Tobacco use is the single most preventable cause of morbidity and mortality in the United States. Current estimates are that between 2000 and 2004, more than 400,000 persons died prematurely from tobacco-related diseases such as lung cancer, cardiovascular disease, and chronic obstructive pulmonary disease.
In 2007, the median prevalence of adults currently smoking in the 50 states and Washington, D.C., was 19.8 percent and higher among men (21.3 percent) than women (18.4 percent). The rates of smoking have been estimated to be higher among lesbian, gay, and bisexual persons, with estimated smoking rates up to 59 percent for gay and lesbian youth and up to 50 percent for adults.[31, 32]
The prevalence of smoking among transgender persons has not been studied adequately; however, small studies suggest that the prevalence rates are higher than the general population.[33, 34] Many factors may have contributed to the higher rates, including the daily stresses of societal homophobia and also the fact that gay and lesbian bars, places of high smoking prevalence, have traditionally been sites of refuge and important components of gay and lesbian social life.
The tobacco industry has directly targeted the LGBT community with cigarette advertising and pro-tobacco imagery frequently found in the lesbian and gay press. Unfortunately, many LGBT individuals do not view tobacco use as a “gay health issue” and may view the targeting as positive in that it legitimizes the community by including them in mainstream marketing campaigns.
Further research is needed to investigate ways in which sexual orientation, gender identity, and social factors influence smoking rates, and how this can then create culturally appropriate tobacco-cessation programs for the community.
Lesbian, Gay, Bisexual, and Transgender Health
Rates of smoking among lesbian, gay, and bisexual adolescents and adults appear to be higher than rates for the general population (Gruskin, et al., 2001; Ryan, et al., 2001; Stall, et al., 1999). Smoking is also likely problematic among transgender people, many of whom face poverty, homelessness, stressful living and work environments, and depression in their daily lives.
Despite the fact that smoking negatively impacts or complicates health issues of particular importance to LGBT persons (e.g., hormone therapy for transgender people, HIV/AIDS), tobacco companies target these communities.
Yet, there is little research on smoking cessation by and for LGBT persons.
Community activists in San Francisco started working more than a decade ago to address these problems. In the early 1990’s, Lyon-Martin Women’s Health Services initiated ÒThe Last Drag,Ó the first stop-smoking group for LGBT and HIV positive smokers. The California Lavender Smokefree Project (CLSP), funded by the state in the mid-90’s, counteracted tobacco industry targeting of LGBT communities. In 1996, the Coalition of Lavender Americans on Smoking and Health (CLASH), with the help of Progressive Research and Training for Action (PRTA), (a community-based organization specializing in LGBT technical assistance), held Alive with Pleasure! the first federally funded conference on tobacco use among California’s LGBT population. In 1998, at the urging of CLASH members, the Center for AIDS Prevention Studies (CAPS) launched its first tobacco study with gay/bisexual men.
History of QueerTIP
With funding from the state of California, CAPS and PRTA identified the importance of smoking cessation research among LGBT people as a high priority. QueerTIP’s aims were to:
- Strengthen collaboration and build capacity among members;
- Develop smoking cessation services specifically designed for LGBT smokers;
- Pilot-test services at three organizations serving diverse sub-segments of LGBT communities (Lyon-Martin, New Leaf, and LYRIC).
QueerTIP was run by CAPS and PRTA community research staff with the participation of and direction defined by a larger collaborative group.
Project staff were responsible for preparation and facilitation of meetings, follow-up on the collaborative group’s decisions, information gathering and dissemination, survey development, and overall project implementation.
QueerTIP collaborative group members refined the research questions, provided direction and input, and implemented activities. A few members also served as paid consultants when their specialized services were required.
The Collaborative Process
The collaborative group met once a month for two hours from September 2000 to July 2001. Prior to each meeting, members received a packet with an agenda, feedback forms to prepare them for discussions, and materials.
Members requested that CAPS host the meetings because of its central location and proximity to public transportation. Refreshments and compensation for travel and parking were provided.
Members received a quarterly stipend for their participation and completed quarterly feedback forms on the collaborative process and project progress.
* Queer is a term reclaimed by the LGBT
community and is intended to include all
Anita Radix, MD, MPhil, MPH, and Gal Mayer, MD, MS
Anita Radix, MD, MPhil, MPH, Director of Research and Education, Callen-Lorde Community Health Center
Dr. Gal Mayer MD practices internal medicine in New York, New York. Callen Lorde Community Health Center
- The Gay and Lesbian Medical Association. Healthy People 2010 companion document for LGBT Health.
- Solarz AL, Institute of Medicine, eds. Lesbian Health: Current Assessment and Directions for the Future. 1st ed. Washington, DC: National Academies Press; 1999.
- Dean L, Meyer I, Robinson K, Sell R, et al. Lesbian, gay, bisexual, and transgender health: findings and concerns. J Gay Lesbian Med Assoc. 2000;4(3):101-151.
- Laumann E, Gagnon J, Michael R, Michaels S. The Social Organization of Sex: Sexual Practices in the United States. Chicago, IL: University of Chicago Press; 1994.
- Pathela P, Hajat A, Schillinger J, Blank S, Sell R, Mostashari F. Discordance between sexual behavior and self-reported sexual identity: a population-based survey of New York City. Men Ann Intern Med. 2006;145:416-425.
- Mosher W, Chandra A, Jones J. Sexual behavior and selected health measures: men and women 15-44 years of age, United States, 2002. Vital Health Stat. 2005;362:21-26.
- Goodenow C, Szalacha L, Rubin L, Westheimer K. Dimensions of sexual orientation and HIV-related risk among adolescent females: evidence from a statewide survey. Am J Pub Health. 2008;98(6):1051-1058.