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Use of Cigarettes and E-Cigarettes/Vaping Among Transgender People: Results From the 2015 U.S. Transgender Survey

  • Luisa Kcomt
    Correspondence
    Address correspondence to: Luisa Kcomt, PhD, Center for the Study of Drugs, Alcohol, Smoking and Health, Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, 400 North Ingalls, Ann Arbor MI 48109-5482.
    Affiliations
    Center for the Study of Drugs, Alcohol, Smoking and Health, Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, Ann Arbor, Michigan
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  • Rebecca J. Evans-Polce
    Affiliations
    Center for the Study of Drugs, Alcohol, Smoking and Health, Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, Ann Arbor, Michigan
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  • Phil T. Veliz
    Affiliations
    Center for the Study of Drugs, Alcohol, Smoking and Health, Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, Ann Arbor, Michigan

    Institute for Research on Women and Gender, University of Michigan, Ann Arbor, Michigan

    Institute for Social Research, University of Michigan, Ann Arbor, Michigan
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  • Carol J. Boyd
    Affiliations
    Center for the Study of Drugs, Alcohol, Smoking and Health, Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, Ann Arbor, Michigan

    Institute for Research on Women and Gender, University of Michigan, Ann Arbor, Michigan

    Addiction Center, Department of Psychiatry, University of Michigan, Ann Arbor, Michigan
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  • Sean E. McCabe
    Affiliations
    Center for the Study of Drugs, Alcohol, Smoking and Health, Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, Ann Arbor, Michigan

    Institute for Research on Women and Gender, University of Michigan, Ann Arbor, Michigan

    Institute for Social Research, University of Michigan, Ann Arbor, Michigan

    Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan

    Center for Human Growth and Development, University of Michigan, Ann Arbor, Michigan

    Center for Sexuality and Health Disparities, School of Nursing, University of Michigan, Ann Arbor, Michigan
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      Introduction

      This study examines the demographic characteristics, transgender-specific factors, and discrimination experiences associated with current cigarette smoking, e-cigarette use/vaping, and dual use in a large sample of transgender people.

      Methods

      This was a secondary analysis of the 2015 U.S. Transgender Survey (n=27,715). Conducted in 2019, logistic regression models were used to estimate the AORs and 95% CIs of current smoking, e-cigarette use/vaping, and dual use among transgender people.

      Results

      Overall, 23.6% of respondents used cigarettes, 9.3% used e-cigarettes/vaping products, and 5.2% reported dual use within the past 30 days. Visually nonconforming individuals had greater odds (cigarettes: AOR=1.49, 95% CI=1.35, 1.65; e-cigarettes/vaping: AOR=1.43, 95% CI=1.25, 1.65; dual use: AOR=1.81, 95% CI=1.52, 2.15) than visually conforming individuals. Transgender people who had disclosed their transgender identity to their social networks had greater odds of cigarette smoking (AOR=1.30, 95% CI=1.17, 1.45), e-cigarette use/vaping (AOR=1.30, 95% CI=1.12, 1.52), and dual use (AOR=1.95, 95% CI=1.61, 2.35) than individuals who were out to none or some people within their networks. Experiencing discrimination (i.e., unequal treatment, verbal harassment, or physical assault) significantly increased the odds for cigarette smoking, e-cigarette use/vaping, and dual use. Transgender people who experienced all 3 types of discrimination had 2 times greater odds of current cigarette smoking (AOR=2.06, 95% CI=1.79, 2.37) and dual use (AOR=2.17, 95% CI=1.73, 2.74) than those who had not experienced discrimination.

      Conclusions

      Discrimination, visual nonconformity, and being out as transgender increased the odds of cigarette smoking, e-cigarette use/vaping, and dual use. This study informs disease prevention efforts for transgender populations with increased risks for these health behaviors.
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