Sexual Identity as a Moderator of the Association Between Serious Psychological Distress and E-Cigarette Use Among US Adults, 2021–2023
Bibliographic Data
| ID | 21646067 |
|---|---|
| Authors | Juhan Lee (0000-0003-0860-3327, Albert Einstein College of Medicine, corresponding author), Maria A Parker (0000-0002-9763-1129, Indiana University Bloomington) |
| Year | 2026 |
| Pages | 1-6 |
| Publication date | 2026-05-11 |
| Peer Reviewed | Yes |
| Open Access | No |
| Type | ARTICLE |
| Venue | Substance Use & Misuse (JOURNAL) |
| Journal identifiers | ISSN: 1082-6084 • E-ISSN: 1532-2491 |
| Publisher | Informa UK Limited (PUBLISHER • GB) |
| DOI | 10.1080/10826084.2026.2670623 |
| PMID | 42112776 |
| OpenAlex | W7160864535 |
| Language | EN |
| References cited | 42 |
Background Compared to adults without serious psychological distress (SPD), adults with SPD have higher e-cigarette use (i.e., nicotine vaping), and both SPD and vaping vary by sexual identity. This study examined whether sexual identity modified the association between SPD and e-cigarette use in a nationally representative US adult sample.Methods Data included adults from the 2021–2023 National Survey on Drug Use and Health (NSDUH; N = 139,524). Logistic regression models of past-month e-cigarette use, including an interaction term between serious psychological distress (measured with Kessler-6; no, yes) and sexual identity (heterosexual/straight, gay/lesbian, bisexual) were estimated, adjusted for survey year, sociodemographics, other tobacco use, and substance use. Moderation was evaluated using regression-based marginal effects.Results Overall, 7.7% of adults experienced past-month serious psychological distress, 2.6% (weighted) identified as gay/lesbian, and 5.4% identified as bisexual. Overall, 7.7% reported past-month e-cigarette use. SPD was associated with higher odds of past-month e-cigarette use overall. Sexual identity was a significant moderator of this association (p < 0.001). Regression-based marginal effects indicated that SPD was associated with an increased predicted probability of e-cigarette use among heterosexual adults, but not among gay/lesbian or bisexual adults. However, bisexual adults exhibited the highest overall prevalence of e-cigarette use regardless of distress status.Conclusions Serious psychological distress was associated with e-cigarette use, but the strength of this association differed by sexual identity. Findings highlight the importance of tailored e-cigarette prevention and cessation programs that recognize heterogeneity in e-cigarette use across sexual identity groups
Distress · Logistic regression · Moderation · Psychological distress · Sexual identity · Sexual orientation · Young adult · Attachment and Relationship Dynamics · LGBTQ Health, Identity, and Policy · Sexuality, Behavior, and Technology
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| Citation velocity | historical |
|---|---|
| Highly cited | No |