# Tobacco Use Trajectories And Disparities Among Sexual Minorities In U.S Adolescents And Adults

> **NIH NIH R21** · UNIVERSITY OF MICHIGAN AT ANN ARBOR · 2020 · $234,000

## Abstract

Project Summary/Abstract
Tobacco use is responsible for enormous health and financial costs in the U.S. including more than 480,000
deaths per year due to cigarette use and more than $193 billion annually in health care costs and loss of
productivity. Sexual minority individuals are at substantially greater risk for tobacco use and tobacco use
disorder (TUD) and tobacco-related health outcomes compared to heterosexual individuals in the U.S.
Longitudinal data is needed to understand differences in tobacco use across time and resultant tobacco-
related health disparities among sexual minorities. This information is necessary to inform tobacco regulatory
policy strategies to reduce these health disparities. We draw on concepts of minority stress and
intersectionality to understand these tobacco use trajectories and related health disparities by sexual
orientation. This proposal is in direct response to RFA-OD-19-022 by using secondary data to examine
tobacco use trajectories and its health effects over time in a vulnerable population, focusing on new tobacco
products. The national and longitudinal Population Assessment of Tobacco and Health (PATH) study provides
an unprecedented opportunity to identify differences in tobacco use trajectories, associated health disparities,
and mechanisms behind these differences. Using PATH data we will be able to examine detailed tobacco use
trajectories across four waves, sexual identity transitions across four waves, and prospective links to health
outcomes. In addition we triangulate both self-report and biological data on stress and health. Using PATH’s
large nationally representative dataset of youth and adults, this study aims to: (1) To examine tobacco product
initiation and use trajectories by sexual orientation and their associations with regular tobacco use and TUD
symptoms; (2) To identify tobacco use trajectories by sexual orientation and differential associations with self
report and biological health outcomes among adults; (3) To examine the role of biological and psychological
stress on tobacco use trajectories, tobacco cessation and tobacco-related health outcomes among adults and
how this differs by sexual orientation and transitions in sexual identity. We will assess tobacco trajectories, with
emphasis on specific changes of critical public health importance including: (1) tobacco use initiation, (2)
progression in the number of tobacco products used (i.e., single product use to dual/polytobacco use) with a
focus on trajectories including e-cigarettes and those without and (3) increases and decreases in tobacco
frequency. Aims 2 and 3 will innovatively make use of the wealth of both survey self-report measures of stress
(psychological distress) and health outcomes (respiratory illness, cancer, cardiovascular disease) alongside
biological markers of stress (e.g., C-reactive protein, interleukin-6) and tobacco-specific markers linked to
cancer risk (NNAL, NNN, TNE2). We will examine important moder...

## Key facts

- **NIH application ID:** 10026894
- **Project number:** 1R21DA051388-01
- **Recipient organization:** UNIVERSITY OF MICHIGAN AT ANN ARBOR
- **Principal Investigator:** Rebecca J Evans-Polce
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $234,000
- **Award type:** 1
- **Project period:** 2020-08-01 → 2022-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10026894

## Citation

> US National Institutes of Health, RePORTER application 10026894, Tobacco Use Trajectories And Disparities Among Sexual Minorities In U.S Adolescents And Adults (1R21DA051388-01). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10026894. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*