Stigma, stress among factors that lead to higher tobacco use higher in LGB community


JAMES RUSSELL  |  Staff Writer

Compared to our heterosexual peers, those of us who are lesbian, gay or bisexual are far more likely to be smokers.

Smoking, even secondhand smoke, has deadly results. Tobacco use leads to more than 480,000 premature deaths and $289 billion in health care costs, the highest of any preventable death in the country.

But until 2013, the Centers for Disease Control had no official way of tracking the disproportionate impact tobacco use has on the LGB community. That changed when the National Health Interview Survey included sexual orientation in its annual survey of U.S. citizens 18 years and older. (Gender identity or expression have yet to be included.)

According to the CDC, one in four LGB adults, or 26.6 percent, smoke cigarettes, compared with roughly one in six, or 17.8 percent, of straight adults.

There are a few reasons for the disparity, according to an American Lung Association fact sheet on tobacco use among LGB people. One of the biggest factors is that LGB people, like many other historically marginalized groups, face discrimination and stigma. Research shows, in fact, “even perceived stigma causes stress.”

According to LGBT Healthlink’s most recent survey of health issues critical to LGBTs, Texas received a C+ average for its inclusion of LGBT people in tobacco use surveys and prevention efforts. The survey uses data compiled by affiliated LGBT health organizations nationwide. In Texas, those include Dallas’ Resource Center, Houston’s Montrose Center and Lesbian Health Initiative, Tyler Area Gays: Project TAG and San Antonio’s Pride Center.

The score, according to the study, was average compared to other states, “with room for improvement.”

Those improvements include integrating LGBTs in policy planning and outreach for tobacco prevention education campaigns as well as monitoring our tobacco use. Out of the 20 maximum points, Texas received only 7.5.

Another factor in our habit? Smoking’s just embedded in our DNA.

Before smoking bans became common, smoky bars were among the few safe spaces for our community. Stressed? Want a drink? Well, have a cigarette too.

At least that’s what the tobacco companies say. The LGB community is one of tobacco companies’ hottest markets, and most reliable revenue streams too.

“LGBT people spend an estimated $7.9 billion dollars each year on smoking, yet we still think of it as a personal choice; it’s time we realize we smoke at such high rates because of systematic targeting by the tobacco industry,” said LGBT HealthLink Director Dr. Scout.

In 2014, the Surgeon General’s office released a report documenting 50 years of its battle against tobacco use. One of the most startling facts to emerge from Health Consequences of Smoking: Documenting 50 Years of Progress, is LGB people spent $7.9 billion on tobacco products a year.

Combating the powerful tobacco industry’s aggressive marketing effort means having just as powerful of a prevention campaign.

That’s why, for the fourth year in a row, the CDC launched its “Tips From Former Smokers” campaign targeting LGBT audiences on broadcast and in print media like the Dallas Voice.

“We’re deeply pleased CDC is doing this level of marketing to reach the LGBT population, because the tobacco industry has been doing it for a long time,” Dr. Scout added.

The campaign isn’t just a marketing campaign, but provides resources as well. The toll free hotline, 1-800-QUITNOW, includes counselors trained specifically in LGBT competency.

“When you call 1-800-QUITNOW you’re very likely to be asked if you’re LGBT, because we urged it; you’re very likely to get a counselor who is trained in LGBT cultural competency, because we provided the training; and in some states you’ll even see locally tailored outreach campaigns too,” he added.

“LGBT communities smoke at rates that are about 50 percent higher than their heterosexual/straight counterparts. CDC is very concerned about this elevated smoking rate and committed to making sure tobacco control campaigns like Tips really do help reduce that disproportionate burden on LGBT communities,” said Dr. Tim McAfee, the senior medical officer in the CDC’s Office on Smoking and Health.

The battle against tobacco use not just about curbing addiction, but a longstanding habit too.

Room for improvement indeed.

This article appeared in the Dallas Voice print edition July 10, 2015.