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Published on: February 12, 2015
Structural stigma and cigarette smoking in a prospective cohort study of sexual minority and heterosexual youth
Mark L Hatzenbuehler1, Hee-Jin Jun, Heather L Corliss
1Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, 722 West 168th St, Room 549.B, New York, NY, 10032, USA, mlh2101@columbia.edu.
Background:
Sexual minority youth are more likely to smoke cigarettes than heterosexuals, but research into the determinants of these disparities is lacking.
Purpose:
This study aimed to examine whether exposure to structural stigma predicts cigarette smoking in sexual minority youth.
Methods:
Prospective data from adolescents participating in the Growing Up Today Study (2000-2005) were utilized.
Results:
Among sexual minority youth, living in low structural stigma states (e.g., states with non-discrimination policies inclusive of sexual orientation) was associated with a lower risk of cigarette smoking after adjustment for individual-level risk factors (relative risk [RR] = 0.97; 95 % confidence interval [CI], 0.96, 0.99; p = 0.02). This association was marginally significant after additional controls for potential state-level confounders (RR = 0.97; 95 % CI, 0.93, 1.00; p = 0.06). In contrast, among heterosexual youth, structural stigma was not associated with past-year smoking rates, documenting specificity of these effects to sexual minority youth.
Conclusions:
Structural stigma represents a potential risk factor for cigarette smoking among sexual minority adolescents.
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