A growing body of research suggests LGBTQ+ youth are not vaping at higher rates simply because of trends or individual choices – they are often coping with stress created by discrimination, rejection and social isolation.
A new study published in the journal Prevention Science examined what researchers described as the “multi-level risk and protective factors” connected to vaping among LGBTQ+ youth. According to the study’s authors, experiences like bullying, violence victimization, family rejection and peer exclusion significantly increase the likelihood that LGBTQ+ young people will use nicotine products as a coping mechanism.
The researchers also found that social pressure and the desire to fit in can play a major role in vaping behavior among LGBTQ+ youth.
The findings build on earlier research from organizations like the Truth Initiative, a nonprofit public health organization focused on tobacco prevention. According to a 2024 report from the organization, 18 percent of LGBTQ+ youth and young adults used e-cigarettes compared to 13 percent of non-LGBTQ+ youth.
According to the Prevention Science study, those disparities are closely tied to what researchers call “minority stress” – the chronic stress marginalized groups experience because of discrimination, stigma and social exclusion.
In everyday terms, minority stress theory suggests that constantly navigating bullying, fear of rejection, pressure to hide one’s identity or the threat of violence creates stress that builds over time and affects both mental and physical health. According to researchers, those stressors are rooted in larger systems of social stigma and discrimination that shape schools, families, policies and public life.
Researchers increasingly argue that public health disparities cannot be separated from the broader social conditions shaping LGBTQ+ people’s daily lives.
According to research from The Trevor Project on LGBTQ+ mental health and substance use, the stress connected to discrimination can become even more intense for people who belong to multiple marginalized groups at once. The organization cited studies showing higher rates of substance use among LGBTQ+ youth of color and transgender youth, particularly those experiencing overlapping forms of discrimination such as racism, homophobia, transphobia or ableism.
The Prevention Science study emphasized that anti-vaping campaigns aimed at LGBTQ+ youth cannot focus only on nicotine use. According to the researchers, successful prevention efforts should also include affirming school environments, family acceptance programs, trauma-informed mental health care and policies that reduce discrimination and victimization.
Truth Initiative previously reported that LGBTQ+ youth living in states with stronger protective policies had significantly lower odds of smoking or vaping than youth living in states with fewer protections.
Those findings raise difficult questions in a political climate where LGBTQ+ books are being removed from school and public library shelves, diversity initiatives are being scaled back and organizations serving LGBTQ+ youth face increasing political scrutiny.
The research suggests reducing vaping disparities among LGBTQ+ youth will require more than anti-vaping campaigns and school discipline policies. Researchers argue that efforts to reduce nicotine use must also address the broader social conditions shaping young people’s lives, including discrimination, exclusion, chronic stress and the pressure to fit into a society that does not fully accept them.