Examining smoking and vaping behaviors, expectancies, and cessation outcomes between bisexual and heterosexual individuals

Abstract

Prior research indicates bisexual individuals have higher smoking and vaping rates and heightened vulnerability to negative health outcomes. Thus, we compared adult bisexual (n = 294) and heterosexual (n = 2412) participants enrolled in a smoking cessation trial on baseline smoking and vaping use behaviors, motivations, and expectancies/beliefs as well as follow-up smoking and vaping status. This is a secondary analysis of a large randomized controlled trial testing a smoking cessation intervention for dual users of combustible and electronic cigarettes (e-cigarettes) in the United States. Self-reported 7-day point prevalence smoking and vaping abstinence were collected at 3-, 12-, and 24-month assessments. Bisexual and heterosexual participants did not differ in sociodemographic variables or baseline smoking and vaping history and behavior. We found significant differences among bisexual and heterosexual individuals in smoking and vaping beliefs/expectancies. Specifically, bisexual participants expressed overall greater positive expectancies regarding smoking and vaping, such as smoking and vaping to reduce negative affect and stress. There were no differences in smoking at any follow-up assessment. Only at 3 months were bisexual individuals more likely to be abstinent from vaping and less likely to be dual users than heterosexual individuals. Despite similar smoking and vaping status over time, bisexual individuals reported greater positive expectancies regarding smoking and vaping. Our findings revealed few targets for tailoring cessation interventions to bisexual individuals; thus, it is possible that there may be greater utility in targeting the disparities in prevalence (i.e., via prevention efforts).

Keywords:

• bisexual
• electronic cigarettes
• sexual minority
• smoking
• vaping

Acknowledgments

The authors would like to thank the participants and all the research and administrative staff who helped conduct the parent study. Biostatistics and Bioinformatics Shared Resource and the Participant Research, Interventions, and Measurements Core Facility at the H. Lee Moffitt Cancer Center and Research Institute, and NCI designated Comprehensive Cancer Center.

Disclosure statement

Dr. Thomas H. Brandon has received research funding and medications from Pfizer, Inc., in previous studies and serves on the Advisory Board of Hava Health, Inc. All other coauthors report no conflicts of interest.

Data availability statement

The data that support the findings of this study are available from the corresponding author, UM, upon reasonable request.

Additional information

Funding

This work was supported by the National Institute on Drug Abuse of the National Institutes of Health (R01DA037961 to T.H.B). This work has also been supported in part by the Biostatistics and Bioinformatics Shared Resource and the Participant Research, Interventions, and Measurements Core Facility at the H. Lee Moffitt Cancer Center and Research Institute, an NCI designated Comprehensive Cancer Center (P30-CA076292). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.