The number of Americans who smoke cigarettes has been in a precipitous free-fall from several decades ago, when nearly half the country’s population was lighting up. However, despite the downward trajectory of American smokers, the tobacco industry still has an outsized impact on one demographic, the LGBT community.
According to 2014 data from the Center for Disease Control And Prevention (CDC), just under 17 percent of people nationwide are classified as smokers (having had over 100 cigarettes in their lifetime). That number spiked upward when adjusting for sexual orientation, with lesbian, gay, bisexual and trans adults reporting smoking at a rate of 23.9 percent while their straight counterparts were just about even with the national average of 16.8 percent.
Those numbers are even more pronounced when broken down by state, with California seeing an even bigger disparity between the LGBT community’s smoking rate (27 percent) and the rest of the state’s population (13 percent). Nationwide, this has translated to approximately 30,000 LGBT deaths annually due to tobacco use, according to the American Cancer Society, but also increasing the rate of HIV and HPV transmissions (due to smoking’s ability to suppress one’s immune system), an increased risk of blood clots and stroke for transgender women taking estrogen pills.
With October serving as LGBT history month which includes National Coming Out Day (October 11) groups are using October as an opportunity to bring this data out of the closet and start the conversation of how tobacco disproportionately affects this community and how the industry has targeted this population with disproportionate advertising.
“What we’re really trying to do is educate Californians, specifically LGBT Californians about the tobacco industry’s disproportionate targeting and marketing tactics that are used within the LGBT communities,” said Linda Aragon, the acting director of the Los Angeles Department of Health’s Division of Maternal,Child and Adolescent Health. “This isn’t something that’s new—the tobacco industry has been doing this since the 90s.”
One infamous effort by the tobacco industry was R.J. Reynolds’ “Project SCUM”, a 1995 campaign directed at the gay and homeless populations in San Francisco. “SCUM”, an acronym for subculture urban marketing, was revealed in 2000 when a court order forced Reynolds to hand over documents regarding the project during litigation by the State of California against tobacco companies during the mid 90s.
More recently, Camel has released a mint-flavored product marketed toward the LGBT community as a way for them to “take pride in their flavor.” The marketing of menthol products could be potentially dangerous since the minty feel and taste make the products more palatable and may encourage more frequent use. CDC statistics also show a higher rate of menthol product use for LGBT smokers, with 36 percent reporting they smoke menthol cigarettes compared to 29 percent of straight smokers.
Aragon said those companies still target the LGBT community, pointing to recent sponsorships of Pride celebrations in cities nationwide as well as national HIV/AIDs organizations. While millions of dollars annually are poured into LGBT events in an effort to normalize tobacco use, this campaign, she said, is meant to do the opposite. She said that in Los Angeles County there are over one million smokers, and while the campaign is focused on how the LGBT community is affected, getting that number to drop in any capacity would be a win.
“Just reducing it any percentage is successful for us. What we’re trying to get folks to do is to learn about this issue if they don’t already know, to talk about it with their friends and families,” Aragon said. “Whatever we can do to get folks to start that conversation.”
There are many ideas of why the disparity in tobacco use exists. Executive Director of the LGBTQ Center Long Beach Porter Gilberg said that despite recent legal advances supporting the community, people still face discrimination, both culturally and economically, that have also led to higher rates of unemployment and poverty among this population set. Unhealthy coping mechanisms, including substance abuse, have been linked to the unique challenges faced by members of the LGBTQ community.
While laws have largely gutted the industry's ability to market in television and print media ads, Gilberg said it still maintains a presence in LGBT bars, something he said the community has historically utilized as a haven and which may have led to it being more “substance-use saturated”.
“The LGBTQ community for many years primarily relied on bars and drinking establishments as avenues to connect with community members and to have a safe space to gather,” Gilberg said. “Historically, until the 70s or 80s, very often bars were the only place they had to gather and that is partially why rates of smoking, alcohol use and substance use appear to be higher in our community.”
He added that while companies do not outright distribute promotional packages of cigarettes as they did in previous decades, they do still pass out coupons for cigarettes, something he experienced while visiting an LGBT bar in Florida on a recent trip. Gilberg said the same thing happens here in Long Beach at popular LGBTQ bars like Hamburger Mary’s and those located on Broadway.
Gilberg said that while other groups have accepted funding from the tobacco industry in the past, the Center has not been one of them. He said the Center has not been approached by a tobacco company to serve as a sponsor during his tenure and that the Center has turned down funding in the past from groups that didn’t align with its values. However, Porter declined to say that the Center would automatically decline any overtures from the tobacco industry in the future.
“That would be a larger discussion that I would have to have with our board of directors,” Gilberg said. “What I can say is that the Center is committed to accepting dollars that are collected equitably and ethically. So, in terms of accepting money from a tobacco company, that’s something we would want to heavily heavily weigh.”
The Center offers many health services but lacks the funding for a smoking cessation program. However, it has worked jointly in the past with the city’s health department to help combat smoking related issues and has counselors on-site that are qualified to help people who want to quit.
Aragon said other efforts can be made to help those who want to quit or even to prevent more people from starting in the first place. She said outreach efforts have been made to LGBT bars and gathering spots to try and reduce the amount of smoking space to make it less desirable. She said making non-smoking a norm could also lead to a more supportive environment for those who want to quit.
Aside from a goal of decreasing the number of smokers in the county from one million, Aragon said she hopes to shed light on the tobacco industry’s routine of playing both sides of the fence when it comes to the LGBT community.
“Even though they sponsor our pride events, they donate to LGBT-related campaigns, they like to position themselves as being on our side but they’re really not an ally of the LGBT community,” Aragon said.
This report was updated on 11/3/2016 at 2:25PM. The original version stated 300,000 LGBT deaths are attributable to tobacco use each year; the correct statistic is 30,000.