Sexual orientation and tobacco use in a cohort study of US adolescent girls and boys

OBJECTIVE: To examine sexual-orientation group disparities in tobacco use in adolescent girls and boys. DESIGN: Survey data from 10685 adolescent girls and boys participating in 1999 in the Growing Up Today Study were examined cross-sectionally. SETTING: Community-based population of adolescents living throughout the United States.Main Outcome Measure Prevalence of tobacco use. RESULTS: Ninety-two percent of the participants described themselves as heterosexual (n = 9296), 5% as mostly heterosexual (n = 511), 1% as lesbian/gay/bisexual (n = 103), and 2% as unsure (n = 226). Ages ranged from 12 to 17 years. Compared with heterosexuals, mostly heterosexual girls were 2.5 (95% confidence interval, 1.8-3.5), lesbian/bisexual girls were 9.7 (95% confidence interval, 5.1-18.4), and mostly heterosexual boys were 2.5 (95% confidence interval, 1.4-4.6) times more likely to smoke at least weekly. In contrast, gay/bisexual boys were not more likely to smoke. Findings persisted even when controlling for multiple sociodemographic and psychosocial covariates. CONCLUSION: Our findings indicate that mostly heterosexual adolescents of both sexes and lesbian/bisexual girls are at heightened risk for tobacco use.