Abstract
Although findings are mixed, discrimination has been identified as a risk factor for smoking in sexual minority women (SMW; e.g., lesbian and bisexual). We examined associations between past-year discrimination and cigarette smoking among SMW. Using regression analyses we examined associations of past-year discrimination including count of types of discriminatory experiences and attributions of the main reason for discrimination (i.e., sexual orientation, race/ethnicity, gender) with smoking outcomes (e.g., current smoking, nicotine dependence, smoking more cigarettes now than 12 months ago). We conducted exploratory analyses to examine whether race/ethnicity and sexual identity moderated the associations of past-year discrimination with smoking outcomes. The sample included 619 SMW. Most identified as lesbian (74.3%) and non-White (61.1%). SMW who reported a higher count of types of discriminatory experiences (AOR 1.54, 95% CI 1.12–2.12) and any gender-based discrimination in the past year (AOR 4.79, 95% CI 1.39–16.45) reported smoking more cigarettes now than 12 months ago. Associations of other past-year discrimination measures with other smoking outcomes were not significant. Compared to White SMW, any discrimination [B (SD) = 2.56 (0.83)] and a higher count of types of discriminatory experiences in the past year [B (SD) = 0.88 (0.31)] were associated with higher nicotine dependence scores in Black/African American SMW. Past-year discrimination are associated with smoking outcomes in SMW. Black/African American race moderated the associations of any past-year discrimination and a higher count of types of discriminatory experiences with nicotine dependence scores in SMW. Targeted interventions to mitigate the influence of discrimination on smoking among SMW are needed.
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Funding
This work was supported by the National Institute on Alcohol Use and Alcoholism (R01AA013328; PI: T.L. Hughes, F32AA025816; PI: C.B. Veldhuis), the National Heart, Lung, and Blood Institute (K01HL146965; PI: B.A. Caceres) and the National Institute on Minority Health and Health Disparities (U54MD012523; Co-I: A.K. Matthews). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
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All authors contributed to the study conception and design. Data collection was performed by Dr. Tonda Hughes. Dr. Caceres conducted data analyses and wrote the first draft of the manuscript. All authors commented on previous version of the manuscript. All authors read and approved the final manuscript.
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Caceres, B.A., Hughes, T.L., Veldhuis, C.B. et al. Past-year discrimination and cigarette smoking among sexual minority women: investigating racial/ethnic and sexual identity differences. J Behav Med 44, 726–739 (2021). https://doi.org/10.1007/s10865-021-00217-x
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DOI: https://doi.org/10.1007/s10865-021-00217-x