ALA Urges Stronger Effort To Curb LGBT Smoking
Releasing a major new report June 29, officials with the American Lung Association said smoking cessation efforts and research on smoking needs to focus more on the LGBT community, and they urged LGBT organizations to make reducing tobacco use a top priority.
In general, the report found that LGBTs are more than twice as likely to smoke than heterosexuals.
"It's clear that targeted interventions are needed," said Bill Blatt, director of tobacco programs at the ALA.
To start with, Blatt and other officials said, more research is needed on the causes and prevalence of smoking among LGBTs. Far too many states and localities, Blatt said, don't include questions specific to sexual orientation when they do surveys and studies on smoking.
"There is a significant data gap," Blatt said.
But there is enough evidence, he said, to indicate the parameters of the problem. The ALA researchers had statistics from Illinois, for example, from 2003 onward, that showed that 28.8 percent of lesbians and gay men smoked tobacco, as compared to 18.9 percent of heterosexuals. For Illinois bisexuals, smoking was even more prevalent, with a 34.2-percent rate.
The study found similar rates in five other states where data was available.
"Like other groups disproportionately affected by tobacco use, including African Americans and Native Americans, the LGBT population needs targeted efforts to reduce smoking rates, which will ultimately save lives," said ALA President and CEO Charles Connor.
The report, titled "Smoking Out a Deadly Threat: Tobacco Use in the LGBT Community," also delved into the factors that lead LGBTs to smoke with greater prevalence. The causes, the report detailed, are multiple, starting with the stresses associated with coming out and dealing with homophobia.
"We do know that higher levels of stress can lead to higher levels of smoking," Blatt said.
Coming out as LGBT, the report said, is also traditionally done in the community's bar culture, because those bars are often the safest spaces to be out.
"Because there is a biological and behavioral link between drinking and smoking, it is likely that the bar culture would have contributed to elevated smoking rates in this population," the report stated. "There is also the social aspect of smoking with peers, which seems to be an especially strong risk among young people."
Researchers also cited less access to healthcare among LGBTs than in the general population, leaving LGBTs with fewer options for medications and programs to stop smoking. Only 55 percent of transgender adults in the U.S., the report noted, have health insurance, compared with 77 percent of gay, lesbian and bisexual adults and 82 percent of heterosexual adults.
"The fact that most people get their health insurance through their employers has meant that unmarried couples, including same-sex couples, are two to three times more likely to be uninsured than married people," the report stated.
Another factor, the researchers found, was the tobacco industry's targeting of LGBTs through advertising, marketing and sponsorship of LGBT events and groups.
Finally, the report said, LGBT organizations haven't made smoking a priority issue. Only 24 percent of LGBT leaders in one survey, the report said, viewed smoking as a community health concern.
The ALA said increased smoking cessation efforts in the LGBT community could have a significant effect, citing one such program in California, The Last Drag. A 2007 report found that 85 percent of those who completed The Last Drag program in San Francisco quit smoking, and 55 percent were still smoke-free six months later.
"Quitting smoking can be a transformative experience that opens the door to a better life," said Gloria Soliz, of The Last Drag.
The report advocated a number of steps to combat smoking in the LGBT community. The U.S. Centers for Disease Control and Prevention should include appropriate sexual orientation questions in its smoking surveys, it said, as should state health departments. It called for more public and private money devoted to curbing smoking among LGBTs and for increased LGBT community representation in developing and administering tobacco control programs.
The report also called on LGBT advocacy groups to press for policies to promote smoking cessation and, where applicable, to refuse contributions and sponsorships from tobacco companies.
"In many ways, what needs to be done is clear, and we must maintain our vigilance and resolve until we are successful," the report said.