Enhancing Precision of Estimates of Sexual Orientation and Gender Identity Disparities in Tobacco and Cannabis use in Young People

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PROJECT SUMMARY FOR ADMINISTRATIVE SUPPLEMENT PROJECT This application is being submitted in response to the Notice of Special Interest (NOSI) identified as “NOT-CA- 23-032. Obtaining estimates of disparities in tobacco product and cannabis use associated with sexual orientation and gender identity (SOGI) among adolescents and young adults (AYAs) is vital for informing strategies to reverse cancer inequities. Existing estimates of SOGI disparities use measures that are insufficiently inclusive, leaving unclear whether disparities extend to specific SOGIs that are often overlooked (e.g., asexual, pansexual, gender non-binary). To address this gap, this administrative supplement will conduct a new secondary analysis of the association of 8 different sexual orientation identities and 5 different gender identities with the use and poly-use of 8 different tobacco and cannabis products. We leverage a NCI-funded R01 parent project (R01-CA0229617) including longitudinal cohort studies of 3,915 adolescents and 2,526 young adults that examines risk factors and consequences of nicotine and cannabis vaping. At each of 5 (semi)annual survey waves conducted 2019-2023, detailed data on tobacco and cannabis product use are being collected for the parent R01’s primary aims, and detailed SOGI data are being collected for descriptive information about the cohorts. This supplement requests funding to cover salary effort for investigators and statisticians to conduct data analysis and manuscript preparation for this new secondary analysis. The primary goal of the supplement project is to determine the concurrent association of various SOGIs with past-30-day tobacco and cannabis product use frequency and poly-use statuses in an adolescent cohort and in a young adult cohort. The secondary goals are to examine whether these associations vary across individuals with changing vs. static SOGIs, chronological time, and race/ethnicity. Because we have repeated measures of SOGI and tobacco/cannabis use, we will have up to 14,843 and 9103 data points for adolescent and young adult cohorts, respectively, which will provide unprecedented power to examine lower prevalence SOGIs (e.g., asexual, pansexual, questioning sexuality, gender non-binary). At the end of this Administrative Supplement project, we will have some of the most contemporary, inclusive, and detailed estimates of SOGI disparities in tobacco and cannabis product use in the vulnerable population of AYAs. This will inform: (a) precise public health measures to reduce SOGI cancer disparities; and (b) if more inclusive measurement of SOGI is needed in national tobacco/cannabis use surveys of AYAs in order to avoid overlooking disparities and, in turn, groups in need of intervention.