LGBTQ people don’t see smoking as the most imminent threat, but it’s a simmering issue
For many in the LGBTQ community, it seems like there are larger, more pressing issues, and in some cases there are. Roaming. Mental health crises. Suicidality.
But smoking, much more likely among LGBTQ people than other groups, is a latent health threat.
“The problem is, it actually takes more lives,” said Scout, executive director of the National LGBT Cancer Network. (Scout is transgender and legally has only one name.)
Authorities in Michigan are working to address the excessive rate of smoking and vaping among LGBTQ people. A survey, funded by a grant from the Michigan Department of Health and Human Services and published in November, found that 26% used some form of tobacco and 28% had ever done so. By comparison, 18.4% of adults and 23% of high school students in Michigan smoked, according to 2020 reports revised this year.
Overall, LGBTQ people are 1.5 to 2.5 times more likely to smoke cigarettes than heterosexual people, the state health department reports.
“I think of all my friends. Most of them are gay and they all smoke,” said Andrew Long, 33, who lives with his boyfriend in Lansing. He’s been a smoker since he was a teenager, isn’t gay yet, and tries to impress or mingle with high school girls.
For him, smoking or vaping is now social. “I think I’m afraid I’ll miss a great conversation when everyone else comes out.”
On average, LGBTQ youth are dating at age 13, Scout said. They are also twice as likely to smoke a cigarette by age 13 than their heterosexual or cisgender counterparts, according to the state health department.
“They’re looking for a way to make friends when making friends is harder for them,” Scout said.
They are looking for methods to deal with this social exclusion, in addition to stress and discrimination.
Scout and others have also noted the impact of tobacco companies. For years, the industry has targeted LGBTQ communities with advertising, promotions, event sponsorships and community outreach, according to the Truth Initiative, a nonprofit health organization committed to eliminating addiction. tobacco and nicotine. “Take Pride in your Flavor,” reads an illustrated example, an advertisement for smokeless tobacco, Camel SNUS.
It started decades ago when the LGBTQ community began to organize, achieved a more visible presence, and garnered growing social and political acceptance, reports the Truth Initiative.
Scout said a few years ago, a study done with the US Centers for Disease Control and Prevention found that in one year, LGBTQ people donated $2.9 billion to tobacco companies. That’s a lot more money than has been invested in LGBTQ civil rights or donated to LGBTQ organizations.
Groups are exploited and vulnerable.
LGBTQ people have been under-protected at the federal and state level. They risk losing their jobs and are vulnerable to inequalities in health and housing. “And all of those things kind of came together to create an atmosphere where people need stress relief,” said Leslie Boker, health coordinator for the Grand Rapids Pride Center.
Earlier in LGBTQ history, there was a bar culture, and smoking was allowed and encouraged. (It wasn’t until 2010 that Michigan banned smoking in public places). person, suffered medical discrimination – “I was once removed from a clinic because they did not like my homosexuality.”
Boker sees access as the most pressing health issue facing his community. “People avoid going to the doctor because they don’t want to be rejected or mistreated. So they don’t get the preventative care they need.
However, unmet need and substance use are linked, and tackling higher smoking rates is important, they and others said, because of all the possible and well-documented consequences. on health associated with smoking. These include cancer, heart and lung disease, and stroke.
“That then amplifies the health disparities that exist,” said Luisa Kcomt, assistant professor and expert in health equity and health disparities at Wayne State University’s School of Social Work. “So if we don’t pay attention to tobacco use, and it continues to proliferate, and we allow tobacco companies to market to them, then they’re just going to have a higher risk of getting sick sooner. and die sooner.”
Of the 348 respondents in last year’s survey, more people ranked alcohol or drug addiction, physical or sexual abuse and HIV/AIDS as physical threats to health than smoking .
“Time and time again, we’ve heard that access to health care is a big issue, as well as access to housing and social assistance. And those things rise to the top as kind of the root of the problem, rather than tobacco use itself,” said Taylor Hartson of DataWise Consulting, formerly the Center for Social Research at Calvin University in Grand Rapids. The company contracted with the Grand Rapids Pride Center to do the survey.
