Primary Submission Category: LGBTQ+
Associations of Sexual Orientation-Related Minority and Military Stressors with Cigarette Smoking among Lesbian, Gay, and Bisexual (LGB) Veterans
Authors: Raymond Ruiz Keren Lehavot Christine Kava Jaimee Heffner India Ornelas
Presenting Author: Raymond Ruiz*
Background: Research indicates that lesbian, gay, and bisexual (LGB) individuals and military Veterans are more likely to report current smoking compared to the general adult population in the United States. The Minority Stress Model may explain the high prevalence of cigarette smoking among LGB individuals who experience unique interpersonal stressors (e.g., discrimination) and intrapersonal stressors (e.g., identity concealment) related to their minoritized sexual orientation. This study assessed whether three types of stressors (interpersonal, intrapersonal, and LGB-specific military) were associated with past-year smoking among LGB Veterans.
Methods: Veterans were recruited for a national online prospective cohort study to understand mental health problems and health risk behaviors. We conducted secondary data analysis of baseline surveys collected from 2019-2020. The study sample included cisgender, LGB Veterans (n=463). Adjusted nested multivariable logistic regression models were used to estimate the association of each stressor with past-year cigarette smoking.
Results: Participants were mostly male (54.0%), non-Hispanic White (82.1%), and at least a college graduate (58.5%). People who smoked in the past year (n=98; 21.2%) were younger, had lower levels of education, income, and healthcare coverage, higher general stressors scores, and PTSD and depressive symptoms. The adjusted odds of smoking in the past year were higher among those who reported higher levels of interpersonal stressors including harassment (aOR=1.13, p=0.032), victimization (aOR=1.21, p=0.024), and family rejection scores (aOR=1.21, p=0.001).
Conclusion: Interpersonal stressors were more salient in their relationship with past-year cigarette smoking. Future multilevel interventions should aim to address policies that reduce prejudice against LGB Veterans, while helping LGB Veterans who smoke identify interpersonal stressors and help develop positive coping skills that support smoking cessation.