Social support moderates the relationship between minority stress and stage of change among LGBTQ Smokers in the Deep South

Lesbian, Gay, Bisexual, Transgender, and Queer (LGBTQ) individuals may smoke as a coping mechanism for minority stress. However, the relationship between social support and LGBTQ smoking behaviors is unclear, since smoking is often a way for LGBTQ smokers to socialize with other LGBTQ individuals. Therefore, this study assessed the moderating effect of social support on the relationship between minority stress and smoking outcomes. An online, one-time, cross-sectional study was implemented for LGBTQ smokers in the Deep South ( n = 1,296). Minority stress exposure variables included prejudice events, perceived stigma, and internalized queerphobia. Smoking outcomes included nicotine dependence level and stage of change. Social support from LGBTQ sources and non-LGBTQ sources were assessed as moderators. Multivariate linear regression models were used to assess the moderation effects. Relationships with significant interaction effects were plotted by each level of the moderator. A significant moderating effect of social support from LGBTQ sources was found on the relationship between internalized queerphobia and stage of change ( p = 0.0322). In addition, a significant moderating effect of social support from non-LGBTQ sources was found on the relationship between prejudice events and stage of change ( p = 0.0416). Increased levels of prejudice events were associated with earlier stage of change, and increased levels of internalized queerphobia were associated with further stage of change, only for individuals with moderate/high levels of non-LGBTQ or LGBTQ social support, respectively. The opposite effect was observed for individuals with poor levels. Findings suggest that social support moderates the association between minority stress and smoking outcomes for LGBTQ smokers.