title: Associations of discrimination and violence with smoking among emerging adults: differences by gender and sexual orientation.
abstract: BACKGROUND
  Lesbian, gay, and bisexual (i.e., sexual minority) populations have higher smoking prevalence than their heterosexual peers, but there is a lack of empirical study into why such disparities exist. This secondary analysis of data sought to examine associations of discrimination and violence victimization with cigarette smoking within sexual orientation groups.
  
  
  METHODS
  Data from the Fall 2008 and Spring 2009 National College Health Assessments were truncated to respondents of 18-24 years of age (n = 92,470). Since heterosexuals comprised over 90% of respondents, a random 5% subsample of heterosexuals was drawn, creating a total analytic sample of 11,046. Smoking status (i.e., never-, ever-, and current smoker) was regressed on general (e.g., not sexual orientation-specific) measures of past-year victimization and discrimination. To examine within-group differences, two sets of multivariate ordered logistic regression analyses were conducted: one set of models stratified by sexual orientation and another set stratified by gender-by-sexual-orientation groups.
  
  
  RESULTS
  Sexual minorities indicated more experiences of violence victimization and discrimination when compared with their heterosexual counterparts and had nearly twice the current smoking prevalence of heterosexuals. After adjusting for age and race, lesbians/gays who were in physical fights or were physically assaulted had higher proportional odds of being current smokers when compared with their lesbian/gay counterparts who did not experience those stressors.
  
  
  CONCLUSIONS
  When possible, lesbian/gay and bisexual groups should be analyzed separately, as analyses revealed that bisexuals had a higher risk profile than lesbians/gays. Further research is needed with more nuanced measures of smoking (e.g., intensity), as well as examining if victimization may interact with smoking cessation.
authors: Translational Tobacco Reduction Research Program, Mary Babb Randolph Cancer Center and Prevention Research Center, Department of Community Medicine, West Virginia University, PO Box 9190, Morgantown, WV 26506, USA. jblosnich@hsc.wvu.edu
authors: John R
authors: JR
authors: Blosnich
authors: Kimberly
authors: K
authors: Horn
mesh_terms: D000293:Adolescent; D001727:Bisexuality / Q000706:statistics & numerical data; D019548:Crime Victims; D005260:Female; D005783:Gender Identity; D054624:Health Status Disparities; D018452:Homosexuality, Female / Q000706:statistics & numerical data; D018451:Homosexuality, Male / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008913:Minority Groups / Q000706:statistics & numerical data; D012725:Sexual Behavior / Q000706:statistics & numerical data*; D019529:Sexuality / Q000706:statistics & numerical data*; D012907:Smoking / Q000453:epidemiology*; D063508:Social Discrimination; D013334:Students / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D014029:Tobacco Use Disorder / Q000453:epidemiology*; D014481:United States / Q000453:epidemiology; D014495:Universities; D014754:Violence; D055815:Young Adult