{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T00:11:35Z","timestamp":1791850295905,"version":"4.3.4"},"reference-count":38,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,5,8]],"date-time":"2025-05-08T00:00:00Z","timestamp":1746662400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,5,8]],"date-time":"2025-05-08T00:00:00Z","timestamp":1746662400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["K99CA260718"],"award-info":[{"award-number":["K99CA260718"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Int J Equity Health"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Sexual and gender minority young adult (SGM YA) populations use tobacco at higher rates than their non-SGM YA peers. Prior studies have identified significant correlations between interpersonal stigma and tobacco use, yet structural stigma may also influence tobacco use among SGM YA. This study aimed to assess the indirect effects of structural stigma on current tobacco use among SGM YA and non-SGM YA via depletion of economic resources, interpersonal discrimination, and perceived psychological stress.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Structural Equation Modeling was used to conduct a secondary data analysis from a cross-sectional parent study. Eligible participants were 18\u201335 years old and currently residing in the U.S. (\n                      <jats:italic>N<\/jats:italic>\n                      \u2009=\u20092,649). Current use of combustible cigarettes and nicotine vapes was our dependent variable. Our independent variable of interest, structural stigma, was a latent variable comprised of three state-level indicator items: Attitudes toward SGM people, SGM protective policies (absence of), and SGM discriminatory policies (introduced or passed in 2022). We assessed three mediators of interest: Depletion of economic resources was a latent variable, which included two indicator items: food insecurity and financial strain. Interpersonal discrimination and perceptions of psychological stress were also assessed. Covariates included race\/ethnicity, age, and educational attainment.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Structural stigma was indirectly associated with current tobacco use via depletion of economic resources for SGM YA, but not non-SGM YA. Structural stigma was not indirectly associated with current tobacco use via interpersonal discrimination or psychological stress for either group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Future tobacco intervention research should consider the role of structural stigma when working with SGM YA; specifically, how interventions promoting economic stability may influence tobacco use and cessation in this population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12939-025-02487-2","type":"journal-article","created":{"date-parts":[[2025,5,8]],"date-time":"2025-05-08T03:27:19Z","timestamp":1746674839000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Examining pathways between structural stigma and tobacco use: a comparison among young adults living in the United States by sexual orientation and gender identity"],"prefix":"10.1186","volume":"24","author":[{"given":"Wilson","family":"Figueroa","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Srinivasan","family":"Sridhar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emma","family":"Jankowski","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alysha","family":"Ennis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne","family":"Trinh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Seiber","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanne G.","family":"Patterson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,5,8]]},"reference":[{"key":"2487_CR1","unstructured":"National Center for Chronic Disease Prevention and Health Promotion (US) Office on Smoking and Health. The health consequences of smoking\u201450 years of progress: a report of the surgeon general. Atlanta (GA): U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health. 