title: A longitudinal examination of risk and protective factors for cigarette smoking among lesbian, gay, bisexual, and transgender youth.
abstract: OBJECTIVE
  To investigate change across development in two smoking outcomes (smoking status and rate), describe demographic differences in smoking, and longitudinally examine the effects of psychosocial variables on smoking (psychological distress, victimization, and social support) in lesbian, gay, bisexual, and transgender (LGBT) youth.
  
  
  METHODS
  Participants were 248 ethnically diverse LGBT youth (ages 16-20 years at baseline) from a longitudinal cohort study with six waves over 3.5 years. Baseline questionnaires included demographic variables and a measure of impulsivity, and longitudinal questionnaires included measures of cigarette smoking (status and average number of cigarettes smoked daily), LGBT-based victimization, psychological distress, and perceived social support. Analyses were conducted with hierarchical linear modeling.
  
  
  RESULTS
  Males had higher odds of smoking and smoking rate than females, but females' smoking rate increased more rapidly over time. Psychological distress was associated with higher odds of smoking and smoking rate at the same wave, and it predicted smoking rate at the subsequent wave. LGBT victimization was associated with higher odds of smoking at the same wave and predicted smoking rate at the subsequent wave. Finally, significant other support predicted higher odds of smoking and smoking rate at the subsequent wave, but family support was negatively correlated with smoking rate at the same wave.
  
  
  CONCLUSIONS
  There are several viable avenues for the development of smoking prevention interventions for LGBT youth. To optimize the efficacy of prevention strategies, we must consider experiences with victimization, the impact of psychological distress, and optimizing support from families and romantic partners.
authors.affiliation: Department of Medical Social Sciences, Northwestern University, Feinberg School of Medicine, Chicago, Illinois. Electronic address: newcomb@northwestern.edu.
authors.forename: Michael E
authors.initials: ME
authors.lastname: Newcomb
authors.affiliation: Center for Healthcare Evaluation, VA Palo Alto Health Care, Menlo Park, California; Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, California.
authors.forename: Adrienne J
authors.initials: AJ
authors.lastname: Heinz
authors.affiliation: Department of Medical Social Sciences, Northwestern University, Feinberg School of Medicine, Chicago, Illinois.
authors.forename: Michelle
authors.initials: M
authors.lastname: Birkett
authors.affiliation: Department of Medical Social Sciences, Northwestern University, Feinberg School of Medicine, Chicago, Illinois.
authors.forename: Brian
authors.initials: B
authors.lastname: Mustanski
mesh_terms: D000293:Adolescent; D001727:Bisexuality / Q000706:statistics & numerical data; D015331:Cohort Studies; D005195:Family Relations; D005260:Female; D018452:Homosexuality, Female / Q000706:statistics & numerical data; D018451:Homosexuality, Male / Q000706:statistics & numerical data; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D010379:Peer Group; D012307:Risk Factors; D012309:Risk-Taking; D019529:Sexuality / Q000523:psychology / Q000706:statistics & numerical data*; D012907:Smoking / Q000453:epidemiology*; D016540:Smoking Cessation / Q000379:methods* / Q000523:psychology; D000074606:Smoking Prevention; D011795:Surveys and Questionnaires; D063106:Transgender Persons / Q000523:psychology / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: Family support; LGBT youth; Psychological distress; Romantic support; Smoking; Victimization