Skip to main content

Advertisement

SpringerLink
Log in

Cigarette Smoking as Part of a Syndemic among Young Men Who Have Sex with Men Ages 13–29 in New York City

  • Published:
Journal of Urban Health Aims and scope Submit manuscript

Abstract

The prevalence of cigarette smoking among young men who have sex with men (YMSM) is significantly higher than among their heterosexual peers. We undertook an analysis to examine cigarette smoking in relation to demographic factors and other risk behaviors among 580 YMSM, ages 13–29, in New York City. Cross-sectional data were collected as part of larger study of risk behaviors using palm devices and targeted active recruitment strategies across all five boroughs of the city. Multivariate modeling suggests that Asian or Pacific Islander and White YMSM are more likely to report cigarette smoking than other racial and ethnic groups, as are men reporting a middle class socioeconomic status. In addition, smoking was related to the likelihood of using a variety of illicit substances, as well as alcohol and pharmaceuticals without a prescription, during the period of assessment. YMSM who smoke cigarettes reported a greater number of casual sex partners and a greater number of transactional sex partners than non-smokers. Episodic analysis of sexual behaviors with casual partners indicated that smokers were more likely to engage in illicit drug and alcohol use immediately before or during sex than did non-smokers. These findings are understood as part of a larger syndemic among YMSM, and suggest that smoking prevention and cessation programs should be embedded as part of larger more holistic health and wellness programs targeting YMSM.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Royce RA, Winkelstein W. HIV infection, cigarette smoking and CD4+ T-lymphocyte counts: preliminary results from the San Francisco Men’s Health Study. AIDS. 1990; 4: 327–333.

    Article  PubMed  CAS  Google Scholar 

  2. Skinner WF. The prevalence and demographic predictors of illicit and licit drug use among lesbians and gay men. Am J Public Health. 1994; 84: 1307–1310.

    Article  PubMed  CAS  Google Scholar 

  3. Skinner WF, Otis MD. Drug and alcohol use among lesbian and gay people in a southern U.S. sample: epidemiological, comparative, and methodological findings from the Trilogy Project. J Homosex. 1996; 30: 59–92.

    Article  PubMed  CAS  Google Scholar 

  4. Stall R, Greenwood GL, Acree M, Paul J, Coates TJ. Cigarette smoking among gay and bisexual men. Am J Public Health. 1999; 89: 1875–1978.

    Article  PubMed  CAS  Google Scholar 

  5. Yankelovich Partners. Gay and lesbian consumers: prepaired for community focus. Yankelovich Partners, Chapel Hill; 1996.

  6. Ryan H, Wortley PM, Easton A, Pederson L, Greenwood G. Smoking among lesbians, gays, and bisexuals: a review of the literature. Am J Prev Med. 2001; 21: 142–149.

    Article  PubMed  CAS  Google Scholar 

  7. Faulkner AH, Cranston K. Correlates of same-sex sexual behavior in a random sample of Massachusetts high school students. Am J Public Health. 1998; 88: 262–266.

    Article  PubMed  CAS  Google Scholar 

  8. Garofalo R, Wolf RC, Kessel S, Palfrey SJ, DuRant RH. The association between health risk behaviors and sexual orientation among a school-based sample of adolescents. Pediatrics. 1998; 101: 895–902.

    Article  PubMed  CAS  Google Scholar 

  9. Remafedi G. Adolescent homosexuality: psychosocial and medical implications. Pediatrics. 1987; 79: 331–337.

    PubMed  CAS  Google Scholar 

  10. Rosario M, Hunter J, Gwadz M. Exploration of substance use among lesbian, gay, and bisexual youth: prevalence and correlates. J Adolesc Res. 1997; 12: 454–476.

    Article  Google Scholar 

  11. Castro FG, Maddahian E, Newcomb MD, Bentler PM. A multivariate model of the determinants of cigarette smoking among adolescents. J Health Soc Behav. 1987; 28: 273–289.

    Article  PubMed  CAS  Google Scholar 

  12. Sheahan SL, Garrity TF. Stress and tobacco addiction. J Am Acad Nurse Pract. 1992; 4: 111–116.

    Article  PubMed  CAS  Google Scholar 

  13. Shiffman S, Wills TA. Coping and substance abuse. New York: Academic; 1985.

    Google Scholar 

  14. Meyer IH. Minority stress and mental health in gay men. J Health Soc Behav. 1995; 36: 38–56.

    Article  PubMed  CAS  Google Scholar 

  15. Meyer IH. Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: conceptual issues and research evidence. Psychol Bull. 2003; 129: 674–697.

    Article  PubMed  Google Scholar 

  16. Achilles N. The development of the homosexual bar as an institution. In: Gagnon JH, Simon U, eds. Sexual deviance. New York: Harper and Row; 1967.

    Google Scholar 

  17. Elliot SA. A campaign urges gay men and lesbians to resist tobacco ads. New York Times; 1997.

  18. Goebel KR. Lesbians and gays face tobacco targeting. Tob Control. 1994; 3: 65–67.

    Article  Google Scholar 

  19. Lipman J. Philip Morris to push brand in gay media. Wall Street Journal; 1992

  20. Stevens P, Carlson LM, Hinman JM. An analysis of tobacco industry marketing to lesbian, gay, bisexual, and transgender (LGBT) populations: strategies for mainstream tobacco control and prevention. Health Promot Pract. 2004; 5: 129–134.

