Scoping review of smoking trend disparities over time in LGBTQ population

Abstract

BACKGROUND: Tobacco use is a major health disparity for lesbian, gay, bisexual, transgender, and queer (LGBTQ) individuals compared to their straight and cisgender counterparts. We asked (a) is this inequity getting better or worse over time and (b) are trends in disparities different between LGBTQ populations?

METHODS: We conducted a scoping review of papers focusing on youth and adult tobacco use and LGBTQ identity by searching five databases in August 2021. Two reviewers independently coded the title and abstract of 2,107 records for inclusion and then coded the full text of 35 records.

RESULTS: Ten studies were included and consistently demonstrated tobacco disparities for LGB samples. No studies examined trends in disparities for gender minority populations, and only one study examined tobacco use disparities by race, with mixed results. Regarding youth, the size of disparity in heavy or daily use for all LGB subgroups compared to heterosexual samples is shrinking longitudinally. Results for early-onset, current, and lifetime smoking were less consistent. Regarding adults, evidence was relatively sporadic; however, after 2010, studies consistently show decreases in disparity longitudinally.

DISCUSSION: Large inequities remain in tobacco use for LGB populations, although encouragingly, trends in the size of tobacco use disparities may be decreasing for some groups. However, the results are not consistent across all groups and measures of tobacco. More evidence is needed, particularly with larger samples, studies in trends in e-cigarette products, and studies in trends by race/ethnicity/gender. Comprehensive interventions are needed to address LGB smoking as an understanding would help efforts in reducing disparities.