Past-year discrimination and cigarette smoking among sexual minority women: investigating racial/ethnic and sexual identity differences.

Although findings are mixed, discrimination has been identified as a risk factor for smoking in sexual minority women (SMW; e.g., lesbian and bisexual). We examined associations between past-year discrimination and cigarette smoking among SMW. Using regression analyses we examined associations of past-year discrimination including count of types of discriminatory experiences and attributions of the main reason for discrimination (i.e., sexual orientation, race/ethnicity, gender) with smoking outcomes (e.g., current smoking, nicotine dependence, smoking more cigarettes now than 12 months ago). We conducted exploratory analyses to examine whether race/ethnicity and sexual identity moderated the associations of past-year discrimination with smoking outcomes. The sample included 619 SMW. Most identified as lesbian (74.3%) and non-White (61.1%). SMW who reported a higher count of types of discriminatory experiences (AOR 1.54, 95% CI 1.12-2.12) and any gender-based discrimination in the past year (AOR 4.79, 95% CI 1.39-16.45) reported smoking more cigarettes now than 12 months ago. Associations of other past-year discrimination measures with other smoking outcomes were not significant. Compared to White SMW, any discrimination [B (SD) = 2.56 (0.83)] and a higher count of types of discriminatory experiences in the past year [B (SD) = 0.88 (0.31)] were associated with higher nicotine dependence scores in Black/African American SMW. Past-year discrimination are associated with smoking outcomes in SMW. Black/African American race moderated the associations of any past-year discrimination and a higher count of types of discriminatory experiences with nicotine dependence scores in SMW. Targeted interventions to mitigate the influence of discrimination on smoking among SMW are needed.

Mental Distress in the United States at the Beginning of the COVID-19 Pandemic.

Objectives. To assess the impact of the COVID-19 pandemic on mental distress in US adults.Methods. Participants were 5065 adults from the Understanding America Study, a probability-based Internet panel representative of the US adult population. The main exposure was survey completion date (March 10-16, 2020). The outcome was mental distress measured via the 4-item version of the Patient Health Questionnaire.Results. Among states with 50 or more COVID-19 cases as of March 10, each additional day was significantly associated with an 11% increase in the odds of moving up a category of distress (odds ratio = 1.11; 95% confidence interval = 1.01, 1.21; P = .02). Perceptions about the likelihood of getting infected, death from the virus, and steps taken to avoid infecting others were associated with increased mental distress in the model that included all states. Individuals with higher consumption of alcohol or cannabis or with history of depressive symptoms were at significantly higher risk for mental distress.Conclusions. These data suggest that as the COVID-19 pandemic continues, mental distress may continue to increase and should be regularly monitored. Specific populations are at high risk for mental distress, particularly those with preexisting depressive symptoms.

Comparing substance use and mental health outcomes among sexual minority and heterosexual women in probability and non-probability samples.

OBJECTIVE: To examine similarities and differences in demographics and key substance use and mental health outcomes in a probability sample of heterosexual women and two samples of sexual minority women (SMW), one recruited using probability and the other using non-probability methods. METHODS: Using data from four waves of the National Alcohol Survey (NAS; n = 315 SMW; 10,523 heterosexual women) and Wave 3 of the Chicago Health and Life Experiences of Women (CHLEW; n = 688 SMW) study, we examined hazardous drinking, drug use, tobacco use, depression, and help-seeking for alcohol or other drug problems. RESULTS: Compared to SMW in the probability sample, SMW in the non-probability sample were older, more likely to be college educated, and more likely to be in a partnered relationship. Compared to heterosexuals, SMW in both the probability and non-probability samples had greater odds of past-year hazardous drinking, marijuana use, and other drug use. We found similar results for lifetime help-seeking for alcohol or drug problems, past week depression, and co-occurring hazardous drinking and depression. In comparisons with heterosexual women, the magnitude of difference for drug use was greater for the SMW non-probability sample; for tobacco use, the difference was greater for the SMW probability sample. CONCLUSION: Given the difficulties recruiting probability samples of SMW, researchers will continue to use non-probability samples in the foreseeable future. Thus, understanding how findings may differ between probability and non-probability samples is critically important in advancing research on sexual-orientation-related health disparities.

Adolescent smoking: are infrequent and occasional smokers ready to quit?

We examined motivation for cessation and plans to quit among 945 high school students in 2001 at three levels of smoking frequency (regular, occasional, and infrequent). Surveys were completed at six Illinois high schools. In multivariate models, females (compared to males) and white students (compared to nonwhite students) were more likely to plan to quit, but plans to quit did not differ by smoking level. In multivariate models to predict motivation for cessation, regular smokers were significantly less motivated to quit than were occasional and infrequent smokers, and occasional smokers were less motivated than infrequent smokers; demographic variables were nonsignificant. Infrequent and occasional smokers are motivated to quit and intend to quit soon, making them an attractive target for cessation programs.

School-based smoking cessation programs for adolescents: what predicts attendance?

The present study examined contextual and individual predictors of attendance in a 10-session school-based teen smoking cessation program. Participants were 349 students at 29 Illinois high schools. Predictor variables included demographics, smoking history, psychosocial variables, and social environment variables. School-level characteristics of interest included proportion of low-income students, group size, and program timing. Overall attendance was predicted by higher motivation and less stress at baseline. Students also were more likely to attend if they had already tried to quit, were more dependent on nicotine, and had more positive smoking expectancies. Percentage of low-income students and program timing also predicted program attendance; students were more likely to attend the program at schools with lower percentages of low-income students and where the program was offered during the school day. We also examined predictors of attendance before and after quit week (week 5). Early in the program, only the school-level variables (program timing and percentage of low-income students) predicted attendance. After quit week, the school variables also were important, and baseline motivation and perceived stress also predicted attendance at these sessions. Results highlight the importance of individual characteristics in determining program participation, as well as the importance of considering school context and programmatic issues when planning school-based smoking cessation programs.