Tobacco product use among youth: the intersection of sexual identity and race/ethnicity.

Abstract

Tobacco use represents a public health concern in the United States. This study aimed to determine whether the association between sexual identity and tobacco use varied across race/ethnicity groups among U.S. high school students. Data from the Centers for Disease Control and Prevention's 2019 Youth Behavior Risk Survey (n = 13,677) were analyzed using bivariate cross-tabulations and adjusted multivariate logistic regression models with interaction terms. A significant interaction was found between sexual identity and race/ethnicity for current electronic vapor, cigar, and smokeless tobacco use. Sexual identity was most strongly associated with electronic vapor use among Black or African American youth as well as Hispanic or Latino youth and most strongly associated with cigar and smokeless tobacco use among Asian, Native Hawaiian, or Pacific Islander youth. The findings highlight the challenges faced by LGBQ (Lesbian, Gay, Bisexual, Questioning) students of color and the need for culturally tailored interventions for youth with multiply marginalized backgrounds.