Understanding pathways to e-cigarette use across sexual identity: A multi-group structural equation model.

Area of Science:

• Public Health
• Adolescent Health
• Mental Health

Background:

• Sexual violence and suicidality are significant public health concerns among adolescents.
• Minority Stress Theory provides a framework for understanding health disparities in sexual minority youth.
• E-cigarette use (vaping) has become prevalent among high school students.

Purpose of the Study:

• To explore the relationships between sexual violence, smoking behaviors, suicidality, and e-cigarette use.
• To examine these relationships within the framework of Minority Stress Theory.
• To test the model's invariance across sexual minority and heterosexual high school students.

Main Methods:

• Utilized data from the 2017 National Youth Risk Behavioral Survey (N=7882).
• Employed multi-group structural equation modeling (SEM).
• Controlled for prior use of cigarettes, cigars, and marijuana.

Main Results:

• Smoking behaviors directly predicted e-cigarette use in both groups.
• Sexual violence and suicidality indirectly affected e-cigarette use via smoking behaviors.
• Sexual violence directly impacted e-cigarette use for sexual minority youth but not heterosexual youth.

Conclusions:

• Victimization from sexual violence may contribute to suicidality and subsequent smoking and e-cigarette use.
• Interventions in schools should target adolescent mental health and substance use, with a focus on sexual minority youth.
• Findings support the application of Minority Stress Theory in understanding youth risk behaviors.