title: Sexual minority specific and related traumatic experiences are associated with increased risk for smoking among gay and bisexual men.
abstract: OBJECTIVE
  This study examined the hypothesis that sexual minority specific stress and trauma histories may explain some of the risk for smoking among gay/bisexual men.
  
  
  METHODS
  Patients at a Boston community health center were invited to complete a 25-item questionnaire assessing demographics, general health, trauma history, and substance use. Of the 3103 who responded, 1309 identified as male and gay or bisexual (82.8% White and mean age of 38.55 [sd = 9.76]).
  
  
  RESULTS
  A multinomial logistic regression with never smoked as referent group and covariates of age, education, employment, HIV status, and race, showed that the number of sexual minority stressors/traumas were significantly related to the odds of both current and former smoking. In comparison to participants with no trauma history, those who reported 1, 2, 3, and 4 traumas had respectively 1.70 (OR = 1.70: 95% CI: 1.24-2.34), 2.19 (OR = 2.19: 95% CI: 1.48-3.23), 2.88 (OR = 2.88: 95% CI: 1.71-4.85), and 6.94 (OR = 6.94: 95% CI: 2.62-18.38) the odds of identifying as a current smoker. Adjusted logistic regression analysis revealed a significant dose effect of number of sexual minority stressors/traumas with odds of ever smoking. Experiencing intimate partner violence, anti-gay verbal attack, anti-gay physical attack, and childhood sexual abuse were each independently associated with increased odds of the smoking outcomes.
  
  
  CONCLUSIONS
  A sexual minority specific trauma history may represent a vulnerability for smoking among gay/bisexual men. Interventions that address trauma may enhance the efficacy of smoking cessation programs and improve the mental health of gay/bisexual men.
authors.affiliation: The Fenway Institute, Boston, MA, USA; Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA. Electronic address: cocleirigh@mgh.harvard.edu.
authors.forename: Conall
authors.initials: C
authors.lastname: O'Cleirigh
authors.affiliation: The Fenway Institute, Boston, MA, USA; Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA.
authors.forename: Sannisha K
authors.initials: SK
authors.lastname: Dale
authors.affiliation: The Fenway Institute, Boston, MA, USA.
authors.forename: Steven
authors.initials: S
authors.lastname: Elsesser
authors.affiliation: The Fenway Institute, Boston, MA, USA; University of Massachusetts Boston, Boston, MA, USA.
authors.forename: David W
authors.initials: DW
authors.lastname: Pantalone
authors.affiliation: The Fenway Institute, Boston, MA, USA; Harvard Medical School, Boston, MA, USA; Beth Israel Deaconess Medical Center, Boston, MA, USA.
authors.forename: Kenneth H
authors.initials: KH
authors.lastname: Mayer
authors.affiliation: The Fenway Institute, Boston, MA, USA.
authors.forename: Judith B
authors.initials: JB
authors.lastname: Bradford
authors.affiliation: The Fenway Institute, Boston, MA, USA; Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA.
authors.forename: Steven A
authors.initials: SA
authors.lastname: Safren
mesh_terms: D000293:Adolescent; D000328:Adult; D001727:Bisexuality; D001900:Boston / Q000453:epidemiology; D005260:Female; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D008875:Middle Aged; D012725:Sexual Behavior / Q000706:statistics & numerical data; D012747:Sexual Partners; D012907:Smoking / Q000453:epidemiology* / Q000523:psychology*; D013315:Stress, Psychological / Q000150:complications* / Q000209:etiology; D019966:Substance-Related Disorders / Q000523:psychology; D011795:Surveys and Questionnaires; D014029:Tobacco Use Disorder / Q000453:epidemiology / Q000523:psychology; D014754:Violence
keywords: Gay; Men; Sexual minority; Smoking; Trauma