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Sexual Orientation and Tobacco Use in a Cohort Study of US Adolescent Girls and Boys

S. Bryn Austin, ScD; Najat Ziyadeh, MPH; Laurie B. Fisher, SM; Jessica A. Kahn, MD, MPH; Graham A. Colditz, MD, DrPH; A. Lindsay Frazier, MD, MSc

Objective  To examine sexual-orientation group disparities in tobacco use in adolescent girls and boys.

Design  Survey data from 10 685 adolescent girls and boys participating in 1999 in the Growing Up Today Study were examined cross-sectionally.

Setting  Community-based population of adolescents living throughout the United States.

Main Outcome Measure  Prevalence of tobacco use.

Results  Ninety-two percent of the participants described themselves as heterosexual (n = 9296), 5% as mostly heterosexual (n = 511), 1% as lesbian/gay/bisexual (n = 103), and 2% as unsure (n = 226). Agesranged from 12 to 17 years. Compared with heterosexu-als, mostly heterosexual girls were 2.5 (95% confidence interval, 1.8-3.5), lesbian/bisexual girls were 9.7 (95% confidence interval, 5.1-18.4), and mostly heterosexual boys were 2.5 (95% confidence interval, 1.4-4.6) times more likely to smoke at least weekly. In contrast, gay/bisexual boys were not more likely to smoke. Findings persisted even when controlling for multiple sociodemographic and psychosocial covariates.

Conclusion  Our findings indicate that mostly heterosexual adolescents of both sexes and lesbian/bisexual girls are at heightened risk for tobacco use.