Abstract:
Sexual and gender minoritized (SGM) populations—including, but not limited to, people who identify as lesbian, gay, bisexual, transgender, queer, intersex, asexual, Two-Spirit, and other minoritized sexual and gender identities (LGBTQIA2S+)—have as much as a 50%-100% higher prevalence of tobacco use than those who are not SGM.1,2 Stigma is thought to play a critical role in SGM tobacco use inequities. SGM people describe tobacco use as a strategy to cope with and resist internalization of SGM-based stigma3 following experiences of intrapersonal stressors (eg, internalized homophobia/transphobia, fear of SGM identity disclosure) and interpersonal stressors (eg, discrimination, victimization). However, the role of structural stigma (eg, policies, societal attitudes) in the initiation and maintenance of tobacco use remains underexplored.
In this commentary, arising from the 2024 Society for Research on Nicotine and Tobacco pre-conference workshop sponsored by the Health Equity Network, “Conducting Research on LGBTQ+ Tobacco Use in High-Stigma Environments,” we examine the role of structural stigma in tobacco use and control within SGM populations. Our aim is to stimulate additional research that incorporates measures of structural stigma experienced by SGM people and to consider how it intersects with the structural stigma that individuals may experience due to their other identities (eg, race/ethnicity or where they live) to impact tobacco use. To accomplish this aim, we first define structural stigma and discuss commonly employed methods of measuring it; provide a few illustrative examples of how structural stigma, including intersectional stigma, may perpetuate tobacco use inequities for SGM populations; and encourage research evaluating the influence of structural stigma on SGM tobacco use and cessation, and on the inclusion of SGM people in tobacco research.
Full Citation:
Antin T, Cartujano-Barrera F, De Genna N, Hinds J, Kaner E, Lee J, Patterson J, Ruiz R, Stimatze T, Tan A, Heffner J (2024). Structural Stigma and Inequities in Tobacco Use Among Sexual and Gender Minoritized People: Accounting for Context and Intersectionality, Nicotine & Tobacco Research, 2024;, ntae280, https://doi.org/10.1093/ntr/ntae280