How work impacts health and smoking practices among sexuality and gender minority young adults

While work has been established as an important social determinant of health, it remains understudied in health inequities research. Although work has the potential to both promote and harm health, this analysis focuses on the health-compromising elements of work in a sample of sexuality and gender minority (SGM) young adults in the San Francisco Bay Area who participated in a study investigating nicotine and tobacco (NT) use practices. Survey and interview data were collected from 100 participants ages 18–25 who reported current or former NT use. In-depth qualitative interviews explored their experiences of daily life, social identities and beliefs about structural oppression, practices of NT use, and perceptions of health and wellbeing. A thematic analysis of the narratives highlighted the centrality of work to daily life. Participants described how work structured time and became a site of daily exploitation. They also identified the structural barriers that shape employment opportunities for SGM young adults, compromising health, and shaping NT use. Results elucidate the harmful practices embedded in daily work and the inequities within the structure of work itself, underscoring the need to shift focus away from individual behaviors like NT use and towards the structural factors that perpetuate health inequities.