Sexual Orientation, Tobacco Use, and Tobacco Cessation Treatment-Seeking: Results From a National U.S. Survey.

Despite higher rates of tobacco use and smoking-related diseases among sexual minorities, tobacco cessation treatment-seeking behaviors (e.g., medication, nicotine replacement products) remain poorly understood across sexual orientation subgroups. This study examines tobacco cessation treatment-seeking behaviors associated with tobacco use disorder (TUD) across the three major sexual orientation dimensions (identity, attraction, behavior) in U.S. adults. Prevalence estimates reflect data collected from a 2012-2013 national sample of adults 18 years and older. More than three-fourths of U.S. adults with TUD had never engaged in tobacco cessation treatment-seeking behaviors, regardless of sexual orientation. Despite having the highest rates of TUD, bisexual men and women had some of the lowest rates of tobacco cessation treatment-seeking. Men who identified as gay, reported same-sex attraction, or reported same-sex behaviors had the highest rates of tobacco cessation treatment-seeking. In contrast, women with same-sex attraction or same-sex behavior had higher rates of TUD but were less likely to engage in tobacco cessation treatment-seeking behaviors than women with only other-sex attraction or other-sex behavior, respectively. Heterosexual women were more likely to engage in tobacco cessation treatment-seeking than heterosexual men; this sex difference was not present for sexual minorities. Medications and nicotine replacement therapy products were the most prevalent forms of treatment-seeking. There were notable differences in tobacco cessation treatment-seeking behaviors based on sex and sexual orientation. Findings highlight the underutilization of tobacco cessation treatment-seeking among all U.S. adults and point to important factors to consider when working with sexual minorities who are trying to reduce or stop using tobacco.