Objectives The dearth of research on age-related differences in risk factors for tobacco use disorder (TUD) among sexual minorities, particularly among older adults, can obscure the differential needs of sexual minority age groups for tobacco prevention and cessation. We examined the association of cumulative ethnic/racial discrimination and sexual orientation discrimination with moderate-to-severe TUD among U.S. sexual minority adults aged 50 years and older. Method We analyzed cross-sectional data from the National Epidemiologic Survey of Alcohol and Related Conditions-III (n = 36,309 U.S. adults). Our sample consisted of 1,258 adults (lesbian/gay-, bisexual-, and heterosexual-identified adults with same-sex attraction/behavior) aged ≥50 years. Multivariable logistic regression analyses estimated the association of cumulative lifetime ethnic/racial discrimination and sexual orientation discrimination with past-year moderate-to-severe TUD and tested whether the association differed for adults aged 50–64 years versus those aged ≥65 years. Results An estimated 8.1% of the sample met criteria for moderate-to-severe TUD. Lifetime ethnic/racial discrimination and sexual orientation discrimination was not significantly associated with moderate-to-severe TUD for adults aged ≥50 years. However, a significant 2-way interaction was found between discrimination and age. In age-stratified analyses, greater discrimination was significantly associated with greater risk for moderate-to-severe TUD for adults aged ≥65 years, but not adults aged 50–64 years. Discussion Greater cumulative discrimination based on ethnicity/race and sexual orientation was associated with increased risk for moderate-to-severe TUD among sexual minority adults aged ≥65 years. Our findings underscore the importance of age considerations in understanding the role of discrimination in the assessment and treatment of TUD.

中文翻译：

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美国性少数老年人的中度至重度烟草使用障碍和歧视

目标 对性少数群体，尤其是老年人中烟草使用障碍 (TUD) 危险因素的年龄相关差异的研究缺乏，可能会掩盖性少数群体对烟草预防和戒烟的不同需求。我们研究了美国 50 岁及以上性少数成年人中累积的种族/种族歧视和性取向歧视与中度至重度 TUD 的关联。方法 我们分析了全国酒精和相关疾病流行病学调查-III（n = 36,309 美国成年人）的横断面数据。我们的样本包括 1,258 名年龄≥50 岁的成年人（具有同性吸引力/行为的女同性恋/男同性恋、双性恋和异性恋成人）。多变量逻辑回归分析估计了累积终生种族/种族歧视和性取向歧视与过去一年中度至重度 TUD 的关联，并测试了 50-64 岁的成年人与 65 岁以上的成年人的关联是否存在差异。结果 估计有 8.1% 的样本符合中度至重度 TUD 的标准。对于 50 岁以上的成年人，终生种族/种族歧视和性取向歧视与中度至重度 TUD 没有显着相关性。然而，在歧视和年龄之间发现了显着的双向交互作用。在年龄分层分析中，更大的歧视与 65 岁以上的成年人发生中度至重度 TUD 的风险显着相关，但与 50-64 岁的成年人无关。讨论 基于种族/种族和性取向的更大累积歧视与年龄≥65 岁的性少数成年人中度至重度 TUD 的风险增加有关。我们的研究结果强调了年龄因素对于理解歧视在 TUD 评估和治疗中的作用的重要性。