Patterns of Tobacco and Cannabis Use Among Sexual Minority Females and Males From PATH Wave 5: The Role of Sociodemographic and Psychosocial Correlates

Katelyn F Romm; Carla J Berg; Yan Wang; Amy M Cohn

doi:10.1177/29767342231222245

Patterns of Tobacco and Cannabis Use Among Sexual Minority Females and Males From PATH Wave 5: The Role of Sociodemographic and Psychosocial Correlates

Subst Use Addctn J. 2024 Jan 28:29767342231222245. doi: 10.1177/29767342231222245. Online ahead of print.

Authors

Katelyn F Romm^{1

2}, Carla J Berg^{3

4}, Yan Wang³, Amy M Cohn^{1

2}

Affiliations

¹ TSET Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
² Department of Pediatrics, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
³ Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA.
⁴ George Washington Cancer Center, George Washington University, Washington, DC, USA.

PMID: 38281150
DOI: 10.1177/29767342231222245

Abstract

Introduction: Although sexual minority (SM; vs heterosexual) individuals display higher rates of tobacco and cannabis use, limited research has examined sociodemographic and psychosocial correlates of single and co-use among this population.

Methods: Participants were SM-identifying female (N = 2419; M_age = 27.80; 50.0% racial/ethnic minority) and male (N = 1142; M_age = 30.34; 46.1% racial/ethnic minority) adults from Wave 5 of the Population Assessment of Tobacco and Health study. Multinomial logistic regressions examined sociodemographic (ie, sexual identity, age, race/ethnicity, education, income) and psychosocial (ie, alcohol use, mental health, substance use) correlates of single and co-use (ie, no use [referent], tobacco-only, cannabis-only, co-use), controlling for state cannabis legalization, among SM females and males, separately.

Results: The proportions of SM females reporting no use, tobacco-only, cannabis-only, and co-use were 37.9%, 24.0%, 10.5%, and 27.6%, respectively. Among males, 40.6%, 27.8%, 10.1%, and 21.5% reported no use, tobacco-only, cannabis-only, and co-use, respectively. Among females and males, substance use problems were associated with all 3 use groups (vs no use); past-month alcohol use was associated with cannabis-only and co-use; and mental health symptoms were associated with co-use (and cannabis-only in males). Sociodemographic correlates among females were: tobacco-only-identifying as bisexual (vs lesbian), White (vs Black), older, lower education, and lower income; cannabis-only-bisexual, other race (vs White); and co-use-White (vs Hispanic), lower education, and lower income. Among males, sociodemographic correlates were: tobacco-only-older, lower education, and lower income; cannabis-only-Black (vs White) and higher income.

Conclusions: Public health efforts to reduce tobacco and cannabis use among SM adults should target single versus co-use patterns and their corresponding sociodemographic, mental health, and substance use profiles.

Keywords: cannabis; co-use; mental health; risk factors; sexual minority; substance use; tobacco.