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Figueroa W, Jankowski E, Curran H, Ennis AC, Poteat T, Morgan E, Klein E, Reczek R, Patterson JG. Minority stressors and tobacco use among a US sample of sexual and gender minority young adults. Drug Alcohol Depend 2024; 261:111356. [PMID: 38889573 DOI: 10.1016/j.drugalcdep.2024.111356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 05/31/2024] [Accepted: 06/02/2024] [Indexed: 06/20/2024]
Abstract
INTRODUCTION Young adults who are sexual and gender minorities (SGM) are at the highest risk for tobacco initiation in young adulthood. Minority stress theory suggests that sexual orientation and gender identity (SOGI)-based discrimination may contribute to nicotine and tobacco use disparities. Our study aimed to quantify the association between SOGI-based distal minority stressors and current tobacco use among SGM young adults living in the United States (US). METHODS Eligible participants-including young adults (aged 18-35 years old), who identified as SGM, and were currently residing in the US (N=1116) -were recruited via Prolific into an online survey. We applied stepwise binary regressions with backward selection to model the association between average past 30-day distal minority stress and current tobacco use (i.e., combustible cigarettes or e-cigarettes), controlling for perceived stress and sociodemographic covariates. We also tested interactions between minority stress and SGM status. Exploratory analyses assessed associations between minority stress and current tobacco use among YA, stratified by SGM subgroup. RESULTS A 1-unit increase in experiencing minority stress in the past 30-days was associated with 1.02 greater odds of current tobacco use among SGM young adults. No difference between SGM subgroups in this association was found. Examining stratified SGM subgroups, a 1-unit increase in minority stress was associated with 1.11 greater odds of current tobacco among transgender adults only. CONCLUSION Distal minority stress is differentially associated with current tobacco use for transgender young adults, which suggests that tobacco prevention and cessation interventions may need tailoring for subgroups. IMPLICATIONS This study details the influence of minority stress on current tobacco use among sexual and gender minority (SGM) young adults. Findings underscore the need for targeted and tailored approaches to tobacco control, wherein SGM young adults most at-risk are engaged in cessation interventions that address minority stress as a contributing factor to tobacco use and which support their resilience. To promote health equity, tobacco control must address the contexts that engender minority stress. Assessment of policy impacts on SGM tobacco use and the effectiveness of interventions disseminated within SGM-supportive and discriminatory policy environments are important next steps.
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Affiliation(s)
- Wilson Figueroa
- Center for Health Outcomes and Policy Evaluation Studies, Ohio State University College of Public Health, 381 Cunz Hall, 1841 Neil Ave, Columbus, OH 43210, USA.
| | - Emma Jankowski
- Division of Health Behavior and Health Promotion, Ohio State University College of Public Health, 353 Cunz Hall, 1841 Neil Ave, Columbus, OH, USA
| | - Hayley Curran
- Division of Health Behavior and Health Promotion, Ohio State University College of Public Health, 353 Cunz Hall, 1841 Neil Ave, Columbus, OH, USA
| | - Alysha C Ennis
- Division of Health Behavior and Health Promotion, Ohio State University College of Public Health, 353 Cunz Hall, 1841 Neil Ave, Columbus, OH, USA
| | - Tonia Poteat
- Duke University School of Nursing, Box 3322 DUMC, Durham, NC 27710, USA
| | - Ethan Morgan
- College of Nursing, Ohio State University, 390 Newton Hall, 295 W 10th Ave, Columbus, OH 43210, USA
| | - Elizabeth Klein
- Division of Health Behavior and Health Promotion, Ohio State University College of Public Health, 353 Cunz Hall, 1841 Neil Ave, Columbus, OH, USA; Center for Tobacco Research, Ohio State University Comprehensive Cancer Center, Columbus, OH 43214, USA
| | - Rin Reczek
- Department of Sociology, Ohio State University, 164 Townsend Hall, 1885 Neil Ave, Columbus, OH 43210, USA
| | - Joanne G Patterson
- Division of Health Behavior and Health Promotion, Ohio State University College of Public Health, 353 Cunz Hall, 1841 Neil Ave, Columbus, OH, USA; Center for Tobacco Research, Ohio State University Comprehensive Cancer Center, Columbus, OH 43214, USA
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Lipperman-Kreda S, Sanders E, Annechino R, Peterkin E, Antin TMJ. Harm perceptions of vaping nicotine relative to cigarette smoking among sexual and gender minority young adults. Drug Alcohol Rev 2024; 43:371-380. [PMID: 38258463 DOI: 10.1111/dar.13812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 12/20/2023] [Accepted: 12/21/2023] [Indexed: 01/24/2024]
Abstract
INTRODUCTION To address gaps in existing research, the current study used a mixed-methods approach to describe, contextualise and understand harm perceptions of vaping nicotine relative to cigarette smoking and associations with nicotine and tobacco (NT) use among young adults who identify their genders and sexualities in ways that classify them as sexual and gender minorities (SGM). METHODS Results are based on cross-sectional surveys and online qualitative interviews with 98 SGM young adults (18-25 years old) in California's San Francisco Bay Area who currently or formerly used combustible tobacco. We generated a measure assessing participants' relative harm perceptions of e-cigarette use versus cigarette smoking and identified those who perceived cigarette smoking as more harmful than e-cigarette use compared to those who perceived it to be equally or less harmful. RESULTS We found that relative harm perceptions of cigarette smoking versus e-cigarette use are likely related to much uncertainty and confusion about the harms of e-cigarette use. Moreover, findings illustrate that public health messages regarding the risks of e-cigarette use may have unintended consequences of increasing cigarette use to replace e-cigarette use for some SGM young adults, a practice that is incongruent with scientific evidence demonstrating that cigarettes and other combustible tobacco products are riskier than e-cigarettes and other forms of NT use. DISCUSSION AND CONCLUSIONS Results suggest the need for evidence-based, clear, and direct messaging about the relative harms of cigarettes versus e-cigarettes to reduce NT-related inequities in SGM populations.
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Affiliation(s)
- Sharon Lipperman-Kreda
- Prevention Research Center, Pacific Institute for Research and Evaluation, Berkeley, USA
- Center for Critical Public Health, Institute for Scientific Analysis, Alameda, USA
| | - Emile Sanders
- Center for Critical Public Health, Institute for Scientific Analysis, Alameda, USA
| | - Rachelle Annechino
- Center for Critical Public Health, Institute for Scientific Analysis, Alameda, USA
| | - Elaina Peterkin
- Center for Critical Public Health, Institute for Scientific Analysis, Alameda, USA
| | - Tamar M J Antin
- Center for Critical Public Health, Institute for Scientific Analysis, Alameda, USA
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