The tobacco industry has a long and disgraceful history of marketing to specific groups identified as susceptible to addiction, including LGBTQ people. A new research initiative funded by the US Centers for Disease Control and Prevention and the Maryland Department of Health’s Center for Tobacco Prevention and Control and led by the UMD Prevention Research Center aims to reduce tobacco related health disparities among lesbian, gay, bisexual, transgender and queer or questioning communities in Maryland.
The initiative is focusing particularly on Prince George’s County and Montgomery County, which have the third and fourth largest LGBTQ populations in the state. Those two counties also account for nearly a fourth of all LGBTQ youth tobacco users in Maryland.
“We're focusing on LGBTQ youth and young adults ages 12 to 30, and in particular Black and Latinx LGBTQ communities, since those are oftentimes targeted for tobacco use by tobacco companies,” said Jessica Fish, assistant professor of family science in the University of Maryland School of Public Health and principal investigator on this project. “We're really focusing on tobacco prevention, quit support efforts, and resource sharing.”
The project in its initial phase will focus on gathering community needs: talking with Black and Latinx LGBTQ young people to understand their perceptions and experiences with tobacco use and advertising in their counties and in their communities.
“We're not coming in and saying ‘this is what we're going to do,’” Fish said. “Right now, we're in this process of just gathering a lot of information and trying to understand the experiences of young, Black, Latinx LGBTQ folks in these communities so that we can work with them to develop strategies, and that will be phase which we'll see come down in the next year or two.”
Fish says that this kind of research is particularly important now: national and state level data show that LGBTQ folks are more likely to be vulnerable to tobacco use and are more likely to persist in that use as they age. A 2021 report from the Truth Initiative shows that overall, lesbian, gay and bisexual adults smoke cigarettes at rates significantly higher than straight adults and are nearly twice as likely to use e-cigarettes and little cigars. It also found that transgender youth currently use tobacco products at higher rates than cisgender youth, including four times higher cigarette use and three times higher e-cigarette use.
“I think, despite a lot of social progress for LGBTQ communities, we have witnessed a continued disparity in tobacco use for LGBTQ communities,” she said.
That disparity is in part the result of tobacco companies particularly targeting the LGBTQ community, and in part the result of social determinants that result from having a marginalized identity.
“Oftentimes when communities are stressed, and individuals are stressed, they can pick up maladaptive coping strategies, like tobacco use, for example,” Fish said. “There's some theoretical and empirical work that supports this idea that folks who experience more discrimination, harassment, or victimization as a result of their LGBTQ identity are more susceptible to tobacco use as they age.”
In the long term, the initiative aims to develop communication and information sharing and eventually programs that can be implemented in these counties in a way that resonates with the LGBTQ community.
“We might actually be able to stave off the uptake of tobacco use for people who are young and potentially are vulnerable to tobacco use, and then to support those who are wanting to quit in a way that's culturally informed and culturally sensitive to those LGBTQ communities,” Fish said.
Fish's collaborators on this project include: Bradley O. Boekeloo, professor of behavioral and community health and director of the UMD Prevention Research Center, Cynthia E Baur, professor of behavioral and community health and director of the Horowitz Center for Health Literacy and Devlon Nicole Jackson, assistant research professor of behavioral and community health.