The effects of e-cigarette and cigarette policies on queer youth

Electronic nicotine delivery systems (ENDS) use among lesbian, gay, bisexual, and questioning (LGBQ) teenagers is nearly 50 percent higher than among their heterosexual counterparts. Yet little is known about how recent efforts to curb nicotine vaping through tobacco control policies impact sexual minorities. The minority stress hypothesis (MSH) suggests that LGBQ teens may use nicotine to mediate unique stressors, which could lead LGBQ teens to be less responsive to state policies designed to curtail use of nicotine products. This study explores this question using data from the 2015-2023 State Youth Behavior Surveys and a generalized difference-in-differences identification strategy. We consider the importance of four common policies in the U.S.: ENDS taxes, cigarette taxes, ENDS minimum legal sales ages, and ENDS flavor bans. We document heterogeneous responses to ENDS taxes and MLSA laws that are consistent with the MSH: ENDS taxes and MLSA laws reduce vaping among heterosexual youth but not among LGBQ youth, despite substantially higher baseline ENDS use in the latter group. We also find that LGBQ teens without mental health stressors respond strongly to ENDS taxes and flavor bans, whereas those with such stressors do not, also consistent with the MSH. Cigarette taxes are largely unrelated to ENDS use among teens.