Tobacco Addiction Continues to Harm LGBTQ+ Communities

Members of the LGBTQ+ community have faced a history of oppression and discrimination that has directly led to disproportionate health risks. This includes having a greater risk of substance abuse and mental health challenges, as well as higher rates of tobacco and vaping use in comparison to the heterosexual/cisgender community. In fact, Big Tobacco was one of the first major consumer industries to target the LGBTQ+ community, a group that had been largely ignored by mainstream advertising. Discriminatory tactics that normalized smoking and linked the LGBTQ+ community and tobacco use have benefitted the tobacco industry while leading to higher smoking rates among LGBTQ+ populations.

Currently, about 1 in 5 LGB adults smoke cigarettes, compared with about 1 in 9 heterosexual/straight adults. When looking at transgender adults the percentage of cigarette smokers is 35% higher than that of straight adults. A 2019 Centers for Disease Control and Prevention (CDC) Youth Risk Behavior survey saw that over 10% of lesbian, gay or bisexual high school students smoke cigarettes—more than twice the percentage of their straight peers. These higher smoking and vaping rates only further hurt the community, as this puts our LGBTQ+ friends and family at greater risk for chronic lung disease.

According to the Food and Drug Administration (FDA), the causes of this disparity include both psychological and environmental factors, such as:

• Internalized homophobia
• Stress due to societal stigma
• Negative reactions to their disclosure of sexual orientation

Smoking-related diseases claim more than 480,000 lives in the U.S. each year, making smoking the number one cause of preventable disease and death worldwide. But, according to the CDC, LGB individuals are five times less likely to call a smoking cessation quit line. So, it is up to healthcare providers to help their LGBTQ+ patients by providing education on tobacco and nicotine cessation.

Further cessation education needs to be given to the transgender community and those on estrogen hormone therapy. This is important because smoking while on estrogen therapy increases the risk of blood clots which can lead to a stroke or a heart attack.

The higher prevalence of tobacco use makes it even more essential to raise lung cancer awareness among LGBTQ+ communities. The CDC states that 19.1% of LGB adults smoke cigarettes compared to 11.6% of heterosexual adults. While anyone with lungs can get lung cancer, smoking is a main cause of both small cell and non-small cell lung cancer, contributing to 80% and 90% of lung cancer deaths in women and men, respectively.

One reason that lung cancer is so deadly is because most cases are diagnosed at a later stage, after the disease has spread. Thankfully, lung cancer screening is available for high-risk individuals which can help catch lung cancer earlier when it is most treatable. If you are 50-80 years old, have a 20 pack-year history of smoking (1 pack a day for 20 years, 2 packs a day for 10 years), and are a current smoker, or have quit within the past 15 years, you’re considered at high risk and qualify for lung cancer screening. The American Lung Association offers “Saved By The Scan,” a free resource to help guide those who may be at a high risk of developing lung cancer. To see if you’re eligible for a low-dose CT scan, visit SavedByTheScan.org.

While this simple screening test has been available since 2015, not enough people who are eligible are getting screened. In fact, only 4.5% of those eligible in the United States have been screened, according to the 2023 State of Lung Cancer report.

More information about lung cancer, lung cancer screening and resources to quit smoking are available at Lung.org/quit-smoking. Additional featured information on Pride month and resources are also available on our website.