    Article  Google Scholar 

  21. Goodwin RD, Keyes KM, Hasin DS. Changes in cigarette use and nicotine dependence in the United States: evidence from the 2001–2002 wave of the national epidemiologic survey of alcoholism and related conditions. Am J Public Health. 2009; 99: 1471–1477.

    Article  PubMed  Google Scholar 

  22. Colfax G, Coates TJ, Husnik MJ, Huang Y, Buchbinder S, Koblin B, et al. Longitudinal patterns of methamphetamine, popper (amyl nitrite), and cocaine use and high-risk sexual behavior among a cohort of San Francisco men who have sex with men. J Urban Health. 2005; 82: i62–i70.

    PubMed  Google Scholar 

  23. Fisher DG, Reynolds GL, Ware MR, Napper LE. Methamphetamine and Viagra use: relationship to sexual risk behaviors. Arch Sex Behav; 2011;(in press)

  24. Halkitis PN, Green KA. Methamphetamine use, sexual behavior, and HIV seroconversion. J Gay Lesbian Psychother. 2006; 10: 95–109.

    Google Scholar 

  25. Semple SJ, Patterson TL, Grant I. Motivations associated with methamphetamine use among HIV + men who have sex with men. J Subst Abuse Treat. 2002; 22: 149–156.

    Article  PubMed  Google Scholar 

  26. Storholm ED, Fisher DG, Reynolds GL, Napper LE, Morrisse TA, Kochems LM. Hepatitis vaccination of men who have sex with men at gay pride events. Prev Sci. 2010; 11: 219–227.

    Article  PubMed  Google Scholar 

  27. Halkitis PN. Two generations and counting: reframing HIV prevention for gay men in the United States. Am Psychol; 2011;(in press).

  28. Stall R, Friedman MS, Cantania JA. Interacting epidemics and gay men’s health: a theory of syndemic production among urban gay men. In: Wolitski RJ, Stall R, Valdiserri RO, eds. Unequal opportunity: health disparities affecting gay and bisexual men in the United States. New York, NY: Oxford Univerisity Press; 2008.

    Google Scholar 

  29. Mustanski B, Garofalo R, Herrick A, Donenberg G. Psychosocial health problems increase risk for HIV among urban young men who have sex with men: preliminary evidence of a syndemic in need of attention. Ann Behav Med. 2007; 34: 37–45.

    Article  PubMed  Google Scholar 

  30. Stall R, Mills TC, Williamson J, et al. Association of co-occurring psychosocial health problems and increased vulnerability to HIV/AIDS among urban men who have sex with men. Am J Public Health. 2003; 93: 939–942.

    Article  PubMed  Google Scholar 

  31. Alessi EJ. Changing directions in HIV prevention: the move toward a psychosocial model. J Gay Lesbian Soc Serv. 2008; 20: 273–287.

    Article  Google Scholar 

  32. Cochran SD, Mays VM. Depressive distress among homosexually active African American men and women. Am J Psychiatr. 1994; 151: 524–952.

    PubMed  CAS  Google Scholar 

  33. Herek GM. The psychology of sexual prejudice. In: Garnets LD, Kimmel DC, eds. Psychological perspectives on lesbian, gay, and bisexual experiences. New York, NY: Columbia University Press; 2003.

    Google Scholar 

  34. Vincke J, Bolton R. Social support, depression, and self-acceptance among gay men. Hum Relat. 1994; 47: 1049–1062.

    Article  Google Scholar 

  35. Rosario M, Schrimshaw EW, Hunter J. A model of sexual risk behaviors among young gay and bisexual men: longitudinal associations of mental health, substance abuse, sexual abuse, and the coming-out process. AIDS Educ Prev. 2006; 18: 444–460.

    Article  PubMed  Google Scholar 

  36. Botvin GJ, Epstein JA, Schinke SP, Diaz T. Predictors of cigarette smoking among inner-city minority youth. J Dev Behav Pediatr. 1994; 15: 67–73.

    Article  PubMed  CAS  Google Scholar 

  37. Newcomb ME, Mustanski B. Moderators of the relationship between internalized homophobia and risky sexual behavior in men who have sex with men: a meta-analysis. Arch Sex Behav; 2011; 40(1): 189–99.

    Google Scholar 

  38. Siconolfi DE, Halkitis PN, Allomong TA, Burton CL. Body dissatisfaction & eating disorders in a sample of gay and bisexual men. Int J Men's Health. 2009; 8: 254–264.

    Article  Google Scholar 

  39. Frost DM, Parsons JT, Nanin JE. Stigma, concealment and symptoms of depression as explanations for sexually transmitted infections among gay men. J Health Psychol. 2007; 12: 636–640.

    Article  PubMed  Google Scholar 

  40. D’Augelli AR, Patterson CJ. Lesbian, gay, and bisexual identities over the lifespan: psychological perspectives. New York, NY: Oxford University Press; 1995.

