Evaluating sexual orientation and gender identity measurement methods to improve research on cigarette relighting

ABSTRACT This application is being submitted in response to the Notice of Special Interest (NOSI) identified as “NOT-CA- 23-032.” Cigarette relighting—extinguishing, saving, and later relighting unfinished cigarettes—is a complex and prevalent behavior that may increase toxicant exposure and negatively impact cessation outcomes. Relighting

is particularly common among populations who bear a disproportionate burden of tobacco-related morbidity and mortality, and our preliminary work suggests that this includes sexual and gender minority (SGM) individuals who smoke. Yet, there is no published research on relighting among these individuals. While the parent R01 is

designed to fill important gaps in the research on relighting prevalence, correlates, and its impact on toxicant exposure and cessation, it is not designed to examine relighting behaviors among SGM individuals specifically. Historically, lack of national measurement standards for sexual orientation identity and gender identity (SOGI)

has led to heterogeneity in SOGI measurement, resulting in inconsistent estimates of risk behaviors and health outcomes among SGM populations. To address this, the National Academies of Science, Engineering, and Medicine (NASEM) released an NIH-commissioned report on SOGI measurement in 2022 that provided

recommendations for measuring SOGI, as well as an accounting of knowledge gaps and future research needs, which include assessing the effects of SOGI question wording and order on response behaviors. For this project, we propose a survey experiment that will directly address research needs described in this report and augment

the parent R01 by enabling estimation of relighting and correlates of relighting among SGM individuals. Specifically, we will embed a 2x2x2 between-subjects online survey experiment into an existing serial, cross- sectional web-based study to examine the impact of SOGI question order and response options on survey

response behaviors (Aim 1) and assess the impact of SOGI measurement choices on estimates of relighting behaviors and correlates among SGM populations (Aim 2). The proposed study will be the first to examine correlates and prevalence of relighting behaviors among SGM individuals and will inform and improve SOGI

measurement, which is essential for identifying SGM populations and addressing the factors that lead to disparate health outcomes among these individuals.