title: Structural stigma and cigarette smoking in a prospective cohort study of sexual minority and heterosexual youth.
abstract: BACKGROUND
  Sexual minority youth are more likely to smoke cigarettes than heterosexuals, but research into the determinants of these disparities is lacking.
  
  
  OBJECTIVE
  This study aimed to examine whether exposure to structural stigma predicts cigarette smoking in sexual minority youth.
  
  
  METHODS
  Prospective data from adolescents participating in the Growing Up Today Study (2000-2005) were utilized.
  
  
  RESULTS
  Among sexual minority youth, living in low structural stigma states (e.g., states with non-discrimination policies inclusive of sexual orientation) was associated with a lower risk of cigarette smoking after adjustment for individual-level risk factors (relative risk [RR] = 0.97; 95 % confidence interval [CI], 0.96, 0.99; p = 0.02). This association was marginally significant after additional controls for potential state-level confounders (RR = 0.97; 95 % CI, 0.93, 1.00; p = 0.06). In contrast, among heterosexual youth, structural stigma was not associated with past-year smoking rates, documenting specificity of these effects to sexual minority youth.
  
  
  CONCLUSIONS
  Structural stigma represents a potential risk factor for cigarette smoking among sexual minority adolescents.
authors.affiliation: Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, 722 West 168th St, Room 549.B, New York, NY, 10032, USA, mlh2101@columbia.edu.
authors.forename: Mark L
authors.initials: ML
authors.lastname: Hatzenbuehler
authors.forename: Hee-Jin
authors.initials: HJ
authors.lastname: Jun
authors.forename: Heather L
authors.initials: HL
authors.lastname: Corliss
authors.forename: S Bryn
authors.initials: SB
authors.lastname: Austin
mesh_terms: D000293:Adolescent; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008913:Minority Groups / Q000523:psychology*; D011446:Prospective Studies; D012307:Risk Factors; D019529:Sexuality / Q000523:psychology*; D012907:Smoking / Q000523:psychology*; D057545:Social Stigma; D055815:Young Adult