Correlates of Tobacco and Nicotine Use among Transgender and Gender Diverse People: A Systematic Review Guided by the Minority Stress Model.

Transgender and gender diverse people have a higher prevalence of tobacco and nicotine use compared to their cisgender peers. Using the minority stress model as a guide, we conducted a systematic review of correlates of tobacco and nicotine use among transgender and gender diverse people. We reviewed literature from Pubmed, PsycINFO, and CINAHL between 04/01/1995 and 04/20/2021. Article inclusion criteria were the following: written in English, reported empirical data, sampled exclusively or reported separate outcomes for transgender/gender diverse people, and reported correlates of tobacco or nicotine use, broadly defined. The first and second authors reviewed the articles retrieved from the search and from grey literature (relevant listserv solicitations) for inclusion. They then reviewed references of any included articles for additional candidate articles. This resulted in 35 articles for review, which were synthesized in a qualitative fashion. The overall quality of the articles was fair, with the articles ranging from poor to fair quality and using primarily cross-sectional design and survey methods. Overall, the literature demonstrated external minority stressors were mostly researched (and supported) correlates of tobacco and nicotine use among transgender and gender diverse people. There is a critical need for higher quality research, such as longitudinal or experimental designs, to improve our understanding and prevention of tobacco and nicotine use in this population.