Understanding tobacco use disparities among Florida adolescents: The impact of sexual minority status and school-based violence victimization.

Introduction: Adolescent tobacco use remains a significant public health issue with long-term health consequences. This study investigates the relationship between sexual minority status, school-based violence victimization, and tobacco use among adolescents. The objective is to determine the prevalence of school-based violence victimization and tobacco use behaviors and identify key demographic and experiential risk factors.

Methods: Data were derived from the Florida Youth Risk Behavior Survey, collected biennially from 2013 to 2021. Participants included high school students who answered demographic questions on sexual orientation, race/ethnicity, sex, and grade. Bivariate analyses and binary logistic regression models examined associations between school-based violence and tobacco use, controlling for demographic factors.

Results: Of the 26510 participants, 15.8% identified as sexual minorities. Cigarette smoking was reported by 18.0% of the sample, with a higher prevalence among sexual minority students (27.3%) and students in 12th grade (22.5%). Sexual minority students reported higher rates of school-based violence, including being bullied at school (24.4%) and electronically bullied (22.6%). Overall, 29.3% of students experienced school-based victimization. Tobacco use was significantly associated with school-based violence (AOR=2.04; 95% CI: 1.91-2.19) with higher odds for sexual minority students (AOR=1.91; 95% CI: 1.75-2.09).

Conclusions: The findings highlight a significant association between school-based violence and tobacco use among adolescents. Sexual minority students are at higher risk for both victimization and tobacco use. These results underscore the importance of violence prevention strategies and creating inclusive, supportive school environments that embrace sexual and gender diversity to mitigate these risks and promote overall student well-being.