{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T16:00:20Z","timestamp":1784736020311,"version":"3.55.0"},"reference-count":52,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2022,7,27]],"date-time":"2022-07-27T00:00:00Z","timestamp":1658880000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100000026","name":"National Institute on Drug Abuse","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000026","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000025","name":"National Institutes of Mental Health","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100000025","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,1,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>Poly-tobacco use (PTU), or the concomitant use of two or more nicotine and tobacco products, are a growing public health concern. Adults reporting increased psychological distress (PD) experience profound nicotine and tobacco health-related disparities. Sexual minority (SM) adults report more PTU and higher levels of PD than heterosexuals, yet little is known about patterns of nicotine and tobacco use and its relationship to PD in SM populations.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Aims and Methods<\/jats:title>\n                  <jats:p>The purpose of this study was to investigate sexual identity differences in PD and PTU. Data were drawn from the 2016\u20132018 National Health Interview Survey (N = 83 017), an annual cross-sectional survey of a nationally representative sample of U.S. adults. PD was assessed using the Kessler Psychological Distress Scale (K6). We fit sex-stratified, weighted, adjusted logistic models to compare PTU and PD by sexual identity.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>PTU was more prevalent in adults with higher K6 scores. Female adults and SM adults had significantly higher K6 scores and were significantly more likely to experience serious PD when compared to their male and heterosexual counterparts.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>The current study provides a snapshot of trends in PTU in relation to PD, gender, and sexual identity. Findings suggest higher rates of both PD and PTU in SM adults. Further research examining the mechanisms underlying this disparity is critical to the development of effective intervention and prevention strategies.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Implications<\/jats:title>\n                  <jats:p>Little is known about sex and sexual identity differences in the relations between patterns of tobacco product use and PD. This study is the first to examine the effect of gender and sexual identity on both PD and PTU. SMs reported higher rates of PD and were more likely to be poly-tobacco users. As new ways of engaging nicotine\/tobacco continue to proliferate, health risks will endure especially for marginalized populations. An increased understanding of the psychological and social correlates of PTU in SMs is warranted.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ntr\/ntac180","type":"journal-article","created":{"date-parts":[[2022,7,27]],"date-time":"2022-07-27T11:31:21Z","timestamp":1658921481000},"page":"19-27","source":"Crossref","is-referenced-by-count":5,"title":["Sex and Sexual Identity Differences in Poly-tobacco Use and Psychological Distress in U.S. Adults: Results From the National Health Interview Survey"],"prefix":"10.1093","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3122-9217","authenticated-orcid":false,"given":"Leia A","family":"Harper","sequence":"first","affiliation":[{"name":"Department of Psychology, Reed College , Portland, OR , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kira C","family":"Beck","sequence":"additional","affiliation":[{"name":"Department of Psychology, Reed College , Portland, OR , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tess K","family":"Drazdowski","sequence":"additional","affiliation":[{"name":"Oregon Social Learning Center , Eugene, OR , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Psychology, Reed College , Portland, OR , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,7,27]]},"reference":[{"issue":"19","key":"2022120214144523100_CIT0001","doi-asserted-by":"crossref","first-page":"e937","DOI":"10.1161\/CIR.0000000000000669","article-title":"New and emerging tobacco products and the nicotine endgame: the role of robust regulation and comprehensive tobacco control and prevention: a presidential advisory from the American Heart Association","volume":"139","author":"Bhatnagar","year":"2019","journal-title":"Circulation."},{"issue":"11","key":"2022120214144523100_CIT0002","doi-asserted-by":"crossref","first-page":"1816","DOI":"10.1093\/ntr\/ntab084","article-title":"Global patterns and prevalence of dual and poly-tobacco use: a systematic review","volume":"23","author":"Chen","year":"2021","journal-title":"Nicotine Tob Res."},{"key":"2022120214144523100_CIT0003","article-title":"Follow the money: a closer look at us tobacco industry marketing expenditures","author":"Levy","year":"2021","journal-title":"medRxiv"},{"key":"2022120214144523100_CIT0004","doi-asserted-by":"crossref","first-page":"278","DOI":"10.1016\/j.addbeh.2018.11.003","article-title":"Polytobacco use and risk perceptions among young adults: the potential role of habituation to risk","volume":"90","author":"Leavens","year":"2019","journal-title":"Addict Behav."},{"issue":"45","key":"2022120214144523100_CIT0005","doi-asserted-by":"crossref","first-page":"1013","DOI":"10.15585\/mmwr.mm6845a2","article-title":"Tobacco product use and cessation indicators among adults\u2014United States, 2018","volume":"68","author":"Creamer","year":"2019","journal-title":"Morb Mortal Wkly Rep."},{"key":"2022120214144523100_CIT0006","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1016\/j.drugalcdep.2018.02.024","article-title":"Correlates of poly-tobacco use among youth and young adults: findings from the Population Assessment of Tobacco and Health study, 2013\u20132014","volume":"187","author":"Osibogun","year":"2018","journal-title":"Drug Alcohol Depend."},{"key":"2022120214144523100_CIT0007","doi-asserted-by":"crossref","first-page":"101032","DOI":"10.1016\/j.pmedr.2019.101032","article-title":"Do inequalities add up? 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