2014 [cited 2023 Sep 29]. (Reports of the Surgeon General). Available from: http:\/\/www.ncbi.nlm.nih.gov\/books\/NBK179276\/"},{"key":"2487_CR2","doi-asserted-by":"publisher","unstructured":"Drope J, Liber AC, Cahn Z, Stoklosa M, Kennedy R, Douglas CE et al. Who\u2019s still smoking? Disparities in adult cigarette smoking prevalence in the United States. CA Cancer J Clin. 2018 [cited 2024 May 6];68(2):106\u201315. Available from: https:\/\/acsjournals.onlinelibrary.wiley.com\/doi\/https:\/\/doi.org\/10.3322\/caac.21444","DOI":"10.3322\/caac.21444"},{"key":"2487_CR3","doi-asserted-by":"crossref","unstructured":"Hinds JT, Loukas A, Perry CL. Sexual and gender minority college students and tobacco use in Texas. Nicotine Tob Res. 2018 [cited 2024 May 6];20(3):383\u20137. Available from: https:\/\/academic.oup.com\/ntr\/article\/20\/3\/383\/3791455","DOI":"10.1093\/ntr\/ntx095"},{"key":"2487_CR4","doi-asserted-by":"publisher","first-page":"108298","DOI":"10.1016\/j.drugalcdep.2020.108298","volume":"217","author":"EA Krueger","year":"2020","unstructured":"Krueger EA, Braymiller JL, Barrington-Trimis JL, Cho J, McConnell RS, Leventhal AM. Sexual minority tobacco use disparities across adolescence and the transition to young adulthood. Drug Alcohol Depend. 2020;217:108298.","journal-title":"Drug Alcohol Depend"},{"key":"2487_CR5","doi-asserted-by":"crossref","unstructured":"Meyer IH, Frost DM. Minority stress and the health of sexual minorities. In: Patterson CJ, D\u2019Augelli AR, editors. Handbook of Psychology and Sexual Orientation. Oxford University Press; 2012 [cited 2023 Sep 29]. pp. 252\u201366. Available from: https:\/\/academic.oup.com\/book\/6050\/chapter\/149494151","DOI":"10.1093\/acprof:oso\/9780199765218.003.0018"},{"key":"2487_CR6","doi-asserted-by":"publisher","unstructured":"Li M, Chau K, Calabresi K, Wang Y, Wang J, Fritz J et al. The effect of minority stress processes on smoking for lesbian, gay, bisexual, transgender, and queer individuals: a systematic review. LGBT Health. 2024 [cited 2024 May 2];lgbt.2022.0323. Available from: https:\/\/www.liebertpub.com\/doi\/https:\/\/doi.org\/10.1089\/lgbt.2022.0323","DOI":"10.1089\/lgbt.2022.0323"},{"key":"2487_CR7","doi-asserted-by":"crossref","unstructured":"Hatzenbuehler ML, Link BG. Introduction to the special issue on structural stigma and health. Soc Sci Med. 2014 [cited 2024 May 2];103:1\u20136. Available from: https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0277953613007090","DOI":"10.1016\/j.socscimed.2013.12.017"},{"key":"2487_CR8","unstructured":"American Civil Liberties Union. Mapping attacks on LGBTQ rights in U.S. State Legislatures in 2023. American Civil Liberties Union. 2023 Dec. Available from: https:\/\/www.aclu.org\/legislative-attacks-on-lgbtq-rights-2023"},{"key":"2487_CR9","doi-asserted-by":"crossref","unstructured":"Hatzenbuehler ML, Lattanner MR, McKetta S, Pachankis JE. Structural stigma and LGBTQ\u2009+\u2009health: a narrative review of quantitative studies. Lancet Public Health. 2024 [cited 2024 May 2];9(2):e109\u201327. Available from: https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S2468266723003122","DOI":"10.1016\/S2468-2667(23)00312-2"},{"key":"2487_CR10","doi-asserted-by":"publisher","first-page":"100058","DOI":"10.1016\/j.dadr.2022.100058","volume":"3","author":"LA Drabble","year":"2022","unstructured":"Drabble LA, Munroe C, Mericle AA, Zollweg S, Trocki KF, Karriker-Jaffe KJ. Impact of the policy environment on substance use among sexual minority women. Drug Alcohol Depend Rep. 2022;3:100058.","journal-title":"Drug Alcohol Depend Rep"},{"key":"2487_CR11","doi-asserted-by":"crossref","unstructured":"Hatzenbuehler ML, Wieringa NF, Keyes KM. Community-level determinants of tobacco use disparities in lesbian, gay, and bisexual youth: results from a population-based study. Arch Pediatr Adolesc Med. 2011 [cited 2024 May 2];165(6):527\u201332. Available from: