The American Lung Association this week released a report that analyzed the motivating factors that cause so many LGBT individuals to smoke cigarettes and urged increased national attention to curb the disproportionately high smoking rates in the community.
“Smoking Out a Deadly Threat: Tobacco Use in the LGBT Community” looked at data from 42 health surveys conducted last year that collected information about the respondents’ sexual orientation and also included information from the six states that have published health reports that reference LGBT tobacco use: Arizona, California, Massachusetts, New Mexico, Oregon and Washington.
All of the state reports found smoking rates higher among gay, lesbian and bisexual individuals than their heterosexual counterparts. The report noted that virtually no data was available about the prevalence of smoking in the transgender community.
The complete data review found that gay men on average were between 1.1 and 2.4 times more likely to smoke than straight men, while lesbians had between 1.2 and 2 times the odds of smoking, compared with heterosexual women.
Bisexuals, however, reported the highest smoking rates.
The state surveys found that between 30-40 percent of all bisexuals reported that they smoke, while the ALA estimates that about 20.6 percent of Americans were current smokers in 2008.
While there was little data about smoking among youth, the report cited one study that found that lesbians and bisexual teen girls were nearly 10 times more likely to smoke than heterosexual girls, while there was no difference among gay or bisexual and heterosexual boys.
“Tobacco use is the number-one cause of preventable death,” said Chuck Connor, ALA president and CEO. “Any group that has higher than average smoking rates is likely to also suffer from illnesses and death at higher rates.”
Bill Blatt, the ALA’s director of tobacco programs, noted that while LGBT individuals are exposed to some of the same smoking risk factors as heterosexual individuals — such as having family and friends who smoke — LGBT individuals can also be influenced by other elements.
Stress and depression can lead one to begin smoking, and Blatt explained that research has shown that homophobia and the social stigma associated with being gay often cause higher levels of stress in LGBT individuals.
Additionally, the report noted that tobacco companies were some of the first corporations to tailor advertising specifically to the LGBT and that LGBT individuals are significantly less likely than heterosexual individuals to have access to healthcare, which could impact their ability to seek treatment and smoking-cessation programs.
Gloria Soliz, facilitator of the “Last Drag” LGBT smoking-cessation program in California, said the nightlife culture in the LGBT community has also fueled the smoking prevalence.
“I work with a lot of people who came out in the ’40s, ’50s and ’60s, which were decades where one was likely to come out in the gay bar. For many, bars were the only perceived safe places to come out. Bars promoted smoking and they would start to smoke to fit in and learned to cope with the stress of being closeted or the social stigma by continuing to smoke,” she said.
Soliz said smokers who are attempting to quit should think ahead when choosing their nighttime activities.
“I tell people they need to plan ahead when they go out for social occasions and that in the next few months they may chose to stay away from friends who smoke or do other things besides going to the club at night. I had three ladies in the program who said, ‘You don’t understand, that’s what we do.’ The bar culture has normalized tobacco use within the LGBT community. Smoking doesn’t make a person gay nor does it need to be a part of the LGBT community. If all members of the community were to become nonsmokers, I’d like nothing better than to have worked myself out of a job.”
Blatt noted that effectively reducing the rates of smoking within the LGBT community requires more than just each individual’s commitment to quitting.
“LGBT community members are in every part of the population, but they’re an invisible minority,” he said. “Like other groups that are disproportionately affected, LGBT populations need targeted efforts to reduce smoking rates and ultimately save lives. This can’t be resolved overnight, we need a focused collaborative effort.”
Blatt said the federal and state governments need to include questions about sexual orientation and gender identity in public-health surveys to better examine the issue, and he noted that the ALA has recommended such a mandate to the Centers for Disease Control and all state health departments.
The report also recommends state and local tobacco-control programs ensure that their smoking-cessation programs and those who staff them are sensitive to the needs of LGBT individuals and also seek input from LGBT agencies in their disparity-reduction and intervention plans.
Blatt said the organizations that represent the LGBT community typically “haven’t seen tobacco use as a priority,” an idea he said needs to change in order for the community to achieve tangible progress.
To view the full report, visit www.lungusa.org.
Jen Colletta can be reached at [email protected].