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BMC Public Health

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Open Access 01-12-2014 | Research article

Sexual orientation, social capital and daily tobacco smoking: a population-based study

Authors: Martin Lindström, Jakob Axelsson, Birgit Modén, Maria Rosvall

Published in: BMC Public Health | Issue 1/2014

Abstract

Background

Studies have suggested poorer health in the homosexual and bisexual groups compared to heterosexuals. Tobacco smoking, which is a health-related behavior associated with psychosocial stress, may be one explanation behind such health differences. Social capital, i.e. the generalized trust in other people and social participation/social networks which decreases the costs of social interaction, has been suggested to affect health through psychosocial pathways and through norms connected with health related behaviours, The aim of this study is to investigate the association between sexual orientation and daily tobacco smoking, taking social capital into account and analyzing the attenuation of the logit after the introduction of social participation, trust and their combination in the models.

Methods

In 2008 a cross-sectional public health survey was conducted in southern Sweden with a postal questionnaire with 28,198 participants aged 18–80 (55% participation rate). This study was restricted to 24,348 participants without internally missing values on all included variables. Associations between sexual orientation and tobacco smoking were analyzed with logistic regression analysis.

Results

Overall, 11.9% of the men and 14.8% of the women were daily tobacco smokers. Higher and almost unaltered odds ratios of daily smoking compared to heterosexuals were observed for bisexual men and women, and for homosexual men throughout the analyses. The odds ratios of daily smoking among homosexual women were not significant. Only for the “other” sexual orientation group the odds ratios of daily smoking were reduced to not significant levels among both men and women, with a corresponding 54% attenuation of the logit in the “other” group among men and 31.5% among women after the inclusion of social participation and trust. In addition, only the “other” sexual orientation group had higher odds ratios of low participation than heterosexuals.

Conclusions

Bisexual men and women and homosexual men, but not homosexual women, are daily smokers to a higher extent than heterosexuals. Only for the “other” sexual orientation group the odds ratios of daily smoking were reduced to not significant levels after adjustments for covariates including trust and social participation.

Kertzner RM, Meyer IH, Frost DM, Stirratt MJ: Social and psychological well-being in lesbians, gay men, and bisexuals: the effects of race, gender and sexual identity. Am J Orthopsychiatry. 2009, 79 (4): 500-510.CrossRefPubMedPubMedCentral

Grella CE, Greenwell LM, Mays VM, Cochran SD: Influence of gender, sexual orientation, and need on treatment utilization for substance use and mental disorders: findings from the California Quality of Life Survey. BMC Psychiatry. 2009, 9: 52-10.1186/1471-244X-9-52.CrossRefPubMedPubMedCentral

Hyde Z, Comfort J, McManus A, Brown G, Howat P: Alcohol, tobacco and illicit drug use amongst same-sex attracted women: results from the Western Australian Lesbian and Bisexual Women’s Health and Well-being Survey. BMC Public Health. 2009, 9: 317-10.1186/1471-2458-9-317.CrossRefPubMedPubMedCentral

King M, McKeown E, Warner J, Ramsay A, Johnson K, Cort C, Wright L, Blizard R, Davidson O: Mental health and quality of life of gay men and lesbians in England and Wales: controlled, cross-sectional study. Br J Psychiatry. 2003, 183: 552-558. 10.1192/bjp.183.6.552.CrossRefPubMed

Danielsson M: Folkhälsorapport 2009 (only in Swedish). 2009, Stockholm: Socialstyrelsen

Berg-Kelly K: Adolescent homosexuality: we need to learn more about causes and consequences. Acta Paediatr. 2003, 92: 141-144.CrossRefPubMed

Axelsson J, Modén B, Rosvall M, Lindström M: Sexual orientation and self-rated health: the role of social capital, offence, threat of violence, and violence. Scand J Public Health. 2013, 41: 508-515. 10.1177/1403494813476159.CrossRefPubMed

Berglund D, Bergsröm K, Nilsson K: Levnadsvanor. Lägesrapport 2011. 2012, Östersund: Statens Folkhälsoinstitut Rapport A, 03; 2012

Kabir Z, Keogan S, Clarke V, Clancy L: Second-hand tobacco smoke exposure levels and tobacco consumption patterns among a lesbian, gay, bisexual and transgender community in Ireland. Public Health. 2013, 127: 467-472. 10.1016/j.puhe.2013.01.021.CrossRefPubMed

10.

