Cigarette Brand Use and Sexual Orientation: Intersections With Gender and Race or Ethnicity

Lesbian, gay, and bisexual (LGB) populations have higher cigarette smoking rates than heterosexual populations. The tobacco industry has leveraged LGB, gender, and racial or ethnic identities to establish cigarette brand preference. We examined cigarette brand use among smokers by sexual orientation and the implications of gender and race or ethnicity for brand use. We used the National Survey on Drug Use and Health (NSDUH; 2015-2017) to conduct weighted bivariate analyses in 2019-2020 of the prevalence of 5 commonly used cigarette brands among adult smokers (N = 24,310) by sexual orientation. We conducted weighted regressions to test relationships between sexual orientation and brand use and interactions between sexual orientation, gender (defined in NSDUH as male or female), and race or ethnicity. LGB smokers were more likely to use Camel (lesbian/gay, OR = 1.7 [95% CI, 1.2-2.3], bisexual, OR = 1.8 [95% CI, 1.5-2.2]) and American Spirit cigarettes (lesbian/gay, OR = 2.8 [95% CI, 1.9-4.1], bisexual, OR = 3.2 [95% CI, 2.5-4.1]) than heterosexual smokers. Lesbian/gay smokers had higher odds of Marlboro cigarette use (OR = 1.2; 95% CI, 1.0-1.4) than heterosexual smokers. Bisexual smokers were more likely to smoke Newport cigarettes (OR = 1.7; 95% CI, 1.4-2.1) than heterosexual smokers. Interactions between LGB and female identities (vs gay or bisexual male) were positively associated with Camel, Marlboro, and Newport use. The interaction between lesbian/gay and Hispanic/Latino ethnicity (vs lesbian/gay White) was also positively associated with Newport use. LGB smokers may be more likely to smoke some commonly used cigarette brands than heterosexual smokers, and gender and race or ethnicity may have implications for brand preference. Future research could examine specific contributors to brand use among LGB smokers (eg, tobacco marketing).