Smoking Discrimination Moderates the Relationship between Smoking Stigma and Cigarettes Per Day among Sexual and Gender Minority Individuals

Background: Sexual and gender minority (SGM) individuals report rates of tobacco use that range from 19% to 40% compared to roughly 20% of the general population. Higher rates of tobacco use, compounded by stress from discrimination, contribute to lower cessation rates and worse smoking-related outcomes for SGM individuals. Having multiple stigmatized identities, such as identifying as SGM and being a person who uses cigarettes, may further increase smoking, and decrease the likelihood of cessation. Smoking-related stigma is one relatively unexplored factor that may be related to smoking frequency. Objectives: The present study sought to examine how smoking stigma was related to smoking frequency, and how discrmination moderates the relationship between smoking stigma and cigarettes per day. Results: A sample of 399 self-identified SGM individuals (Mage = 36.69) was collected via Qualtrics Panels. Participants were primarily White and bisexual. Participants completed a battery of questions, including measures regarding smoking frequency (operationalized in this article as cigarettes per day [CPD]), smoking felt-stigma, smoking self-stigma, and smoking discrimination. Moderation analyses revealed significant interactions of felt- and self-stigma with smoking-related discrimination. For individuals who perceived higher levels of both self- and felt-stigma, experiencing increased smoking discrimination was associated with increased smoking frequency. However, there was no significant interaction with discrimination for individuals who had lower levels of felt- and self-stigma. Results have implications for smoking reduction and cessation. Helping individuals who have higher levels of felt- and self-stigma manage stress related to being stigmatized may motivate individuals to reduce smoking. Ultimately, these findings can play a role in crafting smoking reduction and cessation programs targeted toward SGM communities, particularly individuals who experience high levels of smoking-related stigma.