Use of Electronic Nicotine Delivery Systems for Weight Control Among Sexual and Gender Minority Individuals Who Smoke Cigarettes

Sexual and gender minority (SGM) individuals report higher dual use of cigarettes and electronic nicotine delivery system (ENDS) use than heterosexual individuals. Weight control intentions may contribute to these differences, as SGM individuals experience greater body dissatisfaction and engagement in disordered eating behaviors, which may increase the likelihood of using tobacco/nicotine products for weight control. This study examined correlates of ENDS and cigarette use for weight control among SGM individuals who report dual use.
Between June-July 2023, 545 SGM adults who reported past 30-day cigarette use completed an online survey. We focused on individuals who also reported past 30-day ENDS use (n  =  174). Bivariate correlations explored associations with ENDS and cigarette use for weight control indexed by the adapted version of the Smoking-Related Weight and Eating Episodes Test for ENDS (SWEET-EC) and original the SWEET for cigarettes. Variables with significant associations were entered into regression models to understand their relationship with using ENDS and cigarettes for weight control.
Most participants identified as bisexual (∼48%), women (∼51%), and White (∼68%) with an average age of 35 years (SD = 9.5). Across regression models, gender identity discrimination, disordered eating behaviors and ENDS or cigarette dependence were all positively associated with ENDS and cigarette use for weight control (all ps < 0.05).
Tobacco prevention/intervention programs for SGM populations should consider the impacts of gender-based discrimination and disordered eating behaviors on the use of ENDS and cigarettes for weight control. Given effects observed for dependence additional supports for cessation also may be needed.