Context
A 2009 systematic review synthesized data between 1987 and 2007 and revealed a higher
prevalence of smoking among sexual minority populations than among heterosexuals.
Subsequently, growing attention to tobacco use among sexual minority populations has
spurred more literature on this issue because higher tobacco use prevalence has been
found in certain sexual minority subgroups relative to others. However, a population-level
synthesis of tobacco use prevalence by sexual minority subgroup has not been done
for the past decade.
Evidence acquisition
Investigators conducted a meta-analysis by searching MEDLINE, Web of Science, EMBASE,
and PsycINFO for U.S.-based studies published between 2007 and 2020 that specifically
reported tobacco use prevalence among adults and separated the sexes and gays/lesbians
versus bisexuals. Using random-effects models, meta-prevalence estimates, 95% CIs,
and heterogeneity (I2) were calculated for each sexual minority subgroup.
Evidence synthesis
A total of 30 studies were included in the meta-analysis. The highest current cigarette
use prevalence estimates were found among bisexual women (37.7%), followed by lesbians
(31.7%), gay men (30.5%), and bisexual men (30.1%). Heterosexual men (21.0%) and women
(16.6%) had the lowest prevalence.
Conclusions
Tobacco use prevalence among sexual minorities during 2007–2020 remained at similarly
high levels as those during 1987–2007, and tobacco use disparity between sexual minorities
and heterosexuals persisted in the past decade. Significant heterogeneity existed
in tobacco use across sexual minority subgroups, with bisexual women having the highest
prevalence. These findings are critical for increasing decision maker's awareness
and action to address sexual minorities’ persistent high prevalence of tobacco use,
particularly among bisexual women.
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Article Info
Publication History
Published online: November 17, 2020
Identification
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© 2020 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
