A review of research on smoking behavior in three demographic groups of veterans: women, racial/ethnic minorities, and sexual orientation minorities

ABSTRACT

Background: Veterans comprise a large segment of the U.S. population and smoke at high rates. One significant way to reduce healthcare costs and improve the health of veterans is to reduce smoking-related illnesses for smokers who have high smoking rates and/or face disproportionate smoking consequences (e.g. women, racial/ethnic minorities, sexual orientation minorities). Objectives: We reviewed published studies of smoking behavior in three demographic subgroups of veterans – women, racial/ethnic minorities, and sexual orientation minorities – to synthesize current knowledge and identify areas in need of more research. Methods: A MEDLINE search identified papers on smoking and veterans published through 31 December 2014. Results: Twenty-five studies were identified that focused on gender (n = 17), race/ethnicity (n = 6), or sexual orientation (n = 2). Female and sexual orientation minority veterans reported higher rates of smoking than non-veteran women and sexual orientation majority veterans, respectively. Veterans appeared to be offered VA smoking cessation services equally by gender and race. Few studies examined smoking behavior by race/ethnicity or sexual orientation. Little information was identified examining the outcomes of specific smoking treatments for any group. Conclusion: There is a need for more research on all aspects of smoking and quit behavior for women, racial/ethnic minorities, and sexual orientation minority veterans. The high rates of smoking by these groups of veterans suggest that they may benefit from motivational interventions aimed at increasing quit attempts and longer and more intense treatments to maximize outcomes. Learning more about these veterans can help reduce costs for those who experience greater consequences of smoking.

KEYWORDS:

• Review
• smoking
• tobacco
• veterans
• gender
• race
• sexual orientation

Acknowledgements

The authors thank Joan Weinberger for her assistance in reviewing drafts of this manuscript.

Funding

This work was supported by the VISN 1 New England Mental Illness Research, Education and Clinical Center.

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this paper.

Additional information

Funding

This work was supported by the VISN 1 New England Mental Illness Research, Education and Clinical Center.