Tobacco use and mental health disparities in LGB youth

Objective: In 2019, the Youth Risk Behavioral Survey (YRBS) collected sexual orientation data for the first time in Kentucky. Tobacco use behaviors and mental health status among Lesbian, Gay, and Bisexual (LGB) youth is infrequently documented in southern states such as Kentucky. This study aimed to analyze self-reported tobacco use and mental health in youth by sexual orientation. Design: Cross-sectional survey. Sample: All participants, aged 12–19, of the 2019 Kentucky YRBS that indicated a sexual orientation. Measurements: Differences in response distributions for tobacco use and mental health measures were analyzed via chi square by sexual orientation, with additional stratification by sex. Results: A total of n = 1996 respondents were 12.8% LGB-identified and 82.1% heterosexual-identified. No disparities between LGB and heterosexual youth were observed in tobacco-related behaviors for male students, but disparities were persistent for female students (p =.005 for "tried tobacco before age 13"; p =.007 for "current smoking", p =.012 for "ever smoked"). Mental health disparities between LGB and heterosexual youth were significant for males and females (p <.05, all mental health measures). Conclusions: Findings suggest that tobacco disparities in this most recent data are narrower than in previous years; however, mental health disparities persist between LGB and heterosexual youth in Kentucky.