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Tobacco Use Trajectories and Disparities Among Sexual Minorities in U.S Adolescents and Adults

Principal Investigator: Rebecca Evans-Polce

Funding Mechanism: National Institutes of Health – Grant

ID number: 1R21DA051388-01

Award Date: 7/20/2020

Institution: University of Michigan

Sexual minority individuals comprise a population that is particularly vulnerable to tobacco use. The goal of this project is to analyze tobacco use across time in sexual minorities and resulting tobacco-related health disparities using Population Assessment of Tobacco and Health (PATH) Study data. Of PATH respondents with valid self-reported sexual identity (gay/lesbian, bisexual, something else, or straight) at all four study waves (N=26,696, ages 12+years), 2,520 reported sexual minority identity at one wave or more; 1,474 reported sexual minority identify at wave 1; and 905 reported sexual minority identity at all four waves. Study aims are: (1) to examine tobacco product initiation and use trajectories by sexual orientation and their associations with regular tobacco use and tobacco use disorder symptoms; (2) to identify tobacco use trajectories by sexual orientation and different associations with self-reported and biological health outcomes; and (3) to examine the role of biological and psychological stress on tobacco use trajectories, tobacco cessation, and tobacco-related health outcomes among adults and how these measures differ by sexual orientation. Researchers will assess tobacco use trajectories, including tobacco use initiation; progression in the number of products used, with a focus on e-cigarette use/non-use; and increase and decrease in use frequency. Aims 2 and 3 will involve analysis of survey self-report measures of stress (psychological distress) and health outcomes (respiratory illness, cancer, cardiovascular disease) alongside biological markers of stress (e.g. C-reactive protein, interleukin-6) and tobacco-specific markers linked to cancer risk (NNAL, NNN, TNE2). Researchers will also examine important moderators including age, sex, race and ethnicity throughout in all analyses. This project will provide new data that may inform regulatory activities to address the health burden of tobacco use among sexual minorities.

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