Tobacco use and mental health disparities in LGB youth

Abstract

Objective In 2019, the Youth Risk Behavioral Survey (YRBS) collected sexual orientation data for the first time in Kentucky. Tobacco use behaviors and mental health status among Lesbian, Gay, and Bisexual (LGB) youth is infrequently documented in southern states such as Kentucky. This study aimed to analyze self‐reported tobacco use and mental health in youth by sexual orientation. Design Cross‐sectional survey. Sample All participants, aged 12–19, of the 2019 Kentucky YRBS that indicated a sexual orientation. Measurements Differences in response distributions for tobacco use and mental health measures were analyzed via chi square by sexual orientation, with additional stratification by sex. Results A total of n = 1996 respondents were 12.8% LGB‐identified and 82.1% heterosexual‐identified. No disparities between LGB and heterosexual youth were observed in tobacco‐related behaviors for male students, but disparities were persistent for female students (p = .005 for "tried tobacco before age 13"; p = .007 for "current smoking", p = .012 for "ever smoked"). Mental health disparities between LGB and heterosexual youth were significant for males and females (p < .05, all mental health measures). Conclusions Findings suggest that tobacco disparities in this most recent data are narrower than in previous years; however, mental health disparities persist between LGB and heterosexual youth in Kentucky.

Effects of Tobacco Versus Electronic Cigarette Usage on Nonsuicidal Self-Injury and Suicidality Among Chinese Youth: Cross-Sectional Self-Report Survey Study

“…Although CC usage, EC usage, and dual usage increased an individual’s risk of NSSI and suicidality compared with no usage, we found that only CC usage and dual usage increased the risks of NSSI and suicidality in the SGM population compared to those in the cis-heterosexual population. These results are supported by previous research [ 34 - 42 ]. SGM youth are susceptible to the disproportionately high risk of CC usage due to societal, peer, and community influence, which are the major risk factors for NSSI and suicidality.…”

“…Such societal, peer, and community influences could also be applied to EC usage with its increasing advertisements on social media, and EC usage could be a significant risk factor for mental health risks. Furthermore, recent studies [34][35][36][37][38][39][40][41][42][43] underline the fact that there is a significant overlap between CC and EC users in the SGM population, supporting our finding that individuals with dual usage have the highest risks of NSSI and suicidality compared to individuals with no usage of CC and EC.…”

“…As previously mentioned, a number of explanations have been proposed in past research, including being impacted by the marketing target of the tobacco industry on the media scale, community norms on a group scale, and minority stressors on a personal scale. First, it is well-established that SGM youth are at disproportionately high risk of CC usage [ 41 , 42 ]. Past research also suggests that the SGM population has been the major marketing target of the tobacco industry, resulting in increased difficulties for SGM youth to resist CC usage when such behavior is normalized by the public media [ 44 ].…”

“…Under the influence of increasing exposure to EC-related content among the SGM population, it becomes reasonable to assume that, in social situations with SGM peers (ie, one of the potential triggers for EC usage and combined CC and EC usage), SGM youth would become more susceptible to the rising trend of EC usage among their peers [48]. Third, on a personal scale, as mentioned earlier, the minority stress model underscores that unique stressors experienced by the SGM population, including but not limited to discrimination and internalized homo/bi/transphobia, could result in higher stress levels among this stigmatized group [40][41][42][43][44][45]. Such stress could then contribute to the thought pattern of EC usage being a way for individuals to express or assert their gender identity or to rebel against traditional gender norms [40][41][42][43][44][45].…”

“…Such a disparity arises from a wide range of structural vulnerabilities such as unavoidable systemic discrimination and prejudice in education, employment, and health care opportunities [38,39]. Further, these structural vulnerabilities stem from the imbalanced hierarchical social power structure that is responsible for generating and widening the mental health gap between SGM and cis-heterosexual individuals while limiting SGM individuals' accessibility to determinants of health, leaving the SGM population defenseless against risky behaviors such as substance use [39][40][41][42][43][44][45].…”