Discrimination and Risky Health Behaviors: Examining the Association between Sources of Gender Discrimination and Tobacco Use Among Adolescent Girls

Abstract

We examined the association between gender discrimination and tobacco use among 725 adolescent girls in the United States. Gender discrimination referred to the interpersonal prejudice individuals experienced because of their gender and included multiple forms (overt, subtle) and sources (teenagers, school personnel, and other important adults). Gender discrimination was measured with five subscales: overt gender discrimination from teenagers, overt gender discrimination from school personnel, overt gender discrimination from other important adults, subtle denial of gender discrimination, and subtle negative treatment. Tobacco use included four groups: no use, combustible tobacco use only, nicotine vaping use only, and dual use of these products. Multinomial logistic regression showed that overt and subtle forms of gender discrimination were positively associated with lifetime dual use compared to non-tobacco use. Overt discrimination from school personnel was positively associated with past month dual use compared to non-tobacco use. Social class and race/ethnicity moderated the associations, highlighting intersectionality.

Plain English Summary

Examining the Link Between Gender Discrimination and Tobacco Use in Teen Girls

This study examined how gender discrimination relates to tobacco use among teenage girls in the United States. Gender discrimination refers to the unfair treatment individuals experience because of their gender. This experience can take different forms, such as overt (direct and noticeable) or subtle (ambiguous). It can also originate from various sources such as, other teenagers, school personnel, and other important adults. We surveyed 725 girls, aged 13–18 with diverse racial/ethnic and social class backgrounds. Participants reported their experiences with five types of gender discrimination (a) overt gender discrimination from teenagers, (b) overt gender discrimination from school personnel, (c) overt gender discrimination from other important adults, (d) subtle denial of gender discrimination, and (e) subtle negative treatment. They also reported their use of tobacco use including combustible tobacco and nicotine vaping devices, categorized into four groups: no use, combustible tobacco use only, nicotine vaping use only, and dual use (both combustible tobacco and nicotine vaping). Findings revealed that subtle forms of discrimination were reported more frequently than overt forms, underscoring the pervasive and often hidden nature of gender bias. Results showed that overt and subtle forms of gender discrimination were associated with a greater likelihood of lifetime dual use compared to no tobacco use. Overt discrimination from school personnel was also positively linked to dual use in the past month. These patterns were stronger for girls whose mothers had completed college education compared to those who had not and among Asian American and Pacific Islander girls compared to Latinx girls. Our findings highlight the link between gender discrimination and risky health behaviors in teen girls. Efforts to address gender discrimination, particularly in school settings, can be critical to support healthier outcomes for adolescent girls.