Smoking cessation is difficult to achieve for couples who are both smokers (smoking-concordant). Cessation studies have shown that individuals with smoking partners are more likely to relapse than those with non-smoking partners (Margolis and Wright, 2016, Walsh et al., 2007). For some romantic couples, smoking cigarettes together represents relational behaviors (“those are our good times… our good times together”), ritual for social support (‘‘going with each other’s cravings” as a “courtesy”) (Bottorff et al., 2005), and/or a form of shared stress management (Lewis, 2006). Relational influences and norms about smoking and quitting (Dohnke et al., 2011) which may or may not be concordant within the couple are also important factors that could hinder cessation. In day-to-day contexts, while attempting to quit, observing one’s romantic partner having a cigarette in real time would serve as salient cognitive, olfactory and visual cues in addition to secondhand exposure to cigarette smoke. The current study presents unique data to examine the day-to-day variations in psychological contexts and cessation outcomes among smoking-concordant couples during a quit attempt.

Smoking-concordant, same-sex couples face additional multilevel contextual challenges in their cessation attempts. Studies on cigarette use of non-relational contexts among sexual and gender minority (LGBTQ+) individuals highlight unique contexts embedded in LGBTQ + communities. Cigarette use tends to be more prevalent among LGBTQ + adults (27.4 % among males; 36.0 % among females) compared to heterosexual adults (20.5 % among males; 14.3 % among females) while quit attempts are comparable between LGBTQ+ (45.2 % among males; 54.9 % among females) and heterosexual adults (54.8 % among males; 53.5 % among females) (Johnson, 2016). LGBTQ + individuals show greater odds of more severe tobacco use disorder than heterosexual individuals, especially among middle- and older-aged adults (Gordon, 2021). Qualitative research has identified a range of individual-level and cultural barriers to cessation: cigarette use as a tool to be accepted, as a way to cope with minority stress and permissive community norms (Matthews, 2017). In addition, it has been well-documented that the tobacco industry strategically and deliberately targets LGBTQ + communities through norm-shaping advertisements, discounts, and heavy presence at social venues involving LGBTQ + groups (Acosta-Deprez et al., 2021, Glissmeyer et al., 2018, Hendlin et al., 2023). More prevalent co-use of other substances such as alcohol and cannabis has also been documented in this group compared to heterosexual smokers (Ehlke et al., 2023, Lee et al., 2025, Nguyen et al., 2021, Vogel et al., 2024). This co-use pattern may present additional challenges to LGBTQ + couples during their cigarette cessation to manage negative physiological symptoms associated with nicotine withdrawal.

Minority stress is distinct from general stress experienced by the general population (e.g., job loss), in that minority stress inherently carries stigma and prejudice (e.g., job loss due to institutional heterosexism) (Frost and Meyer, 2023, Meyer, 2003). Minority stress is theorized to result in disparities that adversely affect the health of marginalized individuals, including disproportionate smoking rates (Hoy-Ellis, 2023). External stressors such as stigma and discrimination affect individual health through complex pathways. A recent literature review examined how different levels of “-isms” are at play: structural barriers rooted in systemic racism/sexism, interpersonal discrimination and internalized stigma in a cascading and bi-directional fashion (Akinade, 2023).

Minority stressors are often understood in an intersectional framework in that the oppression and mistreatment are attributable to multiple, simultaneously-intersecting identities of an individual (e.g., gender identity, sexual orientation, race/ethnic minority status, socioeconomic status, religious/societal practices, cultural ideologies, including the outcomes of the interactions of these characteristics) (Huang et al., 2020, Swann et al., 2020, Swann et al., 2023, Takeda et al., 2021). Intersectionality framework calls attention to the complex and synergetic—rather than simply additive, effects of multitudes of identities that an individual holds as well as how the person is perceived by a hegemonic society conflicted with oppression and power (Everett et al., 2019, Rivas-Koehl et al., 2023). Modern extensions of the original minority stress theory (Meyer, 2003) (e.g., Temporal Intersectional Minority Stress theory25) provide a more dynamic view that is augmented by the historical/temporal dimension and related societal contexts, which may help better contextualize the daily experiences of LGBTQ + individuals. In relation to health behaviors, among LGBTQ + individuals, those who experience greater intersectional discrimination and stigma, violence victimization or internalized minority stress (Blosnich and Horn, 2011, Li et al., 2024, McCabe et al., 2019) are more likely to smoke cigarettes (Blosnich and Horn, 2011, McCabe et al., 2019), to meet criteria for tobacco use disorder (Kcomt, 2021), to be more heavily dependent on nicotine (Li, 2024) and to more likely co-use multiple substances including tobacco (Brennan et al., 2012, Reback et al., 2012).

Perceived stigma and discrimination – experienced both directly towards the self and vicariously towards others (Moody, 2023) – has shown adverse effects on physical (Budhwani & De, 2019) and psychological health outcomes (Gessner et al., 2020, Swann et al., 2020), including tobacco use. Directly witnessing or secondhand exposure to others experiencing discrimination (i.e., vicarious discrimination) (Holloway & Varner, 2023) is distressing and can have negative effects on health. The negative effects on mental health have been shown not only for vicarious discrimination directed toward family and acquaintances (Holloway & Varner, 2023) but also vicarious experiences of historical group-based discrimination (Jones, 2015). However, little is known about whether and how vicarious discrimination experiences influence cessation processes among LGBTQ + adults.

Cross-sectional studies have documented the association between perceived discrimination and smoking to explain the differences between heterosexual/cisgender and LGBTQ + groups. However, time-sensitive, acute effects of vicarious discrimination (i.e., effects on same-day outcomes) are rarely studied, especially in the context of romantic couples who share concordant smoking status.

In this study, we examined the extent to which the daily experiences of perceived discrimination (PD; any and intersectional PD) are associated with cessation-related outcomes among these couples. Specifically, we simultaneously tested acute effects of PD on one’s own cessation outcomes (actor effect) as well as on their partner’s cessation outcomes (partner effect) on a given day. For the current paper, we operationalized the latter effect as vicarious discrimination and quantify how daily experiences of PD acutely impact one’s own and their partners’ cigarette use, substance co-use and smoking cessation-related processes during a smoking quit attempt. We hypothesized that on days participants experience PD (vs. days experiencing none), the participants (actor effect) and their partners (partner effect) would report lower 1) perceived quit support, 2) perceived quit stress, and would be more likely to report 3) smoking relapse and 4) co-using substances in addition to cigarettes that day. We further examined whether the acute effects of intersectional PD on these outcomes were different than that of PD.