Differences in Tobacco Advertising Receptivity Among Young Adults by Sexual Identity and Sex: Findings From the Population Assessment of Tobacco and Health Study

Abstract

Tobacco use is disproportionately high among sexual minorities (i.e., lesbian/gay and bisexual [LGB] individuals). Receptivity to tobacco advertising is an established risk factor for tobacco use among the general population, yet little research has assessed how receptivity to tobacco advertising differs based on sexual identity and sex. Additionally, studies often fail to distinguish between LGB identities, creating a monolith of sexual identity that ignores different underlying risk factors and behaviors. This study examined differences in receptivity to advertising of five tobacco product categories (any tobacco, cigarettes, cigars, e-cigarettes, and smokeless tobacco) between straight/heterosexual and lesbian/gay, and bisexual (LGB) young adults by sex. We used data from Wave 1 of the Population Assessment of Tobacco and Health Study Restricted Use File. Analyses were limited to young adults (aged 18–24) with complete data on sexual identity (n= 8,839). Multivariable logistic regressions examined the association between receptivity and sexual identity, controlling for demographics, past 30-day tobacco use, and media use, stratified by sex. In the multivariable models, gay males had higher odds of receptivity to cigar advertising and gay and bisexual males had higher odds of receptivity to e-cigarette advertising, compared with straight/heterosexual males. Compared with straight/heterosexual females, bisexual females had higher odds of receptivity to advertising for all products; lesbian/gay females had higher odds of receptivity to any tobacco advertising. In conclusion, our study identified elevated receptivity to tobacco marketing among sexual minorities—particularly sexual minority women. More research is needed to understand the sources of exposure to tobacco advertising and the reasons for elevated receptivity among LGB individuals.