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A systematic review of the aetiology of tobacco disparities for sexual minorities
  1. John Blosnich1,
  2. Joseph G L Lee2,
  3. Kimberly Horn3
  1. 1Department of Psychiatry, University of Rochester, Rochester, New York, USA
  2. 2Department of Health Behavior & Health Education, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
  3. 3Department of Community Medicine, West Virginia University, Morgantown, West Virginia, USA
  1. Correspondence to Dr John Blosnich, Department of Psychiatry, University of Rochester, 300 Crittenden Blvd. Rochester, NY 14642, USA; john_blosnich{at}


Objective To conduct a systematic review of the literature examining risk factors/correlates of cigarette smoking among lesbian, gay and bisexual (ie, sexual minority) populations.

Methods Sets of terms relevant to sexual minority populations and cigarette smoking were used in a simultaneous search of 10 databases through EBSCOhost. The search was limited to the peer-reviewed literature up to January 2011, using no geographic or language limits. For inclusion, the paper was required to: (1) have been written in English, (2) have sexual minorities (defined by either attraction, behaviour, or identity) included in the study population and (3) have examined some form of magnitude of association for risk factors/correlates of any definition of cigarette smoking. A total of 386 abstracts were reviewed independently, with 26 papers meeting all inclusion criteria. Abstracts were reviewed and coded independently by authors JB and JGLL using nine codes derived from the inclusion/exclusion criteria.

Results Studies used various measures of sexual orientation and of smoking. Risk factors that could be considered unique to sexual minorities included internalised homophobia and reactions to disclosure of sexual orientation. Some studies also indicated common smoking risk factors experienced at higher rates among sexual minorities, including stress, depression, alcohol use and victimisation.

Conclusions This review identified risks that were associated with sexual minority status and common to the general population but experienced at potentially higher rates by sexual minorities. Government and foundation funds should be directed towards research on the origins of this disparity.

  • Disparities
  • priority/special populations
  • advocacy
  • public policy
  • prevention
  • cessation
  • youth
  • young adults
  • adolescent

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  • Funding This work was supported by a dissertation training grant to JB through the National Institute on Drug Abuse (Award 1R36DA030589-01). This paper is solely the responsibility of the authors and does not necessarily represent the official views of the authors' respective institutional affiliations, the National Institute on Drug Abuse, or the National Institutes of Health.

  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.