Overexposure to harassment could explain the high prevalence of smoking among young LGBT people

A US study estimates that the greater exposure to harassment and school violence of young people who identify as sexual minorities is one of the determinants of their high smoking habits. Several avenues are being considered to change this situation.

Higher smoking prevalence is consistently observed among lesbian, gay, bisexual, or trans (LGBT) people, both adults and youth. A team of researchers from the University of Illinois at Chicago investigated some of the psychosocial determinants of this disparity among adolescents.[1].

Exposure to school violence increases tobacco consumption

The work of this team is based on the exploitation of the results of the Youth Risk Behavior Surveillance System (YRBSS) study, which explores every two years at the national level the risk behaviors of young people in school. Focusing on the city of Chicago, the declarative responses of 13,872 adolescents aged 15 to 18 were the subject of bivariate analyses.

These analyses confirmed that adolescents reporting a minority sexual orientation (homosexual, bisexual or uncertain, or 21.1% of the sample) are significantly more consumers of tobacco and nicotine products than heterosexual youth, 2.3 to 4.4 times more depending on the type of product. It is also confirmed that adolescents exposed to bullying (including cyberbullying) and school violence are both more prone to risky behavior and more often consumers of tobacco and nicotine products. Other studies have previously documented the links between substance use and exposure to violence and traumatic events, with a view to regulating anxiety and negative affects.[2].

While heterosexual adolescents exposed to bullying and school violence are generally numerous (28.1 %), this proportion increases significantly among those declaring themselves to be from a sexual minority (41.2 %). Furthermore, among young people declaring themselves to be from a sexual minority, those who have been exposed to bullying and school violence are more often consumers of tobacco and nicotine products than those who have not been exposed to them. The authors thus estimate that 34 % of tobacco use among young people from a sexual minority would be due to bullying and school violence, with other consumption factors also being at work in this population.

Two axes of response to this situation

Among the avenues imagined to resolve this situation, two axes are highlighted. The first concerns prevention actions, which could be conducted on three levels: by carrying out global actions to prevent harassment and school violence; by developing actions targeted at exposure to this violence among young people declaring themselves to be a sexual minority, knowing that the messages may differ from those usually addressed to adults; by encouraging the establishment of student organizations promoting the gay/heterosexual alliance, which strengthen the integration of sexual minorities and reduce their victimization.

The other line of intervention recommended by the authors is to act in parallel with the proven anti-smoking levers. Increasing taxes on tobacco and nicotine products, banning the use of flavors in these products, raising the legal age for buying—and selling—tobacco products to 21, and eliminating discounts and rebates are presented as measures to reduce the consumption of these products among all young people. The authors add that other efforts should be made to reduce the consumption of e-cigarettes, which has clearly supplanted that of tobacco products among young Americans. However, they fail to take into account the specific targeting of sexual minorities by the tobacco industry in the United States, particularly in the marketing of menthol tobacco and nicotine products.

MF