Rebecca J Evans-Polce1, Danielle M Smith2, Philip Veliz3, Carol J Boyd4, Sean Esteban McCabe5. 1. Center for the Study of Drugs, Alcohol, Smoking and Health Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, Ann Arbor, MI, USA. Electronic address: bjevans@umich.edu. 2. Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA. 3. Center for the Study of Drugs, Alcohol, Smoking and Health Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, Ann Arbor, MI, USA; Institute for Social Research, University of Michigan, Ann Arbor, MI, USA. 4. Center for the Study of Drugs, Alcohol, Smoking and Health Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, Ann Arbor, MI, USA; Institute for Research on Women and Gender, University of Michigan, Ann Arbor, MI, USA; Addiction Center, Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA. 5. Center for the Study of Drugs, Alcohol, Smoking and Health Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, Ann Arbor, MI, USA; Institute for Social Research, University of Michigan, Ann Arbor, MI, USA; Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, USA; Institute for Research on Women and Gender, University of Michigan, Ann Arbor, MI, USA; Rogel Cancer Center, University of Michigan, Ann Arbor, MI, USA; Center for Sexuality and Health Disparities, School of Nursing, University of Michigan, Ann Arbor, MI, USA.
Abstract
BACKGROUND: Sexual minority women are consistently at increased risk for tobacco use compared to heterosexual women. Neither biomarkers of nicotine exposure nor biomarkers of tobacco toxicant exposure have been examined by sexual identity. METHODS: This study used interview and biomarker data from women in the biomarker core sample of Wave 1 of the Population Assessment of Tobacco and Health (PATH) study (2013-2014; n = 4930). We examined associations of sexual identity with nicotine exposure (measured with urinary cotinine and TNE-2) and with tobacco-specific nitrosamines (measured with urinary NNAL). Multivariable regression modeling was used to examine these associations among the full biomarker core sample, among past 30-day tobacco users, and among exclusive established cigarette users before and after controlling for tobacco use quantity and intensity. RESULTS: In the full biomarker sample of women, prior to adjusting for tobacco use quantity and intensity, bisexual women had significantly higher cotinine, TNE-2, and NNAL levels compared to heterosexual women. Among exclusive established cigarette users, gay/lesbian women had significantly higher NNAL compared to heterosexual women prior to adjusting for tobacco quantity and intensity. No differences by sexual identity were found after adjusting for tobacco use quantity and intensity. CONCLUSIONS: This is the first study to demonstrate differences in biological markers of tobacco exposure by sexual identity among women in the U.S. This has important public health implications as greater exposure to both nicotine and to tobacco-specific nitrosamines are strongly linked to cancer risk.
BACKGROUND: Sexual minority women are consistently at increased risk for tobacco use compared to heterosexual women. Neither biomarkers of nicotine exposure nor biomarkers of tobacco toxicant exposure have been examined by sexual identity. METHODS: This study used interview and biomarker data from women in the biomarker core sample of Wave 1 of the Population Assessment of Tobacco and Health (PATH) study (2013-2014; n = 4930). We examined associations of sexual identity with nicotine exposure (measured with urinary cotinine and TNE-2) and with tobacco-specific nitrosamines (measured with urinary NNAL). Multivariable regression modeling was used to examine these associations among the full biomarker core sample, among past 30-day tobacco users, and among exclusive established cigarette users before and after controlling for tobacco use quantity and intensity. RESULTS: In the full biomarker sample of women, prior to adjusting for tobacco use quantity and intensity, bisexual women had significantly higher cotinine, TNE-2, and NNAL levels compared to heterosexual women. Among exclusive established cigarette users, gay/lesbian women had significantly higher NNAL compared to heterosexual women prior to adjusting for tobacco quantity and intensity. No differences by sexual identity were found after adjusting for tobacco use quantity and intensity. CONCLUSIONS: This is the first study to demonstrate differences in biological markers of tobacco exposure by sexual identity among women in the U.S. This has important public health implications as greater exposure to both nicotine and to tobacco-specific nitrosamines are strongly linked to cancer risk.
Authors: Cindy M Chang; Selvin H Edwards; Aarthi Arab; Arseima Y Del Valle-Pinero; Ling Yang; Dorothy K Hatsukami Journal: Cancer Epidemiol Biomarkers Prev Date: 2016-11-09 Impact factor: 4.254
Authors: Bradley T Kerridge; Roger P Pickering; Tulshi D Saha; W June Ruan; S Patricia Chou; Haitao Zhang; Jeesun Jung; Deborah S Hasin Journal: Drug Alcohol Depend Date: 2016-11-07 Impact factor: 4.492
Authors: Erin A Vogel; Johannes Thrul; Gary L Humfleet; Kevin L Delucchi; Danielle E Ramo Journal: Health Psychol Date: 2018-11-29 Impact factor: 4.267
Authors: Maciej L Goniewicz; Danielle M Smith; Kathryn C Edwards; Benjamin C Blount; Kathleen L Caldwell; Jun Feng; Lanqing Wang; Carol Christensen; Bridget Ambrose; Nicolette Borek; Dana van Bemmel; Karen Konkel; Gladys Erives; Cassandra A Stanton; Elizabeth Lambert; Heather L Kimmel; Dorothy Hatsukami; Stephen S Hecht; Raymond S Niaura; Mark Travers; Charles Lawrence; Andrew J Hyland Journal: JAMA Netw Open Date: 2018-12-07