LGBTQ people are not supported by larger societal structures. “And so tobacco is not necessarily a priority for them in terms of quitting.”
Long, the Lansing man, spoke about rolling back protections for gender or sexual minorities. “The Supreme Court is garbage. Inflation is a reality. Everything is on fire around me. What’s gonna kill me first? Cigarette ?
More than half of survey respondents reported anxiety and depression. Men were the least likely to report this. About three-quarters of those who are bisexual or pansexual or who were queer, questioning, asexual or demisexual said the same.
Some reported bullying, forced outings and being disowned, injured or kicked out by their families. They also noted the oppression, injustice, and violence against transgender people of color. There was also talk of discriminatory legislation and religious trauma.
One participant in the research, which included Zoom group chats, said long-term health messages about the harms of smoking or tobacco didn’t resonate.
“I’m like, ‘It won’t matter. Honestly, I don’t expect to be there,’ the trans respondent said.
Another person agreed. “I don’t see myself living after (35 years), even if I am in a good and tolerant generation… I don’t know, it’s difficult to project myself specifically into the future; I feel like me and other trans people I know have very similar feelings or similar thoughts about this, which is why a lot of them are turning to smoking…to get away from reality.
The Center for the Study of Drugs, Alcohol, Smoking, and Health at the University of Michigan found that people who experience forms of discrimination have a higher risk of smoking cigarettes. “But we also have to be aware of the fact that among these communities they are also very heterogeneous, aren’t they?” said Kcomt, who previously conducted research with the center at the University of Michigan.
People use a broad phrase like gender or sexual minority communities, but there are subgroups and the risks for each are not all the same, she said.
“And so when I look at this issue, a lot of it is about understanding sexual and gender diversity. Knowing that people have different identities, but also seeing all the ways we can discriminate against them without even thinking about each other. realize it.
Dani Pendergrass, 42, of Lansing, who identified as both lesbian and bisexual, hasn’t given much thought to the idea of quitting, despite knowing she should. His mother died of chronic obstructive pulmonary disease, characterized by airway blockages and breathing problems usually caused by smoking.
“If I’m having a bad day at work or I’m stressed, my body doesn’t necessarily need nicotine. It’s my head telling me, ‘You need a cigarette to calm down.'”
It was the “cool thing to do” in high school. She quit smoking while pregnant with her now adult daughter, but started again. She would burn one here and there. As a result, she bought whole packs.
Her partner, a non-smoker, tries to tell her that she has smoked too much or that she doesn’t need to.
“It’s a disgusting habit. Like, I get that,” Pendergrass said.
The Michigan Department of Health reports as possible solutions: tailored cessation resources and greater access to these resources and to LGBTQ testimonials in commercial anti-tobacco messages.
LGBTQ people feel more comfortable getting smoking cessation resources from LGBTQ organizations, according to the survey.
The Grand Rapids Pride Center provides a monthly health-focused workshop with discussion and activity, such as a community walk, dance or hula hoop lessons. Michigan Tobacco Helpline information would be available and there would be conversations about grounding techniques.
“That way it won’t feel like people who use tobacco are being targeted for health support, but can access it,” Boker said.
The idea is to offer general health support and let people know when they’re ready that there are ways to quit smoking, they said.
“The quit programs of these organizations could also provide the community and social support people need,” read an emailed statement from the state health department.
Holt’s Dylan Pizzie started smoking when he was 17. It started as something he did when he was drunk. A few years ago, he quit cold turkey. “The mere thought of smoking for eight years at age 24 made me so sick that I forced myself to quit.”
It was not easy. He is still thinking about smoking. As he was talking about it, around a table with gay friends in a Lansing bar, he was craving a cigarette, years after his last.
Scout advised not to give up cold turkey. It’s the least successful way to do it, he said. “If you’re considering a withdrawal attempt, I would simply say this: pause, take a deep breath, then focus on all your resources.”
Ask a doctor about possible medications. Take plenty of nicotine replacement therapy and call a helpline for help with evidence-based steps.
“And even then, get ready because…maybe it will take you four tries instead of seven.”
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