LGBT (Lesbian, Gay, Bisexual, and Transgender)

  Population considerations:

  • Increased levels of stress. Members of the LGBT community may be more likely to use smoking as a stress reliever. They may be particularly vulnerable to stress due to sexual identity issues, lack of support from friends and family and prejudices against their sexual preferences (Ryan, 2001).
  • Social Environment. The primary social gathering places for adult members of the LGBT populations are frequently bars and clubs. These types of places are usually associated with higher levels of tobacco use (Ryan, 2001).
  • Tobacco advertising. The tobacco industry has started to target the LGBT population within the last decade (Stevens, 2004). Tobacco companies were among the first large corporations to advertise in LGBT publications, which some in the LGBT community perceived as reinforcement of the LGBT community influence and legitimacy, increased acceptance and an indication of a new social climate (Smith, 2008).
  • Lack of Acceptance. Smoking may provide a means for feelings of social acceptance for members of the LGBT community (Smith, 2008).
  • Risky Behaviors. Members of the LGBT community are more likely to experience risk factors which contribute to substance abuse, such as risk-taking, rebelliousness, low self esteem, alienation and depression (American Legacy Foundation, 2003).

  Strategies to address these considerations:

  • Tailor messages. Providing targeted messages to the LGBT community may be particularly effective. Media campaigns that appeal specifically to the LGBT community may be good outlets because they can target this community without drawing attention to the individual and his/her sexual preference.
  • Educate providers. Providers need to be more sensitive to the needs and issues of the LGBT community in order to provide effective counseling. Some members of the LGBT community do not feel comfortable accessing healthcare and health advice.
  • Use a multi-media approach. Linking tobacco issues with other health or social issues may be more effective. This strategy helps to show an interest in this community’s health and welfare as a whole.
  • Involve the community. Tobacco cessation and information should be provided to LGBT centers or organizations. Cessation interventions centered on an LGBT theme have shown some effectiveness. Intervention strategies should be inclusive of all local health care infrastructures: public health agencies, critical access hospitals and the faith community. Changing policies that can influence organizations, systems and networks requires the involvement of community partners (CDC, 1999).
  • Target programming. Although targeted advertisements to the LGBT market and tobacco sponsorship of community events is ongoing, only limited funding for smoking prevention and treatment efforts is directed toward the LGBT community. Virtually no research has focused specifically on prevention or treatment for this population. Programs that are culturally-appropriate for LGBT people must be designed, implemented and evaluated and the information disseminated. Anti-smoking campaigns specifically targeting this population are necessary. Tobacco use in LGBT individuals should be monitored in an ongoing manner, to collect the in-depth information needed to understand patterns of tobacco use, and to evaluate the impact of prevention and treatment efforts (Ryan, 2001).
  • Educate. Some interventions have used warnings and educational material to deter individuals from smoking in public places. More comprehensive efforts to reduce environmental tobacco smoke include educational campaigns for employees and managers, posting signs about the “no smoking” policy and providing smoking cessation assistance for those who smoke (Barbeau, 2004).
  • Emphasize harmful effects. Emphasizing the harmful effects of tobacco industry targeting and early tobacco addiction on younger members of the LGBT community may mobilize community concern. Messages should represent the entire community (Smith, 2008).
  • Smoke-free environments. “No smoking” policies are the most common method to reduce environmental tobacco smoke in public places (Barbeau, 2004).

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