescents aged ≥14 and adults years not using tobacco at Wave 4 (n=21,676) were included. Wave 4 sexual identity was categorized as heterosexual, gay/lesbian, bisexual, or something else. Associations of sexual identity with (re)uptake of cigarette use, E-cigarette use, and polytobacco use at Wave 5 were assessed, along with possible mediation of these associations by Wave 4‒internalizing and ‒externalizing symptoms.
resultsInternalizing and externalizing symptoms predicted tobacco (re)uptake regardless of sexual identity, particularly for female individuals. Gay/lesbian females (AOR=2.26; 95% CI=1.14, 4.48) and bisexual females (AOR=1.36; 95% CI=1.06, 1.74) had greater odds of E-cigarette (re)uptake than heterosexual females. High internalizing and externalizing symptoms accounted for over one third of the difference in E-cigarette (re)uptake among bisexual compared with that among heterosexual females. Males who reported sexual identity as something-else had lower odds of cigarette (re)uptake than heterosexual males (AOR=0.19; 95% CI=0.06, 0.66); this association was not mediated by internalizing and externalizing symptoms.
conclusionsInternalizing and externalizing symptoms uniquely contribute to E-cigarette (re)uptake among bisexual females. Strategies that reduce sexual minority stressors and resulting psychological distress may help to reduce tobacco use disparities.
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Registered trials
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