Perceived discrimination and youth vaping: The role of intersectional identities

Candice D Donaldson; David A Stupplebeen; Elizabeth T Couch; Adrianna I Rojas; Omara Farooq; Xueying Zhang; Stuart A Gansky; Benjamin W Chaffee

doi:10.1016/j.drugalcdep.2024.111313

Perceived discrimination and youth vaping: The role of intersectional identities

Drug Alcohol Depend. 2024 Apr 26:260:111313. doi: 10.1016/j.drugalcdep.2024.111313. Online ahead of print.

Authors

Candice D Donaldson¹, David A Stupplebeen², Elizabeth T Couch³, Adrianna I Rojas², Omara Farooq², Xueying Zhang², Stuart A Gansky³, Benjamin W Chaffee³

Affiliations

¹ California Tobacco Prevention Program, California Department of Public Health, Sacramento, CA, USA. Electronic address: Candice.Donaldson@cdph.ca.gov.
² California Tobacco Prevention Program, California Department of Public Health, Sacramento, CA, USA.
³ Center for Tobacco Control Research and Education, University of California San Francisco, CA, USA; Division of Oral Epidemiology and Dental Public Health, University of California San Francisco, San Francisco, CA, USA.

PMID: 38718463
DOI: 10.1016/j.drugalcdep.2024.111313

Abstract

Introduction: Electronic cigarettes (also termed e-cigarette or vapes) often contain nicotine, an addictive psychoactive substance, which can have harmful effects during adolescence. Frequent experiences of discrimination are one risk factor shown to increase susceptibility to tobacco use, especially for individuals that identify as a social minority. Applying Intersectionality Theory, this research examined the relationship between youth experiences of discrimination and vape use at the intersection of race/ethnicity and sexual orientation.

Method: Cross-sectional survey data from 4747 youth (ages 12-17) that participated in the 2022 Teens, Nicotine, and Tobacco Project (TNT) online survey were used to evaluate the impact of discrimination on vape use for lesbian, gay, bisexual, and/or queer/questioning (LGBQ+) youth of color.

Results: Multivariable regression analyses showed that identifying as both a sexual and racial/ethnic minority was a risk factor for experiencing discrimination. Frequent discrimination and reporting discrimination due to sexual orientation was associated with a greater likelihood of ever and current vaping. Path models supported that discrimination mediated the relationship between intersectional identity and vape use. LGBQ+ youth of color reported more frequent discrimination, which was associated with a greater likelihood of ever/current vape use.

Conclusions: Intersectionality Theory aids in understanding how discrimination can exacerbate tobacco-related disparities for youth with multiple minority identities. Findings corroborate the importance of measuring discrimination in public health surveys. Effective tobacco interventions could incorporate strategies to cope with discrimination-related stress.

Keywords: Adolescent; Discrimination; Disparities; Racial/ethnic minorities; Sexual orientation; Vaping.