Internalized Homophobia and Cigarette Use Among Latino and Black Sexual Minority Men: Protective and Risk Factors

Latino and Black sexual minority men (SMM) are at elevated risk of cigarette use compared to their heterosexual and White SMM counterparts. Internalized homophobia may affect substance use disparities. However, the research linking internalized homophobia and substance use has been inconsistent. The purpose of the present study was to clarify the association between internalized homophobia and daily cigarette use by testing the roles of internalized racism and ethnic identity acceptance as potential moderators of this link. This study collected data from 165 Black and/or Latino SMMs across the United States (Mage = 23.72, SD = 3.85) as part of a larger study. Data were collected from December 2020 to February 2021 via Qualtrics Panels. Zero-inflated Poisson regression was conducted to examine the association between internalized homophobia and daily cigarette use and whether internalized racism and/or ethnic identity acceptance would moderate the association between internalized homophobia and daily cigarette use. Internalized homophobia was negatively associated with daily cigarette use; however, this association was significantly moderated by internalized racism and ethnic identity acceptance. Simple slope analyses revealed that low levels of internalized racism and high levels of ethnic identity acceptance attenuated the positive association between internalized homophobia and daily cigarette use. At low levels of ethnic identity acceptance, the positive association between internalized homophobia and daily cigarette use was strengthened. This research aids in contextualizing the association between internalized homophobia and daily cigarette use among Latino and Black SMM. Implications for smoking treatment and prevention programs are discussed.