http:\/\/archpedi.jamanetwork.com\/article.aspx?doi=10.1001\/archpediatrics.2011.64.","DOI":"10.1001\/archpediatrics.2011.64"},{"issue":"1","key":"2487_CR12","doi-asserted-by":"publisher","first-page":"48","DOI":"10.1007\/s12160-013-9548-9","volume":"47","author":"ML Hatzenbuehler","year":"2014","unstructured":"Hatzenbuehler ML, Jun HJ, Corliss HL, Austin SB. Structural stigma and cigarette smoking in a prospective cohort study of sexual minority and heterosexual youth. Ann Behav Med Publ Soc Behav Med. 2014;47(1):48\u201356.","journal-title":"Ann Behav Med Publ Soc Behav Med"},{"key":"2487_CR13","doi-asserted-by":"publisher","unstructured":"Hatzenbuehler ML, Flores AR, Gates GJ. Social attitudes regarding same-sex marriage and LGBT health disparities: results from a national probability sample. J Soc Issues. 2017 [cited 2024 May 2];73(3):508\u201328. Available from: https:\/\/spssi.onlinelibrary.wiley.com\/doi\/https:\/\/doi.org\/10.1111\/josi.12229","DOI":"10.1111\/josi.12229"},{"key":"2487_CR14","doi-asserted-by":"publisher","unstructured":"Poteat VP, Sinclair KO, DiGiovanni CD, Koenig BW, Russell ST. Gay\u2013straight alliances are associated with student health: a multischool comparison of LGBTQ and heterosexual youth. J Res Adolesc. 2013 [cited 2024 May 2];23(2):319\u201330. Available from: https:\/\/onlinelibrary.wiley.com\/doi\/https:\/\/doi.org\/10.1111\/j.1532-7795.2012.00832.x","DOI":"10.1111\/j.1532-7795.2012.00832.x"},{"issue":"2","key":"2487_CR15","doi-asserted-by":"publisher","first-page":"82","DOI":"10.1089\/lgbt.2019.0205","volume":"7","author":"RJ Watson","year":"2020","unstructured":"Watson RJ, Park M, Taylor AB, Fish JN, Corliss HL, Eisenberg ME, et al. Associations between community-level LGBTQ-supportive factors and substance use among sexual minority adolescents. LGBT Health. 2020;7(2):82\u20139.","journal-title":"LGBT Health"},{"key":"2487_CR16","doi-asserted-by":"publisher","first-page":"108659","DOI":"10.1016\/j.drugalcdep.2021.108659","volume":"221","author":"RJ Watson","year":"2021","unstructured":"Watson RJ, Fish JN, Denary W, Caba A, Cunningham C, Eaton LA. LGBTQ state policies: a lever for reducing SGM youth substance use and bullying. Drug Alcohol Depend. 2021;221:108659.","journal-title":"Drug Alcohol Depend"},{"key":"2487_CR17","doi-asserted-by":"publisher","unstructured":"Pachankis JE, Hatzenbuehler ML, Br\u00e4nstr\u00f6m R, Schmidt AJ, Berg RC, Jonas K et al. Structural stigma and sexual minority men\u2019s depression and suicidality: a multilevel examination of mechanisms and mobility across 48 countries. J Abnorm Psychol. 2021 [cited 2024 May 2];130(7):713\u201326. Available from: https:\/\/doi.org\/10.1037\/abn0000693","DOI":"10.1037\/abn0000693"},{"issue":"6","key":"2487_CR18","doi-asserted-by":"publisher","first-page":"557","DOI":"10.1093\/abm\/kaaa086","volume":"55","author":"AR Titus","year":"2020","unstructured":"Titus AR, Gamarel KE, Thrasher JF, Meza R, Fleischer NL. State-level structural stigma and smoking among sexual minority adults in the USA, 2012\u20132014. Ann Behav Med Publ Soc Behav Med. 2020;55(6):557\u201370.","journal-title":"Ann Behav Med Publ Soc Behav Med"},{"key":"2487_CR19","doi-asserted-by":"publisher","unstructured":"White BP, Abuelezam NN, Fontenot HB, Jurgens CY. Exploring relationships between state-level LGBTQ inclusivity and BRFSS indicators of mental health and risk behaviors: a secondary analysis. J Am Psychiatr Nurses Assoc. 2023 [cited 2024 May 2];29(3):224\u201331. Available from: http:\/\/journals.sagepub.com\/doi\/https:\/\/doi.org\/10.1177\/10783903211007900","DOI":"10.1177\/10783903211007900"},{"key":"2487_CR20","doi-asserted-by":"publisher","unstructured":"Carpenter CS, Eppink ST, Gonzales G, McKay T. Effects of access to legal same-sex marriage on marriage and health. J Policy Anal Manage. 