Dilley JA, Maher JE, Boysun MJ, Pizacani BA, Mosbaek CH, Rohde K, Stark MJ, Simmons KW, Pickle KE, Tang H, Greenwood GL, Cowling DW, Lloyd JC, Roeseler AG, Bal DG: Cigarette smoking among lesbians, gays, and bisexuals: How serious is the problem? Letter to the Editor. Cancer Causes Control. 2005, 16 (9): 1133-1134. 10.1007/s10552-005-0395-2.CrossRefPubMed

11.

Gruskin EP, Hart S, Gordon N, Ackerson L: Patterns of cigarette smoking and alcohol use among lesbian and bisexual women enrolled in a large health maintenance organization. Am J Public Health. 2001, 91 (6): 976-979.CrossRefPubMedPubMedCentral

12.

Dibble SL, Roberts SA, Nussey B: Comparing breast cancer risk between lesbians and their heterosexual sisters. Women’s Health Issues. 2004, 14: 60-68. 10.1016/j.whi.2004.03.004.CrossRefPubMed

13.

King M, Nazareth I: The health of people classified as lesbian, gay and bisexual attending family practitioners in London: a controlled study. BMC Public Health. 2006, 6: 127-10.1186/1471-2458-6-127.CrossRefPubMedPubMedCentral

14.

Hagger Johnson G, Taibjee R, Semlyen J, Fitchie I, Fish J, Meads C, Varney J: Sexual orientation identity in relation to smoking history and alcohol use at age 18/19: cross-sectional associations from the Longitudinal Study of Young People in England (LSYPE). BMJ Open. 2013, 8: 3-

15.

Jarvis MJ: Patterns and predictors of unaided smoking cessation in the general population. The Tobacco Epidemic, Vol. 28. Edited by: Bolliger CT, Fagerström KO. 1997, Basel: Karger, 151-164.CrossRef

16.

Jarvis MJ, Wardle J: Social patterning of individual health behaviours: the case of cigarette smoking. Social Determinants of Health. Edited by: Marmot M, Wilkinson RG. 2006, Oxford: Oxford University Press, 224-237. 2

17.

Lindström M, Hanson BS, Östergren P-O, Berglund G: Socioeconomic differences in smoking cessation: The role of social participation. Scand J Public Health. 2000, 28: 200-208. 10.1080/140349400444904.CrossRefPubMed

18.

Lindström M, Sundquist J: Ethnic differences in daily smoking in Malmö, Sweden: Varying influence of psychosocial and economic factors. Eur J Public Health. 2002, 12 (4): 287-294. 10.1093/eurpub/12.4.287.CrossRefPubMed

19.

Ali SM, Chaix B, Merlo J, Rosvall M, Wamala S, Lindström M: Gender differences in smoking prevalence in different age strata: A population-based study in southern Sweden. Scand J Public Health. 2009, 37 (2): 146-152. 10.1177/1403494808100274.CrossRefPubMed

20.

Bourdieu P, Wacquant L: Invitation to Reflexive Sociology. 1992, Chicago: Chicago University Press

21.

Portes A: Social capital: Its origins and applications in modern sociology. Annu Rev Sociol. 1998, 24: 1-24. 10.1146/annurev.soc.24.1.1.CrossRef

22.

Coleman JS: Foundations of Social Theory. 1990, Cambridge, Mass, and London England: The Belknap Press of Harvard University Press

23.

Putnam RD, Leonardi R, Nanetti RY: Making Democracy Work. Civic Traditions in Modern Italy. 1993, Princeton, New Jersey: Princeton University Press

24.

