Journal of Health Economics · 2026 · Tony Chuo、Chad D. Cotti、Charles Courtemanche、Johanna Catherine Maclean、Erik T. Nesson、Joseph J. Sabia
中文摘要
女同性恋、男同性恋、双性恋及性向存疑（LGBQ）青少年中电子尼古丁传送系统的使用率比异性恋同龄人高出近50%。然而，对于近期通过烟草控制政策遏制尼古丁电子烟使用的努力如何影响性少数群体，人们知之甚少。少数群体压力假说（MSH）认为，LGBQ青少年可能使用尼古丁来调节其独特的压力源，这可能导致LGBQ青少年对旨在减少尼古丁产品使用的州政策反应较弱。本研究利用2015—2023年州青少年行为调查数据以及广义双重差分识别策略探讨这一问题。我们考察美国四项常见政策的重要性：电子尼古丁传送系统税、卷烟税、电子尼古丁传送系统最低法定销售年龄和电子尼古丁传送系统口味禁令。我们记录了与MSH一致的、对电子尼古丁传送系统税和最低法定销售年龄法律存在的异质性反应：电子尼古丁传送系统税和最低法定销售年龄法律降低了异性恋青少年的电子烟使用，但未降低LGBQ青少年的使用，尽管后者的基线电子尼古丁传送系统使用率大幅更高。我们还发现，没有心理健康压力源的LGBQ青少年对电子尼古丁传送系统税和口味禁令反应强烈，而有此类压力源的青少年则不然，这也与MSH一致。卷烟税与青少年电子尼古丁传送系统使用基本无关。
Abstract
Electronic nicotine delivery systems (ENDS) use among lesbian, gay, bisexual, and questioning (LGBQ) teenagers is nearly 50 percent higher than among their heterosexual counterparts. Yet little is known about how recent efforts to curb nicotine vaping through tobacco control policies impact sexual minorities. The minority stress hypothesis (MSH) suggests that LGBQ teens may use nicotine to mediate unique stressors, which could lead LGBQ teens to be less responsive to state policies designed to curtail use of nicotine products. This study explores this question using data from the 2015-2023 State Youth Behavior Surveys and a generalized difference-in-differences identification strategy. We consider the importance of four common policies in the U.S.: ENDS taxes, cigarette taxes, ENDS minimum legal sales ages, and ENDS flavor bans. We document heterogeneous responses to ENDS taxes and MLSA laws that are consistent with the MSH: ENDS taxes and MLSA laws reduce vaping among heterosexual youth but not among LGBQ youth, despite substantially higher baseline ENDS use in the latter group. We also find that LGBQ teens without mental health stressors respond strongly to ENDS taxes and flavor bans, whereas those with such stressors do not, also consistent with the MSH. Cigarette taxes are largely unrelated to ENDS use among teens.