2021 [cited 2024 May 2];40(2):376\u2013411. Available from: https:\/\/onlinelibrary.wiley.com\/doi\/https:\/\/doi.org\/10.1002\/pam.22286","DOI":"10.1002\/pam.22286"},{"issue":"9","key":"2487_CR21","doi-asserted-by":"publisher","first-page":"1608","DOI":"10.2105\/AJPH.2006.102525","volume":"98","author":"RB Warnecke","year":"2008","unstructured":"Warnecke RB, Oh A, Breen N, Gehlert S, Paskett E, Tucker KL, et al. Approaching health disparities from a population perspective: the national institutes of health centers for population health and health disparities. Am J Public Health. 2008;98(9):1608\u201315.","journal-title":"Am J Public Health"},{"key":"2487_CR22","doi-asserted-by":"crossref","unstructured":"Romm KF, Vogel EA, Dyar C, Drabble LA, Cavazos-Rehg PA, Berg CJ. Minority stress mediates associations of sexual minority state policies and tobacco use among US sexual minority young adults. Drug Alcohol Depend. 2024 [cited 2025 Mar 17];265:112477. Available from: https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0376871624014029","DOI":"10.1016\/j.drugalcdep.2024.112477"},{"key":"2487_CR23","doi-asserted-by":"crossref","unstructured":"Cornelius ME, Loretan CG, Jamal A, Davis Lynn BC, Mayer M, Alcantara IC et al. Tobacco product use among adults\u2013 United States, 2021. MMWR Morb Mortal Wkly Rep. 2023 [cited 2025 Mar 17];72(18):475\u201383. Available from: http:\/\/www.cdc.gov\/mmwr\/volumes\/72\/wr\/mm7218a1.htm?s_cid=mm7218a1_w","DOI":"10.15585\/mmwr.mm7218a1"},{"issue":"1suppl","key":"2487_CR24","doi-asserted-by":"publisher","first-page":"S124","DOI":"10.1177\/1524839919874054","volume":"21","author":"JE Kim-Mozeleski","year":"2020","unstructured":"Kim-Mozeleski JE, Pandey R. The intersection of food insecurity and tobacco use: a scoping review. Health Promot Pract. 2020;21(1suppl):S124\u201338.","journal-title":"Health Promot Pract"},{"key":"2487_CR25","unstructured":"The Relationship between Prejudice and Wage Penalties for Gay Men in the United States. - Ian Burn, 2020. [cited 2024 Jul 19]. Available from: https:\/\/journals.sagepub.com\/doi\/full\/10.1177\/0019793919864891?casa_token=DHkTfZz5v4UAAAAA%3A1M4ZwaeVLzbzp_hHxOIAU0qJXeCIArAA-GNx6f0p9IiCH1puPoAqkMK5WnNtOPG5TeMRbktX1IPg"},{"key":"2487_CR26","doi-asserted-by":"crossref","unstructured":"Hatzenbuehler ML. Structural Stigma and Health: How U.S. policies mitigate and amplify stigma. In: Yang LH, Eger MA, Link BG, editors. Migration Stigma. The MIT Press; 2024 [cited 2025 Mar 17]. pp. 165\u201378. Available from: https:\/\/direct.mit.edu\/books\/book\/5753\/chapter\/4672088\/Structural-Stigma-and-Health-How-U-S-Policies","DOI":"10.7551\/mitpress\/15529.003.0012"},{"key":"2487_CR27","unstructured":"Smith TW, Davern M, Fresse J, Morgan S. General social surveys. 1972\u20132018. GSS Data Explorer, NORC at the University of Chicago; [cited 2023 May 5]. Available from: https:\/\/gssdataexplorer.norc.org\/"},{"key":"2487_CR28","unstructured":"Movement Advancement Project. NONDISCRIMINATION LAWS. Movement Advancement Prokect. 2022. Available from: https:\/\/www.lgbtmap.org\/equality-maps\/non_discrimination_laws"},{"key":"2487_CR29","unstructured":"American Civil Liberties Union. Legislation affecting LGBTQ rights across the country. 2022. Available from: https:\/\/www.aclu.org\/documents\/legislation-affecting-lgbtq-rights-across-country-2022"},{"issue":"3","key":"2487_CR30","doi-asserted-by":"publisher","first-page":"335","DOI":"10.1177\/135910539700200305","volume":"2","author":"DR Williams","year":"1997","unstructured":"Williams DR, Yu Y, Jackson null, Anderson JS. Racial differences in physical and mental health: socio-economic status, stress and discrimination. J Health Psychol. 1997;2(3):335\u201351.","journal-title":"J Health Psychol"},{"key":"2487_CR31","unstructured":"Cohen S. Perceived stress in a probability sample of the United States. In: The social psychology of health. Thousand Oaks, CA, US: Sage Publications, Inc; 1988. pp. 31\u201367. (The Claremont Symposium on Applied Social Psychology)."},{"key":"2487_CR32","doi-asserted-by":"publisher","unstructured":"O\u2019Rourke HP, MacKinnon DP. When the test of mediation is more powerful than the test of the total effect. Behav Res Methods. 