Distinct Motives for Tobacco Use Among Rural Versus Urban Residing Sexual Minority Young Adults in Oklahoma and Surrounding States

Abstract

Introduction:

Sexual minority young adults (SMYAs) report higher rates of tobacco use compared to heterosexual YAs, with emerging evidence suggesting that rural-residing SMYAs may be particularly at-risk. However, little is known about whether tobacco use motives differ by geographic residence and how they relate to tobacco use outcomes among SMYAs.

Methods:

We analyzed 2 waves of survey data among 549 SMYAs (ages 18-25; 67.4% female) residing in Oklahoma and surrounding states. Multivariable linear and logistic regressions examined associations of: (1) rural–urban residence (based on residential zip code) with tobacco use motives (ie, social, self-enhancement, boredom relief, affect regulation); and (2) rural–urban residence and tobacco use motives with tobacco use outcomes (ie, past-month cigarette use and e-cigarette use frequency, single vs polytobacco use and nicotine dependence severity), controlling for sociodemographics. All analyses were conducted among female and male SMYAs, separately.

Results:

Among female SMYAs, rural (vs urban) residence was associated with higher boredom relief and affect regulation motives, which were associated with more frequent cigarette use and greater nicotine dependence. Among male SMYAs, rural residence was associated with lower social and self-enhancement motives and greater nicotine dependence. However, social and self-enhancement motives were not associated with nicotine dependence.

Conclusions:

Findings suggest that interventions promoting healthier coping strategies and increasing access to inclusive social and recreational spaces may help reduce tobacco use among rural female SMYAs.