The Role of Sex and Sexual Orientation and Gender Identity in Smoking and Smoking Cessation Among Adults in the Hispanic Community Health Study/Study of Latinos.

PURPOSE We examined smoking and smoking cessation by sex assigned at birth and sexual orientation and gender identity (SOGI) among Hispanic/Latino adults.

METHODS We used data from visit 1 (2008-2011), visit 2 (2014-2017), and visit 3 (2020-2024) of the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). Our analysis focused on participants (N = 8847) who responded to SOGI questions at visit 3 and provided data on smoking measures at visits 1-3. Accounting for survey design and weights, we estimated logistic regression models of associations between SOGI status and current smoking at visit 1. We also estimated discrete time models of associations between SOGI status and smoking cessation by visit 3.

RESULTS In analyses adjusted for sociodemographic covariates, male sexual and gender minority (SGM) participants had 40% reduced odds of smoking compared with male cisgender heterosexual participants (95% confidence interval [CI]: 0.36-1.00). However, female SGM participants had 2.72 (95% CI: 1.92-3.86) times the odds of smoking compared with female cisgender heterosexual participants. In contrast, we found no significant differences in smoking cessation between male SGM and cisgender heterosexual participants or between female SGM and cisgender heterosexual participants. For all HCHS/SOL participants, the likelihood of cessation increased over time and increased the most for those with more than a high school education.

CONCLUSION SGM females had high rates of current smoking and were as unlikely to quit as other participants. Thus, prevention of smoking initiation is critical. Programs to prevent smoking among Hispanic/Latino individuals should be designed with consideration of differences by sex and SOGI status.