{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,3]],"date-time":"2026-04-03T07:55:44Z","timestamp":1775202944184,"version":"3.50.1"},"reference-count":32,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2019,1,13]],"date-time":"2019-01-13T00:00:00Z","timestamp":1547337600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of School Health"],"published-print":{"date-parts":[[2019,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>BACKGROUND<\/jats:title><jats:p>Tobacco, alcohol, and illicit drug use among lesbian, gay, and bisexual (LGB) high school students as well as related environment and school\u2010level risk and protective factors were examined.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>Data was acquired from the 2015 CDC's Youth Behavior Risk Survey for Kentucky (N\u2009=\u20092577). Prevalence of substance use was calculated for all high school respondents by reported sexual orientation. Multivariate analyses estimated the relationship between school and environmental\u2010level factors (eg, having an adult to talk to) and tobacco, alcohol, and illicit drug use via logistic regressions. Sexual orientation, gender, age, and race\/ethnicity were covariates.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>LGB students used tobacco, alcohol, and illicit drugs more frequently than their heterosexual counterparts. More LGB teens report facing school risk factors (eg, 37% LGB vs 20% heterosexual bullied at school, p\u2009\u2264\u2009.001; 17% LGB vs 5% heterosexual ever threatened or injured at school, p\u2009&lt;\u2009.001; 13% LGB vs 7% heterosexual involved in a school fight, p\u2009=\u2009.001). Adjusting for school related risk factors, having an adult to talk to was associated with a reduced likelihood of daily smoking (adjusted odds ratio [aOR]: 0.43; 95% confidence interval [CI]: 0.26\u20130.73), past 30\u2010day alcohol use (aOR: 0.71; 95% CI: 0.50\u20130.95), and ever marijuana use (aOR: 0.71; 95% CI: 0.50\u20131.00).<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSION<\/jats:title><jats:p>Innovative strategies are needed to create safe, supportive school environments. These strategies are particularly needed in predominately rural states like Kentucky.<\/jats:p><\/jats:sec>","DOI":"10.1111\/josh.12731","type":"journal-article","created":{"date-parts":[[2019,1,14]],"date-time":"2019-01-14T05:34:14Z","timestamp":1547444054000},"page":"219-225","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Substance Use and School Characteristics in Lesbian, Gay, Bisexual, and Heterosexual High School Students"],"prefix":"10.1111","volume":"89","author":[{"given":"Amanda","family":"Fallin\u2010Bennett","sequence":"first","affiliation":[{"name":"University of Kentucky, 520 College of Nursing, Lexington, KY 40536"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amie","family":"Goodin","sequence":"additional","affiliation":[{"name":"University of Florida, College of Pharmacy, 1225 Center Drive, Gainesville, FL 32610"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,1,13]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2008.06.014"},{"key":"e_1_2_6_3_1","volume-title":"Preventing Tobacco Use Among Youth and Young Adults: A Report of the Surgeon General","author":"US Department of Health and Human Services","year":"2012"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1360-0443.2005.01053.x"},{"key":"e_1_2_6_5_1","first-page":"w13805","article-title":"Profiles of drug users in Switzerland and effects of early\u2010onset intensive use of alcohol, tobacco and cannabis on other illicit drug use","volume":"143","author":"Baggio S","year":"2013","journal-title":"Swiss Med Wkly"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.addbeh.2012.06.006"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/dar.12158"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/ntr\/ntt062"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2013.301764"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2015.303005"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jadohealth.2011.07.009"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jadohealth.2010.09.012"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/1468-0009.12124"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2016.02.022"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/1753-6405.12364"},{"key":"e_1_2_6_16_1","unstructured":"US Centers for Disease Control and Prevention. 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