ArticleAnnals of behavioral medicine : a publication of the Society of Behavioral Medicine2021
State-Level Structural Stigma and Smoking Among Sexual Minority Adults in the USA, 2012-2014.
Article in Annals of behavioral medicine : a publication of the Society of Behavioral Medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed.
- Cigarette and E-Cigarette Use in Greater Philadelphia: Proportion of Use Compared to National Data and Local Predictors of Smoking Status.Preventive medicine reports · 2026Article
- Examining pathways between structural stigma and tobacco use: a comparison among young adults living in the United States by sexual orientation and gender identity.International journal for equity in health · 2025Article
- LGB (lesbian, gay, and bisexual) state policy protections and substance use disparities.Health affairs scholar · 2025Article
- Associations of sexual orientation and state-level antidiscrimination policy protections with alcohol, tobacco, and mental health outcomes in a U.S. sample of adolescents and adults.Social science & medicine (1982) · 2025Article
- Minority stress mediates associations of sexual minority state policies and tobacco use among US sexual minority young adults.Drug and alcohol dependence · 2024Article
- Opportunities for incorporating intersectionality into biomedical informatics.Journal of biomedical informatics · 2024Article
- Structural Stigma, Racism, and Sexism Studies on Substance Use and Mental Health: A Review of Measures and Designs.Alcohol research : current reviews · 2024Review
- A Systematic Review Evaluating Disparities in State-Run Quitline Utilization and Effectiveness in the U.S.AJPM focus · 2023Review
- Impact of the policy environment on substance use among sexual minority women.Drug and alcohol dependence reports · 2022Article
Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
backgroundExposure to structural stigma (i.e., societal norms and policies that constrain access to resources) may help explain poor health outcomes among sexual minority (SM) individuals in the USA. PURPOSE: We examined the relationship between structural stigma and smoking prevalence among U.S. SM and heterosexual adults.
methodsWe adapted an index to capture multiple state-level structural stigma indicators, including attitudes toward same-sex marriage; the geographical density of same-sex couples; and state-level policies toward SMs. The outcome variable was current smoking, derived from the National Adult Tobacco Survey (2012-2014). Poisson regression models stratified by SM status were used to assess the relationship between structural stigma and the prevalence ratio (PR) of current smoking. We included a squared term for stigma to explore nonlinear relationships between stigma and smoking. Interaction terms were used to examine effect modification by sex.
resultsAdjusted models suggested a curvilinear PR relationship between stigma and smoking for both SM (linear PR = 1.03 [0.97-1.08]; quadratic PR = 0.98 [0.97-1.00]) and heterosexual (linear PR = 1.00 [0.99-1.02]; quadratic PR = 0.99 [0.988-0.995]) adults. The quadratic term was significant (p < .05) for both SM and heterosexual respondents, however, the change in probability of smoking associated with structural stigma was more pronounced among SM individuals. Specifically, the highest and lowest exposures to stigma were associated with the lowest probabilities of smoking. There was no apparent effect modification by sex.
conclusionsFindings lend support to addressing SM structural stigma as a driver of smoking, particularly among SM adults.
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