Intersectional Disparities in Youth Tobacco Use by Sexual and/or Gender Minority Status and Race/Ethnicity.

This study examines how intersecting identities of sexual and/or gender minority (SGM) status and race and/or ethnicity relate to youth tobacco use, psychological outcomes, and societal factors using data from the 2019–2020 California Student Tobacco Survey of over 133,000 8th to 12th graders. Findings indicate that SGM youth, particularly those who are also racial minorities—most notably Black or African American SGM adolescents—experience poorer school tobacco education and cessation support, lower school and family connectedness, higher anxiety and depression symptoms, and a higher prevalence of ever using combustible tobacco products compared to non-SGM white youth. Conversely, non-SGM white youth showed higher rates of ever and current vaping. The study underscores the value of applying Intersectionality Theory to better understand and address tobacco-related disparities among youth and recommends that public health policies and interventions incorporate intersectional approaches to promote equity.