title: Transgender Use of Cigarettes, Cigars, and E-Cigarettes in a National Study.
abstract: BACKGROUND
  Tobacco use among transgender adults continues to be an area of research with few reported findings. The limited literature indicates higher cigarette use among transgender adults, compared with the general population. This national study is the first to report on cigarettes, cigars, and e-cigarettes by examining differences in transgender tobacco use independent of sexual orientation.
  
  
  METHODS
  Data were collected in 2013 using a nationally cross-sectional online survey of U.S. adults (cisgender, n=17,164; transgender, n=168) and analyzed in 2015. Past 30-day tobacco use point estimates and adjusted logistic regression while controlling for false discovery rate were reported for transgender and cisgender respondents.
  
  
  RESULTS
  Transgender adults reported higher past 30-day use of any cigarette/cigar/e-cigarette product (39.7% vs 25.1%) and current use of cigarettes (35.5% vs 20.7%), cigars (26.8% vs 9.3%), and e-cigarettes (21.3% vs 5.0%) compared with cisgender adults (all p-values ≤0.003). Transgender respondents had significantly higher odds of past 30-day tobacco product use for any cigarette/cigar/e-cigarette product (OR=1.97, 95% CI=1.25, 3.1), e-cigarettes (OR=5.15, 95% CI=3.36, 7.88), cigars (OR=3.56, 95% CI=2.27, 5.59), and cigarettes (OR=2.10, 95% CI=1.35, 3.28) versus cisgender respondents (all p-values ≤0.0035).
  
  
  CONCLUSIONS
  Transgender adults are at higher risk for tobacco use than cisgender adults and risk of specific product use varies by gender. This is the first U.S. national study to assess differences in use of various tobacco products using questions that specifically ask for gender identity separately from sexual orientation. This study provides data that can inform targeted interventions to promote transgender health.
authors.affiliation: Horizons Foundation, San Francisco, California. Electronic address: franciscobuchting@outlook.com.
authors.forename: Francisco O
authors.initials: FO
authors.lastname: Buchting
authors.affiliation: Moores Cancer Center at the University of California, San Diego, San Diego, California.
authors.forename: Kristen T
authors.initials: KT
authors.lastname: Emory
authors.affiliation: Boston University School of Public Health, Boston, Massachusetts.
authors.lastname: Scout
authors.affiliation: National Opinion Research Center at the University of Chicago, Chicago, Illinois.
authors.forename: Yoonsang
authors.initials: Y
authors.lastname: Kim
authors.affiliation: Fay W. Boozman College of Public Health at the University of Arkansas for Medical Sciences, Little Rock, Arkansas.
authors.forename: Pebbles
authors.initials: P
authors.lastname: Fagan
authors.affiliation: VeraCite Inc., San Diego, California.
authors.forename: Lisa E
authors.initials: LE
authors.lastname: Vera
authors.affiliation: National Opinion Research Center at the University of Chicago, Chicago, Illinois.
authors.forename: Sherry
authors.initials: S
authors.lastname: Emery
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D066300:Electronic Nicotine Delivery Systems / Q000706:statistics & numerical data*; D005260:Female; D006306:Health Surveys / Q000706:statistics & numerical data; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology*; D062789:Tobacco Products / Q000706:statistics & numerical data*; D064424:Tobacco Use / Q000453:epidemiology*; D014029:Tobacco Use Disorder / Q000453:epidemiology* / Q000517:prevention & control; D063106:Transgender Persons / Q000706:statistics & numerical data*