title: Minority Stress, Smoking Patterns, and Cessation Attempts: Findings From a Community-Sample of Transgender Women in the San Francisco Bay Area.
abstract: BACKGROUND
  Research has demonstrated associations between reports of minority stressors and smoking behaviors among lesbian, gay, and bisexual populations; however, little is known about how minority stressors are related to smoking behaviors and cessation attempts among transgender women. The purpose of this study was twofold: (1) to examine the associations between transgender-based discrimination and smoking patterns among a sample of transgender women; and (2) to identify barriers to smoking cessation in a sample of transgender women with a history of smoking.
  
  
  METHODS
  A community sample of 241 transgender women completed a one-time survey. Binary and multinomial logistic regression models examined associations between minority stressors and (1) smoking behaviors and (2) cessation attempts. Both models adjusted for income, education, race/ethnicity, recent sex work, HIV status, depression, alcohol use, and current hormone use.
  
  
  RESULTS
  Overall, 83% of participants indicated that they had smoked a cigarette in the last month. Of these women, 62.3% reported daily smoking and 51.7% reported an unsuccessful quit attempt. Discrimination was positively associated with currently smoking (adjusted odds ratio [AOR] = 1.04, 95% confidence interval [CI]: 1.01, 1.08). Discrimination was positively associated with unsuccessful cessation (AOR = 1.03, 95% CI: 1.01, 1.18) and never attempting (AOR = 1.04, 95% CI: 1.01, 1.11) compared to successful cessation. Discrimination was also positively associated with never attempting compared to unsuccessful cessation (AOR = 1.01, 95% CI: 1.00, 1.03).
  
  
  CONCLUSIONS
  Smoking cessation may be driven by unique transgender-related minority stressors, such as discrimination. Future research is warranted to address unique stigmatizing contexts when understanding and providing tailored intervention addressing smoking among transgender women.
authors.affiliation: Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI; kristi_gamarel@brown.edu.
authors.forename: Kristi E
authors.initials: KE
authors.lastname: Gamarel
authors.affiliation: Center for Alcohol and Addiction Studies, Brown University, Providence, RI; Department of Behavioral and Social Sciences, School of Public Health, Brown University, Providence, RI;
authors.forename: Ethan H
authors.initials: EH
authors.lastname: Mereish
authors.affiliation: Department of Behavioral and Social Sciences, School of Public Health, Brown University, Providence, RI;
authors.forename: David
authors.initials: D
authors.lastname: Manning
authors.affiliation: Public Health Institute, Oakland, CA.
authors.forename: Mariko
authors.initials: M
authors.lastname: Iwamoto
authors.affiliation: Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI; Center for Alcohol and Addiction Studies, Brown University, Providence, RI; Department of Behavioral and Social Sciences, School of Public Health, Brown University, Providence, RI;
authors.forename: Don
authors.initials: D
authors.lastname: Operario
authors.affiliation: Public Health Institute, Oakland, CA.
authors.forename: Tooru
authors.initials: T
authors.lastname: Nemoto
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001727:Bisexuality / Q000208:ethnology / Q000523:psychology; D003430:Cross-Sectional Studies; D005260:Female; D018452:Homosexuality, Female / Q000208:ethnology / Q000523:psychology; D006801:Humans; D008875:Middle Aged; D008913:Minority Groups / Q000523:psychology*; D012111:Residence Characteristics; D012495:San Francisco / Q000208:ethnology; D012907:Smoking / Q000208:ethnology / Q000523:psychology*; D016540:Smoking Cessation / Q000208:ethnology / Q000523:psychology*; D013315:Stress, Psychological / Q000208:ethnology / Q000523:psychology*; D063106:Transgender Persons / Q000523:psychology*; D055815:Young Adult; D008297:Male