Momentary Associations Among Minority Stress, Craving, Affect, and Nicotine Use Among Sexual Minority Youth

ABSTRACT

Objectives

Sexual minority youth are more likely to use nicotine relative to heterosexual youth. The minority stress model posits these disparities are partly due to unique stress (i.e., minority stress) specific to their stigmatized identities. However, there is a dearth of research exploring the fine-grained dynamic interplay between minority stressors, mediating processes, and nicotine use in sexual minority youth’s daily lives and natural environment. We leveraged ecological momentary assessment over a 30-day monitoring period to test the mediating effects of craving and negative and positive affect on the momentary associations between minority stressors and subsequent nicotine use among sexual minority youth who were active nicotine users and recruited from the community.

Methods

Participants were 85 nicotine users, ages 15–19 years old (M age = 17.96, SD = 1.10; 56.6% cisgender female; 56.6% bisexual; 73.5% non-Hispanic White) and half (51.8%) were daily nicotine users.

Results

Results indicated that exposure to a minority stressor was associated with momentary elevations in nicotine craving and negative affect and decreases in positive affect. Nicotine craving and positive affect were also associated with greater probability of subsequent nicotine use. The associations between minority stressors and subsequent nicotine use were mediated through craving and positive, but not negative affect.

Conclusions

Our findings provide the first ecological momentary assessment evidence of these associations among sexual minority youth and help support and advance both addictions and sexual minority-specific models (e.g., minority stress) of nicotine use among youth.

Data Availability Statement

The data that support the findings of this study are available from author, EHM and RM, upon reasonable request.

Disclosure Statement

No potential conflict of interest was reported by the author(s).

Notes

¹ We were initially interested in the relationship between minority stress and negative affect subdomains, especially due to the well-documented cross-sectional and some longitudinal associations between minority stress and psychological distress; therefore, we included subscales for negative affect to capture the wide range of negative affective experiences. However, given the role of positive affect in addiction, we also included a positive affect scale to understand its potential impact. We used as few items as possible to make each EMA survey as brief as possible in order to reduce participant burden.

Additional information

Funding

This work was supported by the National Institute on Minority Health and Health Disparities (R21MD010761 [PIs: Mereish & Miranda]), the National Institute on Alcohol Abuse and Alcoholism (K08AA025011 [PI: Mereish]; K23AA024808 [PI: Treloar Padovano]; K24AA026326 [PI: Miranda]), and the National Institute of Health funded Center of Biomedical Research Excellence (P20GM130414; PI: Treloar Padovano). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.