Aside from prevalence estimates and comparisons to heterosexual and presumed cisgender (i.e., not transgender) samples, little is known about transgender and gender diverse (TGD) young adult tobacco use. This study explored reasons and contexts TGD young adults used a variety of tobacco products through 25 one-on-one semi-structured qualitative interviews in 2018. Thematic analysis yielded four themes: (1) smoking in response to anxiety, depression, or stress, (2) social smoking, (3) accepting smoking-related norms, and (4) appealing aspects of tobacco. The first three themes contained elements specifically tied to TGD identity; the final theme related to perceptions of tobacco unrelated to identity. Findings suggest reasons for smoking that are unique to TGD young adults, who frequently reported smoking cigarettes as a coping response to an amalgam of stressors. Accounting for unique stressors related to TGD identity will assist in developing culturally relevant interventions to reduce the disproportionate tobacco burden in TGD communities.
Keywords: LGBT; Transgender; minority stress; tobacco use; young adults.