Kawachi I, Kennedy BP, Glass R: Social capital and self-rated health: a contextual analysis. Am J Public Health. 1999, 89: 1187-1193. 10.2105/AJPH.89.8.1187.CrossRefPubMedPubMedCentral

25.

Lindström M: Social capital and the miniaturization of community among daily and intermittent smokers: A population-based study. Prev Med. 2003, 36 (2): 177-184. 10.1016/S0091-7435(02)00049-X.CrossRefPubMed

26.

Lindström M, Moghaddassi M, Bolin K, Lindgren B, Merlo J: Social capital and daily tobacco smoking: A population-based multilevel analysis in Malmö. Sweden Scand J Public Health. 2003, 31 (6): 444-450. 10.1080/14034940310006203.CrossRefPubMed

27.

Giordano GN, Lindström M: The impact of social capital on changes in smoking behaviour-a longitudinal cohort study. Eur J Public Health. 2011, 21 (3): 347-354. 10.1093/eurpub/ckq048.CrossRefPubMed

28.

Norusis MJ: SPSS for Windows Advanced Statistics. Release 20.0. 2012, Chicago: SPSS

29.

Scott J, Marshall G: Oxford Dictionary of Sociology. 2005, Oxford: Oxford University Press, Third Edition

30.

Homosexuellas, bisexuellas och transpersoner hälsosituation: The Health Situation of homosexuals, bisexuals and transgender persons. 2005, Stockholm: Statens Folkhälsoinstitut (National Institute of Public Health), 19-

31.

Putnam RD: Bowling Alone. The Collapse and Revival of American Community. 2000, New York: Simon and Schuster

32.

Hublet A, De Bacquer D, Valimaa R, Godeau E, Schmid H, Rahav G, Maes L: Smoking trends among adolescents from 1990 to 2000 in ten European countries and Canada. BMC Public Health. 2006, 10 (6): 280-CrossRef

33.

Giordano GN: Social Capital and Self-Rated Health. Testing Association with Longitudinal and Multilevel Methodologies. Doctoral Dissertation. 2012, Malmö: Lund University

34.

Lindström M: Does social capital include trust? Commentary on Carpiano and Fitterer (2014). Soc Sci Med. 2014, in press

35.

Carlsson F, Merlo J, Lindström M, Östergren PO, Lithman T: Representativity of a postal questionnaire survey in Sweden, with special reference to ethnic differences in participation. Scand J Public Health. 2006, 34 (2): 132-139. 10.1080/14034940510032284.CrossRefPubMed

36.

Lindström M, Fridh M, Rosvall M: Economic stress in childhood and adulthood, and poor psychological health: Three life course hypotheses. Psychiatry Res. 2014, 215: 386-393. 10.1016/j.psychres.2013.11.018.CrossRefPubMed

37.

Boström G, Roth N, Nykvist K: Hälsa på lika villkor? Hälsa och livsvillkor bland hbt-personer. 2006, Stockholm: Statens Folkhälsoinstitut, 08-Rapport 2006

38.

Steffensen FH, Lauritzen T, Sörensen HT: Validity of self-reported smoking habits. Scand J Prim Health Care. 1995, 13: 236-237. 10.3109/02813439508996767.CrossRefPubMed

39.

Wells AJ, English PB, Posner SE, Wagenknecht LE, Perez-Stable EJ: Classification rates for current smokers misclassified as non-smokers. Am J Public Health. 1998, 88: 1503-1509. 10.2105/AJPH.88.10.1503.CrossRefPubMedPubMedCentral

The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1471-2458/14/565/prepub

Title: Sexual orientation, social capital and daily tobacco smoking: a population-based study
Authors: Martin Lindström
Jakob Axelsson
Birgit Modén
Maria Rosvall
Publication date: 01-12-2014
Publisher: BioMed Central
Published in: BMC Public Health / Issue 1/2014
Electronic ISSN: 1471-2458
DOI: https://doi.org/10.1186/1471-2458-14-565

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Sexual orientation, social capital and daily tobacco smoking: a population-based study

Abstract

Background

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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