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Using multivariable logistic regression, the odds of past-30-day nicotine\/tobacco use at W4 were estimated as a function of gender stability\/variability, psychological distress, number of tobacco products used by family\/friends, anti-tobacco marketing exposure, and change in gender minority-related policies from 2015 to 2017.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Gender-varying individuals had higher odds of nicotine\/tobacco use compared with gender-stable individuals (AOR range = 1.7\u20132.3, p &amp;lt; .01). In the overall sample, positive change in gender minority policy protections (tallied from medium to high) was associated with lower odds of any nicotine\/tobacco, other tobacco, and poly-tobacco use (AOR = 0.8, p &amp;lt; .05) compared to states with no change in their negative policies. Anti-tobacco marketing exposure was associated with lower odds of any tobacco, cigarette, e-cigarette, and poly-tobacco use compared with those who had no anti-tobacco marketing exposure (AOR = 0.9, p &amp;lt; .05). Higher psychological distress (AOR range = 1.7\u20132.4, p &amp;lt; .001) and an increasing number of tobacco products used by family\/friends (AOR range = 1.1\u20131.3, p &amp;lt; .001) were associated with increased odds of nicotine\/tobacco use.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Multilevel prevention and intervention strategies are needed to reduce the risk of nicotine\/tobacco use among gender-varying and gender-stable individuals.<\/jats:p><\/jats:sec>","DOI":"10.1093\/abm\/kaad066","type":"journal-article","created":{"date-parts":[[2023,11,20]],"date-time":"2023-11-20T20:39:13Z","timestamp":1700512753000},"page":"1-11","source":"Crossref","is-referenced-by-count":3,"title":["Social Ecological Influences on Nicotine\/Tobacco Use Among Gender-Varying and Gender-Stable Adolescents and Adults in the USA"],"prefix":"10.1093","volume":"58","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5815-0966","authenticated-orcid":false,"given":"Luisa","family":"Kcomt","sequence":"first","affiliation":[{"name":"School of Social Work, Wayne State University , Detroit, MI , USA"},{"name":"Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, University of Michigan , Ann Arbor, MI , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1848-4018","authenticated-orcid":false,"given":"Rebecca J","family":"Evans-Polce","sequence":"additional","affiliation":[{"name":"Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, University of Michigan , Ann Arbor, MI , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4791-8567","authenticated-orcid":false,"given":"Curtiss W","family":"Engstrom","sequence":"additional","affiliation":[{"name":"Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, University of Michigan , Ann Arbor, MI , USA"},{"name":"Survey Research Center, Institute for Social Research, University of Michigan , Ann Arbor, MI , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2308-7159","authenticated-orcid":false,"given":"Jodene","family":"Takahashi","sequence":"additional","affiliation":[{"name":"School of Medicine, Wayne State University , Detroit, MI , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0074-681X","authenticated-orcid":false,"given":"Phoenix A","family":"Matthews","sequence":"additional","affiliation":[{"name":"School of Nursing, Columbia University , New York, NY , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2544-3468","authenticated-orcid":false,"given":"Phil T","family":"Veliz","sequence":"additional","affiliation":[{"name":"Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, University of Michigan , Ann Arbor, MI , USA"},{"name":"Survey Research Center, Institute for Social Research, University of Michigan , Ann Arbor, MI , USA"},{"name":"Institute for Research on Women and Gender, University of Michigan , Ann Arbor, MI , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0160-1388","authenticated-orcid":false,"given":"Brady T","family":"West","sequence":"additional","affiliation":[{"name":"Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, University of Michigan , Ann Arbor, MI , USA"},{"name":"Survey Research Center, Institute for Social Research, University of Michigan , Ann Arbor, MI , USA"},{"name":"Institute for Healthcare Policy and Innovation, University of Michigan, North Campus Research Complex , Ann Arbor, MI , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9622-4652","authenticated-orcid":false,"given":"Sean Esteban","family":"McCabe","sequence":"additional","affiliation":[{"name":"Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, University of Michigan , Ann Arbor, MI , USA"},{"name":"Survey Research Center, Institute for Social Research, University of Michigan , Ann Arbor, MI , USA"},{"name":"Institute for Research on Women and Gender, University of Michigan , Ann Arbor, MI , USA"},{"name":"Institute for Healthcare Policy and Innovation, University of Michigan, North Campus Research Complex , Ann Arbor, MI , USA"},{"name":"Rogel Cancer Center, University of Michigan , Ann Arbor, MI , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2023,11,20]]},"reference":[{"key":"2023121915590880000_CIT0001","volume-title":"Current Cigarette Smoking Among Adults in the United States. 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