Objective: Cigarette smoking has been found to be more prevalent among adults and youths with a minority sexual orientation (lesbian, gay, bisexual, LGB) than among the general population, while less is known about smoking among LGB youth in low- and middle-income countries. The goal of the study was to examine cigarette smoking in relation to sexual orientation in a community-based sample of youth in Shanghai, China.
Methods: A multi-center cross-sectional survey of 17,016 youth aged 15-24 years was conducted in rural and urban areas of Hanoi, Vietnam; Taipei, Taiwan; and Shanghai, China in 2006. In this article, analysis was restricted to the 6,299 respondents in Shanghai. Assessments included ever smoking, age at first smoking, frequency of smoking, and number of cigarettes smoked daily. Logistic regression was used to estimate the association between sexual orientation and cigarette smoking.
Results: Nine percent (594/6,299) of eligible participants considered themselves as LGB youths; 34.2% ever smoked, 14.81% initiated smoking before age 13, 15.9% smoked in the past 30 days, and 14.1% were moderate or heavy smokers. LGB identity predicted moderate or heavy smoking (OR 2.2, 95% CI 1.3, 3.9). Male LGB youth smoked more cigarettes daily (OR 2.2, 95% CI 1.3, 3.9) whilst female LGB youth reported less any prior cigarette use (OR 0.7, 95% CI 0.5, 1.0).
Conclusions: Few meaningful disparities in cigarette smoking were related to sexual orientation, except male LGB youth consumed more cigarettes daily. Prevention and cessation should target this population, especially male LGB youth.