Abstract A022: “Let me smoke that”: Exploring combustible tobacco use and smoking cessation behavior among sexual minority young adult smokers in Washington, D.C.

Background: In the U.S., lesbian, gay, bisexual, and transgender individuals (LGBT) are medically underserved, understudied, and are often difficult for researchers to access due in part to risks to participation (i.e., discrimination and stigma). While evidence regarding combustible tobacco use among LGBT adults is relatively underdeveloped, significant health disparities exist in this population. LGBT young adults in particular are nearly twice as likely to use tobacco compared to their heterosexual and cisgender counterparts, indicating that LGBT smokers have higher rates of tobacco-related cancers, including lung cancer. Informed by the Theory of Planned Behavior, this qualitative pilot study explored in depth attitudes, subjective norms, and perceived behavioral control toward combustible tobacco product use and cessation behaviors among a sample of young adult LGB smokers residing in Washington, D.C. Methods: Semistructured face-to-face interviews were conducted with self-identified lesbian (n=1), gay (n=5), and bisexual (n=2) young adult smokers. Interviews were audio-recorded, transcribed, and analyzed using thematic analysis methodology. Digital audio recordings of the interviews were transcribed verbatim and edited to remove identifiers. Results: Participants ranged in age from 18 to 25 (M = 23.25, SD = 2.05). Five participants identified as African American and four identified as male. Three participants reported part-time employment and four reported that they “don’t meet basic expenses”. The mean age for cigarette smoking onset was 15.6. All participants reported menthol cigarette preference, four reported daily menthol cigarette use, and five reported past 30-day little cigar/cigarillo use. Attitudes, subjective norms, and perceived behavioral control toward combustible tobacco use and cessation behaviors fell under the broad themes of individual-level factors (self-image), psychosocial factors (stress and anxiety), socio-cultural factors (pro-smoking social norms), and stage of readiness. Intention to quit smoking in the next six months was low and influenced by pro-smoking attitudes and behaviors in the social environment surrounding LGBT young adults. Conclusions: Study findings contribute to a limited body of research investigating theoretically grounded variables related to combustible tobacco use among sexual minority young adult smokers. Multilevel cessation interventions are needed to address the psychosocial, socioeconomic, and cultural underpinnings of combustible tobacco use by distinct sexual identity. Additionally, study findings suggest opportunities to inform prevention campaigns like “This Free Life,” the Food and Drug Administration’s public education campaign designed to prevent and reduce tobacco use among LGBT young adults. Citation Format: Sabrina L Smiley. “Let me smoke that”: Exploring combustible tobacco use and smoking cessation behavior among sexual minority young adult smokers in Washington, D.C. [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr A022.