title: Sexual-orientation disparities in cigarette smoking in a longitudinal cohort study of adolescents.
abstract: BACKGROUND
  Youths with a minority sexual orientation (i.e., gay, lesbian, bisexual, and mostly heterosexual) are at high risk for cigarette smoking. We examined sexual-orientation disparities in smoking during adolescence and emerging adulthood and investigated the role of age at first smoking in contributing to smoking disparities.
  
  
  METHODS
  We used data from the Growing Up Today Study, a large longitudinal cohort of adolescents followed from ages 12 to 24 years (N = 13,913). Self-administered questionnaires filled out annually or biennially assessed age at first smoking, current smoking, frequency of smoking, number of cigarettes smoked daily, and nicotine dependence. Proportional hazards survival analysis and repeated measures regression estimated sexual-orientation differences in smoking.
  
  
  RESULTS
  Compared with completely heterosexuals, lesbian/gay, bisexual, and mostly heterosexual youths smoked their first cigarette at younger ages, were more likely to be current smokers, and had higher frequency of smoking. Among past-year smokers, sexual-minority females smoked more cigarettes daily and scored higher on nicotine dependence than completely heterosexual females. In some instances, gender and age modified relationships between sexual orientation and smoking, with relative risk accentuated in female sexual minorities and in sexual minorities during younger ages. Younger age of smoking onset contributed to elevated smoking in mostly heterosexuals and bisexuals, and to a lesser extent in lesbians, but not in gay males.
  
  
  CONCLUSIONS
  Sexual-orientation minorities are at greater risk for smoking during adolescence and emerging adulthood than heterosexuals. Disparities are larger in females and evident in early adolescence. Prevention and cessation efforts should target this population, preferably beginning in early adolescence.
authors.affiliation: Division of Adolescent and Young Adult Medicine, Children's Hospital, Boston, MA 02115, USA. heather.corliss@childrens.harvard.edu
authors.forename: Heather L
authors.initials: HL
authors.lastname: Corliss
authors.forename: Brianna M
authors.initials: BM
authors.lastname: Wadler
authors.forename: Hee-Jin
authors.initials: HJ
authors.lastname: Jun
authors.forename: Margaret
authors.initials: M
authors.lastname: Rosario
authors.forename: David
authors.initials: D
authors.lastname: Wypij
authors.forename: A Lindsay
authors.initials: AL
authors.lastname: Frazier
authors.forename: S Bryn
authors.initials: SB
authors.lastname: Austin
mesh_terms: D000293:Adolescent; D000367:Age Factors; D001727:Bisexuality / Q000706:statistics & numerical data; D002648:Child; D015331:Cohort Studies; D005260:Female; D018452:Homosexuality, Female / Q000706:statistics & numerical data; D018451:Homosexuality, Male / Q000706:statistics & numerical data; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D012725:Sexual Behavior / Q000706:statistics & numerical data*; D012907:Smoking / Q000453:epidemiology*; D014029:Tobacco Use Disorder / Q000453:epidemiology; D014481:United States; D055815:Young Adult