Patterns of Vaping and Smoking by Sexual Orientation and Age Group after Tobacco 21 Implementation

• In Event: Uneven Impacts of Universal Policies related to Health and Economic Equity

Abstract

In December 2019, federal Tobacco 21 (T21) raised the federal minimum legal sales age to purchase tobacco products from age 18 to age 21. The objective of this study was to estimate current tobacco use, including vaping and smoking status, following implementation of T21 policy stratified by age group and sexual orientation. Data come from the 2021-2023 Behavioral Risk Factor Surveillance System. We used logistic regression models to estimate the marginal effect on the interaction between sexual orientation and age group to estimate unadjusted prevalences of vaping and smoking. The analytic sample included n= 596,197 respondents, 8.5% (survey weighted) of whom identified as sexual minority, representing 100 million adults living in 25 states. Among respondents ages 18-20 impacted by Tobacco 21, sexual minority young adults were 29% more likely to report vaping20.6% versus 15.9%); and 70% more likely to report smoking (5.8% versus 3.4%) compared to heterosexual peers. We also find that disparities in early adulthood likely widen over the life course. Current tobacco use peaked in older age groups among sexual minority adults with 32.6% among respondents between ages 40-44, compared to heterosexual adults with 23.4% among respondents between ages 21-24. After implementation of T21, sexual minority populations continued to report higher levels of current tobacco use compared to heterosexual peers of all age groups. Disparities in current tobacco use were present in early adulthood driven by vaping and were widest in mid-life driven by smoking.

Author

• Nathaniel M Tran, University of Illinois, Chicago
  Presenting Author