Structural stigma and cigarette smoking in a prospective cohort study of sexual minority and heterosexual youth

Ann Behav Med. 2014 Feb;47(1):48-56. doi: 10.1007/s12160-013-9548-9.


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.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Female
  • Humans
  • Longitudinal Studies
  • Male
  • Minority Groups / psychology*
  • Prospective Studies
  • Risk Factors
  • Sexuality / psychology*
  • Smoking / psychology*
  • Social Stigma*
  • Young Adult