Cigarette smoking is significantly more prevalent among gay men than in the general adult male population, underscoring a need for anti-smoking campaigns that target gays, say researchers at the University of California, San Francisco.
In a new study published in the December issue of the American Journal of Public Health, the UCSF team reports 48 percent of gay men in the research survey smoked, compared to an overall rate of 27 percent among U.S. men. The study involved 2,600 self-identified gay or bisexual men.
In addition to smoking prevalence, the study looked at related behavioral, socio-economic, and health factors, such as heavy drinking, frequenting gay bars, educational background, and HIV status. The study was designed and conducted by a research team from the UCSF Center for AIDS Prevention Studies.
"This study yielded findings that showed, at least in the early 1990s, about half of all gay men smoked tobacco, and one possible interpretation is that current tobacco prevention efforts designed for men in general are failing gay men," said Ron Stall, PhD, lead author and associate professor with UCSF CAPS.
"Even among the youngest participants in our study-ages 18 to 24-the smoking prevalence rate was 50 percent, which suggests that smoking will be a danger to gay men's health for many, many more years. The time has now come to consider how we can design tobacco prevention and cessation campaigns that would work specifically for gay men," Stall added.
If future public health interventions are to be effective, additional research is needed on a number of issues particular to gay men who smoke, including psycho-social factors such as the effect of the AIDS epidemic, noted co-author Thomas J. Coates, PhD, director of UCSF CAPS and executive director of the UCSF AIDS Research Institute.
"In this study alone, we saw a correlation between smoking and those who experienced a loss to AIDS, so we know a targeted message must integrate several complicated issues," he said. He also emphasized the need to include smoking prevention and cessation, HIV prevention, and substance use issues into a comprehensive gay and lesbian health agenda.
Gay and bisexual men taking part in the study were recruited in Portland, Ore., and Tucson, Ariz., in 1992. Ranging in age from 18 to about 65 years, participants represented white, African American, Hispanic, Native American, and Asian/Pacific Islander ethnic groups. Their information was compared with 1994 epidemiological data from the Centers for Disease Control and Prevention for the general male population.
Among the research findings:
- In both gay men and men in general, a higher educational level was associated with lower incidence of smoking. However, gay men at all educational levels had a higher smoking incidence, with gay male college graduates smoking at rates near those of high school graduates in the general male population.
- Smoking rates were lowest among the oldest men in both groups.
- White, African American, and Hispanic gay men were more likely to smoke than their counterparts in the general male group.
- Among gay men, those more likely to smoke were associated with heavy drinking, frequent attendance at gay bars, and an AIDS-related loss.
- Gay men less likely to smoke were associated with better health, HIV-negative or unknown HIV status, a regular exercise regimen, eating a healthy breakfast, graduation from college, and higher income.
Study co-authors are Gregory L. Greenwood, PhD, MPH; Michael Acree, PhD; and Jay Paul, PhD, all of UCSF CAPS.
The study was funded by the National Institute of Mental Health and the Tobacco- Related Diseases Research Program of the University of California.
UCSF CAPS is part of the UCSF AIDS Research Institute, a campuswide enterprise without walls that encompasses all UCSF AIDS programs under a single umbrella and includes close to 1,000 investigators. The UCSF ARI is dedicated to cutting edge advances in HIV clinical care, prevention and health services, policy, immune reconstitution, and vaccine development.
Journal
American Journal of Public Health