    Google Scholar 

  41. Hunter J, Mallon GP. Lesbian, gay, and bisexual adolescent development: dancing with your feet tied together. In: Greene B, Croom GL, eds. Education, reseach, and practice in lesbian, gay, bisexual, and transgendered psychology: a resource manual. Thousand Oaks, CA: Sage Publications; 2000.

    Google Scholar 

  42. Savin-Williams RC. Lesbian, gay male, and bisexual adolescents. In: D’Augelli AR, Patterson CJ, eds. Lesbian, gay, and bisexual identities over the lifespan: psychological perspectives. New York, NY: Oxford University Press; 1995.

    Google Scholar 

  43. Arnett JJ. Emerging adulthood: a theory of development from the late teens through the twenties. Am Psychol. 2000; 55: 469–480.

    Article  PubMed  CAS  Google Scholar 

  44. Halkitis PN, Sussman RD, Brockwell S, Moeller RW, Siconolfi DE, Cutler B. Sexual behaviors of adolescent, emergent, and young adult MSM ages 13–29 in New York City. J Acquir Immune Defic Syndr. 2011; 56: 285–291.

    Article  PubMed  Google Scholar 

  45. Gruskin EP, Byrne KM, Altschuler A, Dibble SL. Smoking it all away: influences of stress, negative emotions, and stigma on lesbian tobacco use. J LGBT Health Res. 2008; 4: 167–179.

    Article  PubMed  Google Scholar 

  46. Kleinjan M, Wanner B, Vitaro F, Van den Eijnden RJ, Brug J, Engels RC. Nicotine dependence subtypes among adolescent smokers: examining the occurrence, development and validity of distinct symptom profiles. Psychol Addict Behav. 2010; 24: 61–74.

    Article  PubMed  Google Scholar 

  47. Lerman C, Audrain J, Orleans CT, et al. Investigation of mechanisms linking depressed mood to nicotine dependence. Addict Behav. 1996; 21: 9–19.

    Article  PubMed  CAS  Google Scholar 

  48. O’Loughlin J, DiFranza J, Tarasuk J, et al. Assessment of nicotine dependence symptoms in adolescents: a comparison of five indicators. Tob Control. 2002; 11: 354–360.

    Article  PubMed  Google Scholar 

  49. Halkitis PN, Palamar JJ. Multivariate modeling of club drug use initiation among gay and bisexual men. Subst Use Misuse. 2008; 43: 871–879.

    Article  PubMed  Google Scholar 

  50. Kandel DB, Treiman D, Faust R, Single E. Adolescent involvement in legal and illegal drug use: a multiple classification analysis. Soc Forces. 1976; 55: 438–458.

    Article  Google Scholar 

  51. Des Jarlais DC, Paone D, Milliken J, et al. Audio-computer interviewing to measure risk behaviour for HIV among injecting drug users: a quasi-randomised trial. Lancet. 1999; 353: 1657–1661.

    Article  PubMed  CAS  Google Scholar 

  52. Cornfield J, Haenzel W, Hammond EC, Lilienfeld AM, Shimkin MB, Wynder EL. Smoking and lung cancer: recent evidence and a discussion of some questions. Int J Epidemiol. 2009; 38: 1175–1191.

    Article  PubMed  Google Scholar 

  53. Jha P. Avoidable global cancer deaths and total deaths from smoking. Nat Rev Cancer. 2009; 9: 655–664.

    Article  PubMed  CAS  Google Scholar 

  54. Menvielle G, Boshuizen H, Kunst AE, et al. The role of smoking and diet in explaining educational inequalities in lung cancer incidence. J Nat Cancer Inst. 2009; 101: 321–330.

    Article  PubMed  Google Scholar 

  55. Rosenbaum E, Kandel DB. Early onset of adolescent sexual behavior and drug involvement. J Marriage Fam. 1990; 52: 783–798.

    Article  Google Scholar 

Download references

Acknowledgments

This publication contains information which was obtained under contract with Public Health Solutions on behalf of the New York City Department of Health and Mental Hygiene. Its contents are solely the responsibility of the authors and do not necessarily reflect the opinions or views of the New York City Department of Health and Mental Hygiene or Public Health Solutions.

Author information

Authors and Affiliations

  1. Center for Health, Identity, Behavior & Prevention Studies, the Steinhardt School of Culture, Education, and Human Development, New York University, 82 Washington Square East, Pless 555, New York, NY, 10003, USA

    Erik David Storholm, Perry N. Halkitis, Daniel E. Siconolfi & Robert W. Moeller

Authors
  1. Erik David Storholm
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Perry N. Halkitis
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Daniel E. Siconolfi
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Robert W. Moeller
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Perry N. Halkitis.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Storholm, E.D., Halkitis, P.N., Siconolfi, D.E. et al. Cigarette Smoking as Part of a Syndemic among Young Men Who Have Sex with Men Ages 13–29 in New York City. J Urban Health 88, 663–676 (2011). https://doi.org/10.1007/s11524-011-9563-8

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11524-011-9563-8

Keywords

Search

Navigation