Stress, stigma and belonging: understanding social
drivers of cannabis and E-cigarettes use among sexual
and gender minority teens
Costanza Brevi (2162348), Maria Kalantzi (2156153), Fenna Steemers (2071399) – Group 1
1490 words
Introduction
Vaping of e-cigarettes and cannabis among adolescents is a growing public health concern,
associated with nicotine dependence, impaired neurocognitive development, and mental health
challenges (Hammond et al., 2020; Meier et al., 2012). Sexual and gender minority (SGM)
adolescents are particularly vulnerable, reporting higher rates of tobacco, e-cigarette, and can-
nabis use compared to heterosexual and cisgender peers (Azagba et al., 2025). These disparities
are associated with broader social inequalities and highlight the importance of understanding
substance use not just as an individual behavior but as one influenced by minority stress, stigma,
and peer dynamics.
The quantitative findings of Azagba et al. (2025) provide valuable insights into prevalence pat-
terns across diverse sexual and gender identities. For example, bisexual, pansexual, and queer
youth reported the highest rates of e-cigarette use, while asexual adolescents showed elevated
cannabis vaping. Nonbinary, transgender, and genderfluid youth also reported higher overall
rates of substance use. While these results are critical for identifying at-risk groups, survey data
cannot explain why these disparities exist. Quantitative research captures patterns but overlooks
the subjective experiences and meanings behind behaviors. Key questions therefore remain un-
answered: Why do some SGM adolescents engage in vaping while others show less interest in
it? What role do stress, stigma, and peer influences play in these decisions? And what meanings
does cannabis vaping hold for youth across diverse identities?
The Minority Stress Model (Meyer, 2003) provides a theoretical foundation to examine these
processes. It suggests that members of stigmatized groups face unique stressors, such as dis-
crimination, victimization, and anticipated rejection that increase vulnerability to maladaptive
coping strategies, including substance use. Empirical evidence supports this claim, showing
that stigma and social stressors are linked to higher rates of smoking and vaping among SGM
, youth (Day et al., 2017; Figueroa et al., 2024). Although, the knowledge about the way adoles-
cents themselves describe these processes and connect them to their everyday realities remains
limited.
A qualitative approach is well-suited to address this limitation. Focus groups allow for in-depth
exploration of sensitive issues such as stigma, identity, and coping strategies, while also cap-
turing how peer norms and group dynamics influence substance use. Unlike quantitative sur-
veys, qualitative methods uncover subjective meanings and shared narratives, offering a richer
understanding of how behaviors are embedded in social contexts. This has both scientific and
societal relevance: scientifically, it bridges the gap between prevalence data and lived experi-
ence, while societally, it informs identity-sensitive prevention and support programs that reso-
nate with adolescents’ realities.
Building on the limitations of Azagba et al. (2025), this study focuses on SGM adolescents’
perspective to examine how minority stress, stigma, and peer influences inform their vaping
experiences. Therefore, the following research question will be addressed in this study:
“How do sexual and gender minority adolescents who have vaped cannabis in the past 30 days
describe and perceive the roles of minority stress, stigma, and peer dynamics in their decisions
to use, or not use e-cigarettes and cannabis?”
drivers of cannabis and E-cigarettes use among sexual
and gender minority teens
Costanza Brevi (2162348), Maria Kalantzi (2156153), Fenna Steemers (2071399) – Group 1
1490 words
Introduction
Vaping of e-cigarettes and cannabis among adolescents is a growing public health concern,
associated with nicotine dependence, impaired neurocognitive development, and mental health
challenges (Hammond et al., 2020; Meier et al., 2012). Sexual and gender minority (SGM)
adolescents are particularly vulnerable, reporting higher rates of tobacco, e-cigarette, and can-
nabis use compared to heterosexual and cisgender peers (Azagba et al., 2025). These disparities
are associated with broader social inequalities and highlight the importance of understanding
substance use not just as an individual behavior but as one influenced by minority stress, stigma,
and peer dynamics.
The quantitative findings of Azagba et al. (2025) provide valuable insights into prevalence pat-
terns across diverse sexual and gender identities. For example, bisexual, pansexual, and queer
youth reported the highest rates of e-cigarette use, while asexual adolescents showed elevated
cannabis vaping. Nonbinary, transgender, and genderfluid youth also reported higher overall
rates of substance use. While these results are critical for identifying at-risk groups, survey data
cannot explain why these disparities exist. Quantitative research captures patterns but overlooks
the subjective experiences and meanings behind behaviors. Key questions therefore remain un-
answered: Why do some SGM adolescents engage in vaping while others show less interest in
it? What role do stress, stigma, and peer influences play in these decisions? And what meanings
does cannabis vaping hold for youth across diverse identities?
The Minority Stress Model (Meyer, 2003) provides a theoretical foundation to examine these
processes. It suggests that members of stigmatized groups face unique stressors, such as dis-
crimination, victimization, and anticipated rejection that increase vulnerability to maladaptive
coping strategies, including substance use. Empirical evidence supports this claim, showing
that stigma and social stressors are linked to higher rates of smoking and vaping among SGM
, youth (Day et al., 2017; Figueroa et al., 2024). Although, the knowledge about the way adoles-
cents themselves describe these processes and connect them to their everyday realities remains
limited.
A qualitative approach is well-suited to address this limitation. Focus groups allow for in-depth
exploration of sensitive issues such as stigma, identity, and coping strategies, while also cap-
turing how peer norms and group dynamics influence substance use. Unlike quantitative sur-
veys, qualitative methods uncover subjective meanings and shared narratives, offering a richer
understanding of how behaviors are embedded in social contexts. This has both scientific and
societal relevance: scientifically, it bridges the gap between prevalence data and lived experi-
ence, while societally, it informs identity-sensitive prevention and support programs that reso-
nate with adolescents’ realities.
Building on the limitations of Azagba et al. (2025), this study focuses on SGM adolescents’
perspective to examine how minority stress, stigma, and peer influences inform their vaping
experiences. Therefore, the following research question will be addressed in this study:
“How do sexual and gender minority adolescents who have vaped cannabis in the past 30 days
describe and perceive the roles of minority stress, stigma, and peer dynamics in their decisions
to use, or not use e-cigarettes and cannabis?”
