The use of electronic cigarettes (e-cigarettes), colloquially termed vaping, involves the inhalation of heated aerosol that typically contains nicotine, flavors, and/or other chemicals (Goniewicz et al., 2014), and has become the most popular tobacco product used among youth (Gentzke et al., 2019). Although vapes might represent a cessation tool for adult cigarette smokers, the nicotine found in vapes can have negative health implications for adolescents including addiction, dependence, long-term harm to brain development (Abreu-Villaça et al., 2003), an increased odds of cigarette initiation and frequent smoking behavior (Staff et al., 2022), poor mental health outcomes (Wang and Donaldson, 2023), and the use of other illicit substances (Park et al., 2020). Epidemiological studies also point to the negative impact of vaping on human health, including associations with respiratory disorders (Wills et al., 2021) and cardiovascular disease (Gordon et al., 2022). Understanding and preventing vape use and initiation among vulnerable youth therefore represents a global public health priority. For example, a growing body of evidence suggests that tobacco-related disparities exist based on demographic characteristics (Donaldson et al., 2022, Donaldson et al., 2023, Felner et al., 2022), with research indicating that youth who identify as lesbian, gay, bisexual, and/or queer/questioning (LGBQ+) are more likely to engage in tobacco use than their heterosexual peers (Blosnich et al., 2013).

The minority stress model has been applied to understand underlying risk factors that drive LGBQ+ substance use disparities (Meyer, 2003). Minority stress (e.g., stigma, prejudice, discrimination) is persistent, originates from social systems, and creates a hostile social environment that can cause psychiatric distress and substance use problems (Meyer, 2003). In particular, discrimination represents chronic experiences of unfair treatment based on a person’s perceived or actual membership with a stigmatized group (Williams et al., 1997), and is an example of a minority stressor that is shown to negatively impact well-being (Schmitt et al., 2014). In addition to impacting health directly via biological stress responses (Harrell et al., 2003), discrimination is also argued to result in harmful health behaviors, such as tobacco use (Wiehe et al., 2010), in an attempt to self-medicate and cope with psychosocial and emotional distress (Unger, 2018). An improved understanding of the relationship between discrimination and tobacco use is helpful for ending the tobacco epidemic and informing public health policies and interventions.

Evidence supports that tobacco use also differs at the intersection of race/ethnicity and sexual orientation, with LGBQ+ youth of color shown to be at an increased risk of use compared to their heterosexual counterparts of the same race/ethnicity (Blosnich et al., 2011, Corliss et al., 2014, Donaldson et al., 2023). Accordingly, tobacco use and experiences of discrimination might be better understood through the lens of Intersectionality (Bowleg, 2012, Crenshaw, 1990). This framework considers how health disparities are impacted by the unique experiences of individuals that identify with multiple marginalized groups and the additive forms of stress they might experience (e.g., racism, homophobia) within the context of societal systems of oppression (Bowleg, 2012, Crenshaw, 1990, Sheffer et al., 2022). Intersectionality theory has recently been applied to understand differences in youth tobacco use, showing that sexual minority youth of color are at an increased risk of using combustible tobacco products (Donaldson et al., 2023) and vapes (Lee and Tan, 2022). Thus, understanding unique differences in experiences of discrimination and vape use using an intersectional approach is likely to have important implications for informing tailored prevention and cessation efforts that target at-risk teens (Donaldson et al., 2023).