Smoking behaviours among heterosexual and sexual minority youth? Findings from 15 years of provincially representative data

Jessica N. Fish, Ryan J. Watson, Jacqueline Gahagan, Carolyn M. Porta, Dominic Beaulieu-Prévost, Stephen T. Russell

Research output: Contribution to journalArticlepeer-review

17 Scopus citations


Introduction and Aims: Sexual identity disparities in smoking behaviours are well established; however, there is limited research on whether these disparities have diminished as the social and political landscape has changed for lesbian, gay and bisexual people. Thus, we examined changes in prevalence and sexual identity disparities in three smoking behaviours among Canadian adolescents from 1998 to 2013. Design and Methods: Data are from the provincially representative British Columbia Adolescent Health Survey (N = 99 373). Using sex-stratified, age-adjusted logistic regression models, we estimated: (i) trends in lifetime cigarette use, early onset, and past 30-day use for heterosexual and three subgroups of sexual minority (i.e. mostly heterosexual, bisexual and gay/lesbian) youth; (ii) sexual identity disparities in these cigarette-related behaviours within each survey year (1998, 2003, 2008, 2013); and (iii) whether the size of the disparity has changed from 1998 to 2013. Results: Smoking has declined for all youth from 1998 to 2013, although less consistently for sexual minority youth. Within-year disparity estimates indicated elevated prevalence of cigarette use for sexual minority compared to heterosexual youth, particularly among females. Trends in sexual identity and smoking behaviours indicated that the degree of differences between heterosexual and sexual minority youth have remained stable or, in some cases, widened. Heterosexual and sexual minority youth differences widened for early onset among sexual minority boys and lifetime and past 30-day use for sexual minority girls. Discussion and Conclusions: Efforts to prevent smoking behaviours among youth should continue. Tailored preventive strategies for sexual minority youth might help address existing disparities.

Original languageEnglish (US)
Pages (from-to)101-110
Number of pages10
JournalDrug and Alcohol Review
Issue number1
StatePublished - Jan 2019

Bibliographical note

Funding Information:
This study was funded by grants #CPP 86374 and #MOP 119472 (awarded to Dr Elizabeth Saewyc) from the Canadian Institutes of Health Research. The authors acknowledge the McCreary Centre Society ( for access to the British Columbia Adolescent Health Survey, and Dr Elizabeth Saewyc for her leadership related to the data collection, paper conceptualisation and other various mentorship for this project. JNF was funded by the National Institute on Alcohol Abuse and Alcoholism, F32AA023138. JNF and STR also received support from grant P2CHD042849, Population Research Center, awarded to the Population Research Center at The University of Texas at Austin by the Eunice Kennedy Shriver National Institute of Child Health and Human Development. JNF gratefully acknowledges support from the Eunice Kennedy Shriver National Center for Child Health and Human Development grant P2C-HD041041, Maryland Population Research Center. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. STR also acknowledges support from the Priscilla Pond Flawn Endowment at the University of Texas at Austin.

Publisher Copyright:
© 2018 Australasian Professional Society on Alcohol and other Drugs


  • LGB
  • adolescents
  • sexual minority
  • smoking behaviours
  • tobacco use


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