ArticleBMC psychology2026
Invisible minority stress and addictive behaviors: disparities in psychological distress and e-cigarette use among lesbian, gay, and bisexual adults in China.
Article in BMC psychology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundEvidence shows that lesbian, gay, and bisexual (LGB) groups face disparities in e-cigarette use, but little is known about e-cigarette use among the Chinese LGB population. China, with the largest LGB population and as the leading global producer in the e-cigarette industry, presents a unique context for studying this phenomenon.
methodsUsing the theoretical framework of minority stress, this study hypothesized a moderated mediation model to test the mediating effect of psychological distress and the moderating effect of eHealth use on the association between sexual orientation and e-cigarette use. Data from a nationally representative Chinese survey conducted between January and September 2023 (n = 4,901) were analyzed.
resultsThe results indicated that LGB individuals had 11.1% higher odds of distress compared to heterosexual populations, was associated with higher e-cigarette use (bp = 0.038, p < .001). However, the direct association between sexual minority identity and e-cigarette use was non-significant. Furthermore, eHealth use moderated the disparities in psychological distress between LGB and heterosexual groups (bp = - 0.160, p < .05).
conclusionThe pattern of e-cigarette use among Chinese sexual minorities is distinct: e-cigarettes are less commercialized and serve mainly as a coping mechanism. These findings highlight the importance of mental health support and eHealth interventions in reducing psychological distress and e-cigarette use among LGB individuals in China.
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