Smoking in the LGBTQ Community

Smoking Cessation at Howard Brown

Tobacco Use in the General Population

Smoking is the leading cause of preventable death in the United States, accounting for more than 480,000 deaths each year according to U.S. Department of Health and Human Services.

Tobacco Use in the LGBTQ Community

Tobacco is the number one cause of death in the LGBTQ community. The American Cancer Society estimates that over 30,000 LGBT people die each year of tobacco-related diseases. That means that there are more deaths in the community from smoking-related illness than alcohol, car accidents, suicide, AIDS, homicide, and illegal drugs combined. More startling is that researchers believe that the accepted estimate of LGBTQ smoking related-deaths is majorly underestimated, given that the American Cancer Society based their estimate on smoking rates of the general population not the LGBTQ community. The fact is that smoking rates in the LGBTQ population are disproportionately high compared to those in the general population. Recent studies suggest that the LGBTQ community smokes at a rate 50% to 200% higher than the general population.

Why So High?

Researchers believe the disproportionately high smoking rates in the LGBTQ community are due to a multitude of factors.

  • Stress due to stigma and discrimination of identifying as LGBTQ leads to increased depression, anxiety and substance use/abuse
  • Aggressive targeting of the community from the tobacco industries.
    • The tobacco industry’s aggressive targeting of the LGBTQ community was revealed in the 1990’s after internal document “Project Scum” (Subculture Urban Marketing) was made public. Project Scum outlined a predatory marketing scheme to specifically target the gay and homeless communities in San Francisco. Today, tobacco companies continue to target our community and profit at the expense of our health.
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  • Lack of competent and  accessible health care services for LGBTQ  individuals

Why Quit?

Quitting smoking is the single most important step a smoker can take to improve their health.

Smoking and HIV/AIDS

Smoking in HIV-infected populations is a significant problem; studies suggest between 50% to 70% of all HIV-infected people smoke cigarettes.

It is especially important for people diagnosed with HIV/AIDS to quit smoking. While smoking is harmful for the general population, HIV-infected populations are at increased risk of the negative health outcomes associated with smoking. This is due to the fact that smoking weakens the immune system and therefore is a major threat to people whose immune systems have already been compromised by HIV/AIDS. Smoking cigarettes makes it harder for these individuals to fight off opportunistic infections associated with HIV leading to increased incidents  HIV-related infections, including:

  • Thrush (a mouth infection, also called oral candidiasis)
  • Hairy leukoplakia (white mouth sores)
  • Bacterial pneumonia
  • Pneumocystis pneumonia (a dangerous lung infection)

Cigarette smoking by individuals with diagnosed with HIV/AIDS may reduce the benefits of antiretroviral medications and increase their chances of developing, heart disease due to lypodystrophy, as well as AIDS and non-AIDS related cancers:

  • Cervical Cancer
  • Anal Cancer
  • Lung Cancer
  • Neck cancers

HBHC understands there are additional social factors that influence the health outcomes of HIV-positive individuals and the lack of accessible resources. To change this HBHC has a number of resources available to HIV-positive individuals including the Project Adhere Research Study, the first study smoking cessation and medication adherence intervention for the gay HIV+ African American men.

Psychological Addiction

According to a recent gallop poll (2013), most smokers actually want to quit…so why not?

Some of us smoke because it helps reduce stress, distracts us from our problems and gives us a break from our day. Like other coping mechanisms, smoking is a learned behavior that has become part of our day-to-day routines. Many people associate smoking with daily activities such as drinking coffee, taking lunch breaks or driving. After a while, these activities become automatic triggers for smoking, creating a psychological addiction.

Physical Addiction

Nicotine- the extremely addictive chemical found in tobacco- stimulates the release of various ‘feel good’ chemicals in your brain that provide pleasure. This pleasure is temporary, enticing you to smoke again, and again and eventually leads to dependence. This dependency is why folks trying to quit often experience physical withdrawal symptoms, such as headaches, fatigue, or flu-like symptoms. It’s important to remember that these symptoms occur while your body is readjusting and are only temporary.

Lack of Resources

Researchers believe that the lack of effective LGBTQ focused and community supported cessation programs make it difficult for many people to reach their quitting goals.  Smoking cessation programs have been primarily developed for the general population. Until 2011 there were not interventions for tobacco dependence, treatment, or prevention among LGBTQ populations. This is especially troubling considering the high smoking rates in the community. reveals the number of smoking intervention studies for specific populations.