title: Disparities in tobacco use by sexual orientation among high school students.
abstract: OBJECTIVE
  This study examined whether cigarette use is associated with sexual orientation among high school students.
  
  
  METHODS
  Data were from a 2012 cross-sectional survey of 5994 students in grades 9, 10 and 12 attending public schools in Atlantic Canada. Multilevel logistic regression analysis was used to examine differences in cigarette use by sexual orientation.
  
  
  RESULTS
  Lesbian, gay and bisexual adolescents (LGB) reported higher prevalence (22%) of daily cigarette use compared with heterosexuals (11%). Multilevel logistic regression analysis, controlling for standard covariates, found that LGB adolescents were more likely to be daily smokers than non-LGB adolescents (odds ratio 2.00, 95% confidence interval 1.50-2.68). Bisexual adolescents were at least twice more likely to be a smoker compared with heterosexual adolescents.
  
  
  CONCLUSIONS
  Prevalence of cigarette use was significantly higher among LGB adolescent students. Our results join a growing body of evidence indicating that sexual minorities are at heightened risk of tobacco use. Smoking cessation measures that specifically target this group may be beneficial given that there is no one size fits all approach.
authors.affiliation: Propel Centre for Population Health Impact, University of Waterloo, Canada; School of Public Health and Health Systems, University of Waterloo, Canada. Electronic address: sazagba@uwaterloo.ca.
authors.forename: Sunday
authors.initials: S
authors.lastname: Azagba
authors.affiliation: Department of Community Health and Epidemiology, Dalhousie University, Canada.
authors.forename: Mark
authors.initials: M
authors.lastname: Asbridge
authors.affiliation: Department of Community Health and Epidemiology, Dalhousie University, Canada.
authors.forename: Donald
authors.initials: D
authors.lastname: Langille
authors.affiliation: Propel Centre for Population Health Impact, University of Waterloo, Canada; School of Public Health and Health Systems, University of Waterloo, Canada.
authors.forename: Bruce
authors.initials: B
authors.lastname: Baskerville
mesh_terms: D000293:Adolescent; D001727:Bisexuality / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D003863:Depression; D005260:Female; D020010:Heterosexuality / Q000706:statistics & numerical data; D006716:Homosexuality / Q000706:statistics & numerical data*; D006801:Humans; D016015:Logistic Models; D008297:Male; D009523:Newfoundland and Labrador / Q000453:epidemiology; D009674:Nova Scotia / Q000453:epidemiology; D011581:Psychological Tests; D012574:Schools; D017678:Sex Distribution; D012907:Smoking / Q000453:epidemiology*; D013334:Students; D064424:Tobacco Use / Q000453:epidemiology
keywords: Bisexual; Gay; Heterosexual; High school students; Lesbian; Prevalence; Sexual minority; Tobacco use