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Published on September 19th, 2017 | by Deb Wolf

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Tobacco Use and the LGBTQ Community: A Critical Health Disparity

Current prEvents  September 21, 2017   Times Argus
By Ginny Burley

Tobacco use reduction is one of the big American public health victories. With huge effort and investment, smoking rates have achieved historic lows of 15% among adults and 8% among youth, according to the Center for Disease Control (CDC).

However, not all Americans have benefited equally from this progress. Smoking rates among lesbian, gay, bisexual, transgender and questioning individuals (LGBTQ) are significantly higher than among the total population. Among LGBTQ individuals, the smoking rate is 20.6%; among transgender adults alone (T) in 2013 the rate was a whopping 35.5%. Tobacco use kills at least 30,000 LGBTQ people each year in the United States.

In Vermont, according to the 2016 Behavioral Risk Factor Surveillance Survey (BRFSS), 5% of Vermont adults identify as LGBTQ. Among Vermont’s LGBTQ population, smoking rates are 29% compared to non-LGBTQ at 17%. Vermont LGBTQ individuals also share other risk factors, including low income, physical and mental health challenges, and limited access to emotional and social support.

As overall smoking rates have declined, the tobacco industry has worked hard to find “replacement smokers.” How has the tobacco industry targeted LGBTQ people? According to an article in Slate.com called “Freedom” and “Choice”: How Cigarette Companies target the LGBTQ Community by Catherine Kulke, they do so by using language such as “Take Pride in your Flavor,” which co-opts the use of the word “pride” which is central to LBGTQ advocacy; advertising at LGBTQ events; using advertisements that include values that are important to LGBTQ, such as “freedom” (to marry, to inhale…); giveaways from the tobacco industry; sponsorship of LGBTQ events; and positioning themselves as allies of the movement, in an effort to make smoking an integral part of the culture.

If part of the disparity is caused by targeted marketing by Big Tobacco, can part of the solution be targeted outreach by Prevention? What would this look like?

In response to the efforts by the tobacco industry to target LGBTQ, many Pride organizations are pushing back by advocating events that are smoke free or have smoke free areas; by raising awareness of the social justice issues raised by the disproportionate tobacco impact on the LGBTQ community; by offering support and opportunity for smokers to quit; by refusing to accept advertising or giveaways from tobacco companies; and by educating their community on the dangers of secondhand smoke. Some communities have organized Gay American Smokeouts to parallel the American Cancer Society’s Great American Smokeout (Nov. 16 in 2017), a national day to encourage quitting tobacco.

The Pride Center of Vermont http://www.pridecentervt.org provides support for those who want to quit smoking. You can contact LGBTQuits@pridecentervt.org, or call Mike at 802-860-7812. Or check out their LGBTQuits page at http://www.pridecentervt.org/news/item/lgbtquits-story-josie .

Community members can play a part by increasing their awareness of the challenges facing LGBTQ individuals. Medical providers, educators, counselors and others can include tobacco use in their conversations, and offer referrals to cessation resources, such as 802Quits – http://802quits.org/ Parents can talk to their children and their friends about tobacco risk factors. Community organizations can educate their members about the LGBTQ community and the health disparities they face.

While this article explores tobacco health disparities with a focus on LGBTQ individuals, other populations are similarly affected by disparities, according to the CDC. These populations include:

  • Gender: more men than women smoke;
  • Education: the lower the level of education, the higher the smoking rate;
  • Poverty: low socioeconomic status (26% smoke);
  • Race: non-Hispanic black men have higher rates; non-Hispanic Asians have lower rates; Hispanics of both genders have lower rates;
  • Military status: military service members and veterans have higher rates.
  • Other vulnerable populations include people living with HIV and people with mental health conditions.

Big Tobacco is very much aware of the vulnerability of the populations described here, and is ready to exploit that vulnerability for their profit. Prevention advocates need to be aware of the impact of health disparities among populations, and look beyond the successes in reducing tobacco use to concentrate on the work that still needs to be done.

Ginny Burley is the Prevention Specialist at Central Vermont New Directions Coalition working with the Vermont Department of Health to address tobacco use among at risk populations.


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