Coping and Social Support in Relation to Minority Stress and Cigarette Smoking Among Lesbian, Gay, and Bisexual Veterans.

The intersection between a minoritized sexual orientation identity and a U.S. military Veteran status places lesbian, gay, and bisexual (LGB) Veterans at increased risk for cigarette smoking. Guided by the Minority Stress Model, this study assessed whether coping and three types of social support (general, Veteran-specific, and lesbian, gay, bisexual, and transgender [LGBT]-specific) moderated the association between minority stressors and past-year smoking among LGB Veterans. Participants were recruited online for a prospective cohort study. We conducted secondary data analysis of baseline surveys collected from September 2019 to December 2020. The study sample included cisgender LGB Veterans ( = 463). Adjusted multivariable logistic regression models estimated the odds of past-year smoking with interaction terms between minority stressors and coping/social support to test for moderation. Four statistically significant interaction terms were found. Higher versus lower levels (i.e., one-point score increase) of coping buffered the relationship between victimization and past-year smoking; Veteran-specific social support buffered the relationship between interpersonal LGB military stress and past-year smoking; and LGBT-specific social support buffered the relationship between intrapersonal LGB military stress and past-year smoking. However, general social support strengthened the relationship between social exclusion and past-year smoking. Findings provide some evidence for the minority stress model; however, regarding cigarette smoking, coping and social support may mitigate stress in some cases and exacerbate stress in others. LGB Veterans may benefit from learning positive coping skills and leveraging social support linked to LGB and Veteran identities to support smoking cessation.