Intersectional Disparities in Youth Tobacco Use by Sexual and/or Gender Minority Status and Race/Eth
Thursday, January 5, 2023
Posted by: Natalia Gromov
Donaldson
CD, Stupplebeen DA, Wilkinson ML, Zhang X, Williams RJ.
Intersectional Disparities
in Youth Tobacco Use by Sexual and/or Gender Minority Status and
Race/Ethnicity.
[published online ahead of print, 2022 Nov 17]. Nicotine Tob Res.
2022;ntac264. doi:10.1093/ntr/ntac264
Introduction. The
current study applied an intersectional lens to examine societal factors,
individual psychological outcomes, and youth combustible tobacco and vape use
at the intersection of sexual and/or gender minority (SGM) status and
race/ethnicity.
Methods. Data
were drawn from 133,969 youth respondents surveyed in the 2019-2020 California
Student Tobacco Survey, a representative school-based survey of 8 th and 10 th
grade public school students throughout California. The impact of multiple
marginalized group membership using four mutually exclusive intersectional
positions (non-SGM White, SGM White, racial minority only, and both SGM and
racial minority), in addition to specific differences across ten SGM by
race/ethnicity groups (e.g., non-SGM Black/African American, SGM Black/African
American, etc.) were assessed.
Results. Compared
to heterosexual/cisgender White youth, SGM and racial minority adolescents were
shown to experience poorer school tobacco education quality and cessation
support, lower school and family connectedness, and higher anxiety/depression
symptoms. SGM and racial minority youth had a higher prevalence of ever
combustible tobacco use but were less likely to be current vape users compared
to non-SGM White respondents. In examining specific group differences, results
revealed that SGM teens had the highest risk of ever combustible tobacco use.
This disparity was amplified for those belonging to multiple marginalized
groups, with Black/AA SGM teens evidenced to be at the highest risk of current
combustible tobacco.
Conclusions. Information
from this study has useful implications for SGM measurement in surveillance
systems and highlights the usefulness of adopting an intersectional approach to
inform equity driven public health policy and intervention.
Implications. This
representative study of California youth supports that identifying as a sexual
and/or gender minority (SGM) is an important risk factor for combustible
tobacco use. Particularly, observed SGM disparities were magnified for youth
belonging to marginalized groups, as Black/African American SGM teens were
shown to be at the highest risk of current combustible tobacco use. Findings
support that Intersectionality Theory represents a useful framework for
examining tobacco-related disparities and underscores the importance of
assessing how the intersection of multiple social categories impacts youth
tobacco use.
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