2015 [cited 2025 Mar 17];47(2):424\u201342. Available from: http:\/\/link.springer.com\/https:\/\/doi.org\/10.3758\/s13428-014-0481-z","DOI":"10.3758\/s13428-014-0481-z"},{"key":"2487_CR33","unstructured":"National Conference of State Legislatures. 2017 Religious Freedom Restoration Act Legislation. National Conference of State Legislatures; 2017. Available from: https:\/\/www.ncsl.org\/research\/civil-and-criminal-justice\/2017-religious-freedom-restoration-act-legislation"},{"key":"2487_CR34","unstructured":"Hasenbush A, Flores AR, Kastanis A, Sears B, Gates GJ. The LGBT divide: a data portrait of LGBT people in the midwestern, mountain & southern states. The Williams Institute; 2014. Available from: https:\/\/escholarship.org\/content\/qt17m036q5\/qt17m036q5_noSplash_76bbb27af26d1e610afb63d07a9c903f.pdf"},{"key":"2487_CR35","doi-asserted-by":"crossref","unstructured":"Singh GK, Lee H, Azuine RE. Food insecurity among lesbian, gay, bisexual, and transgender adults during the COVID-19 pandemic in the United States, July-October 2021. Int J Transl Med Res Public Health. 2022 [cited 2025 Mar 17];6(1). Available from: https:\/\/ijtmrph.org\/lgbt-health-food-insecurity-among-lesbian-gay-bisexual-and-transgender-adults-during-the-covid-19-pandemic-in-the-united-states-july-october-2021\/","DOI":"10.21106\/ijtmrph.413"},{"key":"2487_CR36","doi-asserted-by":"crossref","unstructured":"Morales DX. The mental cost of food insecurity among LGBTQ\u2009+\u2009Americans. Popul Res Policy Rev. 2024 [cited 2025 Mar 17];43(3):34. Available from: https:\/\/link.springer.com\/10.1007\/s11113-024-09881-8","DOI":"10.1007\/s11113-024-09881-8"},{"key":"2487_CR37","doi-asserted-by":"crossref","unstructured":"Berg CJ, Solomon M, Barkley A, Bailey E, Goodwin SB, Kegler MC. Tobacco taxes in the Southeastern US states: views from former legislators. Health Behav Policy Rev. 2015 [cited 2025 Mar 17];2(5):333\u201342. Available from: http:\/\/openurl.ingenta.com\/content\/xref?genre=article%26issn=2326-4403%26volume=2%26issue=5%26spage=333","DOI":"10.14485\/HBPR.2.5.1"},{"key":"2487_CR38","doi-asserted-by":"crossref","unstructured":"Br\u00e4nstr\u00f6m R, Pachankis JE. Structural stigma and 7-year improvement in life satisfaction among diverse groups of sexual minority individuals: a repeated cross-sectional study across 28 countries. Soc Probl. 2023;spad029.","DOI":"10.1093\/socpro\/spad029"}],"container-title":["International Journal for Equity in Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12939-025-02487-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12939-025-02487-2\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12939-025-02487-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,8]],"date-time":"2025-05-08T03:27:35Z","timestamp":1746674855000},"score":1,"resource":{"primary":{"URL":"https:\/\/equityhealthj.biomedcentral.com\/articles\/10.1186\/s12939-025-02487-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,8]]},"references-count":38,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["2487"],"URL":"https:\/\/doi.org\/10.1186\/s12939-025-02487-2","relation":{"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.3.rs-5417843\/v1","asserted-by":"object"}]},"ISSN":["1475-9276"],"issn-type":[{"value":"1475-9276","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,8]]},"assertion":[{"value":"8 November 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 April 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"8 May 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The parent study was approved by The Ohio State University Institutional Review Board, which adheres to the ethical principles for the protection of research participants summarized in the Belmont Report and complies with federal regulations, guidance, and state laws related to human subjects protection, (2021C0020). All participants consented prior to completing the survey.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"128"}}