Sexual orientation, minority stress, social norms, and substance use among racially diverse adolescents

Abstract

Background Sexual minority adolescents are more likely than their heterosexual peers to use substances. This study tested factors that contribute to sexual orientation disparities in substance use among racially and ethnically diverse adolescents. Specifically, we examined how both minority stress (i.e., homophobic bullying) and social norms (i.e., descriptive and injunctive norms) may account for sexual orientation disparities in recent and lifetime use of four substances: tobacco, alcohol, marijuana, and prescription drugs. Procedures A probability sample of middle and high school students (N = 3012; aged 11–18 years old; 71.2% racial and ethnic minorities) using random cluster methods was obtained in a mid-size school district in the Southeastern United States. Results Sexual minority adolescents were more likely than heterosexual adolescents to use substances, experience homophobic bullying, and report higher descriptive norms for close friends and more permissive injunctive norms for friends and parents. While accounting for sociodemographic characteristics, multiple mediation models concurrently testing all mediators indicated that higher descriptive and more permissive injunctive norms were significant mediators of the associations between sexual orientation and recent and lifetime use of the four substances, whereas homophobic bullying was not a significant mediator of the associations between sexual orientation and recent and lifetime use of any of the substances. Conclusions Descriptive and injunctive norms, in conjunction with minority stress, are important to consider in explaining sexual orientation disparities in substance use among racially diverse adolescents. These results have implications for substance use interventions among sexual minority adolescents.

Risk and Protective Factors for Substance Use Among Sexual and Gender Minority Youth: a Scoping Review

“…Adaptive personality traits (e.g., being ambitious, open to new experiences, less narcissistic) mitigated the adverse relationship between discrimination and alcohol misuse among SMY [49]. At least one study [38] found that connection to the sexual minority community was protective, while other studies either only found this association among a subset of SMY (e.g., gay-identified youth) or found no association at all [50, 51, 45, 52]. This inconsistency in findings may be partially explained by differences in peer group drinking norms [50, 53].…”

“…Parental attachment moderated cannabis risk among bisexual youth [10] and was associated with reduced overall drug use among Chinese young SMM involved in sex work [71]. In contrast, SMY community connectedness did not mitigate general drug use disparities [50, 51, 72, 52, 45], possibly due to differences in peer drug use norms [51]. Finally, policies at the state (e.g., employment non-discrimination; marriage equality) and school levels (e.g., anti-bullying) were associated with lower rates of both general drug and cannabis use [27], and drug-related consequences [31].…”

“…Related to these findings, cisgender adolescent SMM who reported being reprimanded in childhood for gender nonconforming behavior were more likely to report alcohol and cannabis use as well as depressive and anxiety symptoms [79]. Additionally, compared to heterosexual peers, adolescent SMY reported greater overall substance use among their peers and more permissive peer attitudes toward substance use [51]. Both factors mediated the relationship between sexual-minority status and lifetime substance use.…”

Differences in Substance Use Disparities Across Age Groups in a National Cross-Sectional Survey of Lesbian, Gay, and Bisexual Adults

“…1 Previous studies have also documented higher lifetime rates of illicit drug use among LGB youth. [2][3][4][5][6][7] National surveys have found that LGB adults, especially women, are more likely to smoke, and to be heavy smokers, than heterosexual peers of the same gender. [8][9][10] Disparities in lifetime marijuana use and illicit drug use have also been observed among LGB adults.…”

Social Norm, Family Communication, and HBV Screening among Asian Americans

“…The literature provides strong evidence for the impact of social norms on a variety of behaviors, including alcohol consumption (Padon, Rimal, Jernigan, Siegel, & DeJong, 2016; Pedersen et al, 2017; Rimal, 2008; Rimal & Mollen, 2013), tobacco use (Ali & Dwyer, 2009; Mead, Rimal, Ferrence, & Cohen, 2014; Mereish, Goldbach, Burgess, & DiBello, 2017), cannabis use (Ecker & Buckner, 2014; Mereish et al, 2017), healthy food consumption (Mollen, Rimal, Ruiter, & Kok, 2013), contraceptive use (Rimal & Lapinski, 2015), and HIV testing (Batona, Gagnon, Simonyan, Guedou, & Alary, 2015). Findings on the role of norms do vary, however.…”