Mental Health Correlates of Cigarette Use in LGBT Individuals in the Southeastern United States

Christopher F. Drescher, Eliot J. Lopez, James A. Griffin, Thomas M. Toomey, Elizabeth D. Eldridge, Lara M. Stepleman

Research output: Contribution to journalArticlepeer-review

7 Scopus citations


Background: Smoking prevalence for lesbian, gay, bisexual, and transgender (LGBT) individuals is higher than for heterosexual, cisgender individuals. Elevated smoking rates have been linked to psychiatric comorbidities, substance use, poverty, low education levels, and stress. Objectives: This study examined mental health (MH) correlates of cigarette use in LGBT individuals residing in a metropolitan area in the southeastern United States. Methods: Participants were 335 individuals from an LGBT health needs assessment (mean age 34.7; SD = 13.5; 63% gay/lesbian; 66% Caucasian; 81% cisgender). Demographics, current/past psychiatric diagnoses, number of poor MH days in the last 30, the Patient Health Questionnaire (PHQ) 2 depression screener, the Three-Item Loneliness Scale, and frequency of cigarette use were included. Analyses included bivariate correlations, analysis of variance (ANOVA), and regression. Results: Multiple demographic and MH factors were associated with smoker status and frequency of smoking. A logistic regression indicated that lower education and bipolar disorder were most strongly associated with being a smoker. For smokers, a hierarchical regression model including demographic and MH variables accounted for 17.6% of the variance in frequency of cigarette use. Only education, bipolar disorder, and the number of poor MH days were significant contributors in the overall model. Conclusions/Importance: Less education, bipolar disorder, and recurrent poor MH increase LGBT vulnerability to cigarette use. Access to LGBT-competent MH providers who can address culturally specific factors in tobacco cessation is crucial to reducing this health disparities.

Original languageEnglish (US)
Pages (from-to)891-900
Number of pages10
JournalSubstance Use and Misuse
Issue number6
StatePublished - May 12 2018


  • LGBT
  • cigarette use
  • education
  • health disparities
  • mental health

ASJC Scopus subject areas

  • Health(social science)
  • Public Health, Environmental and Occupational Health
  • Psychiatry and Mental health
  • Medicine (miscellaneous)


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