Abstract: The Mediating Roles of Victimization and Social Support in the Effects of Nicotine Dependence on Psychological Distress Among Sexual and Gender Minority Adolescents and Emerging Adults (Society for Social Work and Research 28th Annual Conference - Recentering & Democratizing Knowledge: The Next 30 Years of Social Work Science)
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The Mediating Roles of Victimization and Social Support in the Effects of Nicotine Dependence on Psychological Distress Among Sexual and Gender Minority Adolescents and Emerging Adults

Schedule:
Sunday, January 14, 2024
Monument, ML 4 (Marriott Marquis Washington DC)
* noted as presenting author
Chenglin Hong, MSW, MPH, PhD Candidate, University of California, Los Angeles, Los Angeles, CA
Elizabeth Wu, MPH, Research Director, University of California, Los Angeles, CA
Risa Flynn, Manager, Los Angeles LGBT Center, CA
Robert Bolan, MD, Medical Director, Los Angeles LGBT Center, CA
Ian Holloway, Professor, University of California, Los Angeles
Background and purpose

Sexual and gender minority (SGM) adolescents and emerging adults (SGMAEAs) face unique challenges and stressors that may increase their likelihood of experiencing psychological distress. One such stressor is nicotine dependence, which has been shown to be associated with increased psychological distress and considered as a coping mechanism among this population. However, the mechanisms underlying this relationship are not well understood. Based on the Minority Stress Model, the effects of nicotine dependence on psychological distress may be exacerbated by traumatic experiences and lack of social support in this populations. This study aimed to examine the mediating role of victimization and social support in the association between nicotine dependence and psychological distress among a sample of SGMAEAs in California.

Methods

Data were derived from a larger study exploring the disparities in tobacco product use among SGMAEAs. Recruitment occurred between 2020 and 2021 through both online and in-person strategies. For this analysis, we only included individuals who self-reported as cis-gender sexual minority men/women or transgender or gender nonconforming (n=846). We used the Penn State Nicotine Dependence Index and the Kessler-6 scale (K6) to assess nicotine dependence and psychological stress, respectively. We measured victimization and social support using an adapted 6-item victimization scale and the Multidimensional Scale of Perceived Social Support scale. We first conducted multivariable linear regression to assess the association between nicotine dependence and psychological distress adjusting for sociodemographic characteristics. Two separate path analyses were conducted to test the mediating role of victimization and social support using providing path coefficient estimates (β) and boot-strapped 95% confidence intervals (95% CI) for indirect effects based on 5000 bootstrapping resamples.

Results

The average age of participants was 23.1 (SD=3.11). The prevalence of nicotine dependence among SGMAEAs in our study sample was 7.3% and 54.0% were screened for psychological distress based on K6. Multivariable regression revealed that nicotine dependence was significantly associated with increased psychological distress among SGMAEAs after adjusting for sociodemographic characteristics (adjusted β=0.14, SE=0.04, p<0.01). In path analyses, the direct effect of nicotine dependence on psychological distress was no longer significant (β=0.064 and β=0.094, p>0.2 for both), while the indirect effects of nicotine dependence on psychological via victimization (β=0.363) and social support (β=-0.114) were statistically significant (p<0.001 for both). The models suggested the full mediating roles of victimization and social support with 77% and 37% of the effect of nicotine dependence on psychological distress was mediated by victimization and social support.

Conclusions

We observed high rates of psychological distress among SGMAEAs in California and increased psychological distress was associated with nicotine dependence. Our mediating analyses revealed the underlying mechanism and suggested there might be potential pathways between this association that while victimization exacerbated the effects of nicotine dependence on psychological distress, social support could buffer the negative effects. These findings highlight the need for interventions that target both nicotine dependence and psychological distress among SGM individuals, with a particular emphasis on increasing social support and reducing victimization experiences.

Back to: Social Resources that Moderate the Mental Health Impacts of Social Stressors for Youth
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