Figueroa Wilson, Sridhar Srini, Jankowski Emma, Ennis Alysha, Trinh Anne, Seiber Eric, Patterson Joanne
The Ohio State University.
Res Sq. 2024 Dec 17:rs.3.rs-5417843. doi: 10.21203/rs.3.rs-5417843/v1.
Sexual and gender minority young adult (SGM YA) populations use tobacco at higher rates than their non-SGM YA peers. Prior studies have identified significant correlations between interpersonal stigma and tobacco use, yet structural stigma may also influence tobacco use among SGM YA. This study aimed to assess the indirect effects of structural stigma on current tobacco use among SGM YA and non-SGM YA via depletion of economic resources, interpersonal discrimination, and perceived psychological stress.
Structural Equation Modeling was used to conduct a secondary data analysis from a cross-sectional parent study. Eligible participants were 18-35 years old and currently residing in the U.S. (N = 2,857). Current use of combustible cigarettes and nicotine vapes was our dependent variable. Our independent variable of interest, structural stigma, was a latent variable comprised of three state-level indicator items: Attitudes toward SGM people, SGM protective policies (absence of), and SGM discriminatory policies (introduced or passed in 2022). We assessed three mediators of interest: Depletion of economic resources was a latent variable, which included two indicator items: food insecurity and financial strain. Interpersonal discrimination and perceptions of psychological stress were also assessed. Covariates included race/ethnicity, age, and educational attainment.
Structural stigma was indirectly associated with current tobacco use via depletion of economic resources for SGM YA, but not non-SGM YA. Interpersonal discrimination was also directly and indirectly associated with current tobacco use via depletion of economic resources for both groups.
Future tobacco intervention research should consider the role of structural stigma when working with SGM YA; specifically, how interventions promoting economic stability may influence tobacco use and cessation in this population.
性取向和性别少数青年（SGM YA）群体吸烟率高于非SGM YA同龄人。先前的研究已经确定人际耻辱感与吸烟之间存在显著关联，但结构性耻辱感也可能影响SGM YA群体的吸烟行为。本研究旨在评估结构性耻辱感通过经济资源耗尽、人际歧视和感知心理压力对SGM YA和非SGM YA当前吸烟行为的间接影响。
采用结构方程模型对一项横断面母研究的二次数据分析。符合条件的参与者年龄在18 - 35岁之间，目前居住在美国（N = 2857）。当前可燃香烟和尼古丁电子烟的使用情况是我们的因变量。我们感兴趣的自变量，即结构性耻辱感，是一个潜在变量，由三个州级指标项目组成：对SGM人群的态度、SGM保护政策（缺乏）以及SGM歧视性政策（2022年出台或通过）。我们评估了三个感兴趣的中介变量：经济资源耗尽是一个潜在变量，包括两个指标项目：粮食不安全和经济压力。还评估了人际歧视和心理压力感知。协变量包括种族/族裔、年龄和教育程度。
对于SGM YA群体，结构性耻辱感通过经济资源耗尽与当前吸烟行为间接相关，但对于非SGM YA群体则不然。人际歧视对于两个群体而言，也通过经济资源耗尽与当前吸烟行为直接和间接相关。
未来烟草干预研究在针对SGM YA群体开展工作时应考虑结构性耻辱感的作用；具体而言，促进经济稳定的干预措施如何影响该群体的吸烟行为和戒烟情况。
