LGBTQ community still struggling with the influence of smoking

The use of tobacco and nicotine products has hit the LGBTQ community harder than most, especially the youth. Results from the 2019 Healthy Kids Colorado survey showed LGBTQ-identifying youth are more than twice as likely as their heterosexual peers to currently smoke.

“Smoking causes cancer, heart disease, stroke, lung diseases, diabetes, and chronic obstructive pulmonary disease (COPD), which includes emphysema and chronic bronchitis. Smoking also increases the risk for tuberculosis, certain eye diseases and problems of the immune system, including rheumatoid arthritis,” according to the Center for Disease Control and Prevention, or CDC.

The U.S. Food and Drug Administration, or FDA, reported 480,000 deaths are caused by cigarette smoking each year. In the LGBTQ community, more than 30,000 adults die of tobacco-related illnesses every year, according to Tobacco Free Colorado and the American Cancer Society.

The FDA cites targeted marketing by the tobacco industry as a significant risk factor in LGBTQ tobacco use, particularly for youth.

“Tobacco companies will often advertise at Gay Pride parties and other events specific to the LGBT community. In LGBT lifestyle publications and media, tobacco ads often portray tobacco use as normal and widely accepted behavior,” the FDA website stated. “This strategic marketing plays a part in the initiation and continued use of tobacco products among LGBT young adults.”

Though the FDA heavily restricts how tobacco companies can advertise and promote tobacco products, including prohibiting free samples and event sponsorship, cigarettes still often appear in films and television. A 2012 report from the U.S. Surgeon General specifically addresses the impact that media depictions of smoking can have on all adolescents.

“Adolescents actively rely on external information as they seek to shape their own identities, often looking to media stars as models of what to wear and what to do. Adolescents today are highly exposed to entertainment media, which — because they present smoking in the context of a story rather than as a commercial presentation — tend to dispel the skepticism that would attend a commercial presentation,” the report states. “The suspension of disbelief that occurs in viewing entertainment media, and the fact that the message is conveyed by an influential figure, provides a theoretical underpinning for an effect of entertainment media on smoking during adolescence, a strong one.”

“Historical targeting of the LGBTQ community from tobacco companies has long-term tails to it in that if you look at the historical pieces, you’ll see drag queens and leading men smoking. Those pieces are still there,” Out Boulder County Executive Director Mardi Moore said. “You watch a movie and you see the cool kid or the LGBTQ character smoking on screen. That’s still like advertising that smoking is cool.”

Quitting nicotine addiction can be difficult, both to start and maintain. According to the National Institute on Drug Abuse, only 6% of adults who attempt to quit tobacco in any given year succeed. CDC data stated LGBTQ individuals are less likely to be aware of smoking quitlines — trained professional services who help individuals stop smoking — despite having similar exposure to cessation methods as heterosexuals. 

“Our messaging isn’t ‘Oh smoking is bad, you should quit,’ our messaging is ‘If you want to, we can connect you with resources to give it a shot,’” Out Boulder County Executive Director Mardi Moore said. “At Out Boulder, we know it's easier to ensure that members of our community, especially our youth, don’t pick up the habit. It’s easier to keep people from starting than it is to help them stop, so we spend a lot of time on education through social media on ways to quit and prevent people from picking up the habit.”

OBC goes beyond education through social media to affect change.  In efforts to promote a healthier image and to encourage the community to stay away from tobacco and nicotine products, Moore said all of Out Boulder County’s events are smoke-free and promote healthy activities and exercise. 

In 2019, OBC also backed Boulder’s ban on the sale of flavored nicotine products in e-cigarettes and vapes. However, the social stigma associated with smoking is still difficult to combat.

“Smoking is taboo to a large extent in Boulder County. If you’re someone that’s not part of the group that makes things taboo, those things can pique an interest,” Moore said.

Additionally, tax increases, restrictions on public smoking and limiting visibility of nicotine and tobacco products in stores can all be put into place by municipalities and governing bodies to limit access and discourage adults and youth from picking up a nicotine habit.

Boulder County expanded the smoke-free ordinance on June 28 to encompass unincorporated Boulder County in addition to the municipalities, like Boulder and Longmont. Longmont passed an ordinance in 2019 banning smoking and vaping on public streets and avenues along Main Street between First Avenue and Longs Peak Avenue, including the breezeways.

Additionally, in an attempt to address tobacco and electronic vapor devices in youth and adults, the city of Boulder passed several ordinances in 2019 and 2020 raising the legal age of nicotine products to 21, increasing sales tax on electronic vapor devices to 40% and banning the sale of flavored tobacco and e-cigarette products in city limits.

“I’m the person who knows that policy is important but it doesn’t directly create the change you’re looking for, and policy often comes before cultural shifts,” Moore said. “Have they seen a decline in smoking and vaping with youth in Boulder because they passed that policy? ”

“The data on the impact on sales bans of flavored e-cigarettes and other tobacco products are emerging. A couple of studies in other states are finding sales bans on flavored products have the potential to curb youth tobacco use almost immediately,” Jennifer Woodard of the Center for Public Health Practice at the Colorado University Anschutz said. “Flavor bans and restrictions can reduce the chances that youth will ever try a flavored tobacco product or use tobacco at all.”

Despite efforts made by policymakers, Woodard said prevention remains a key component in preventing both youth and adults from picking up the habit. However, there are options for those who need a little help.

OBC has a number of sources available to help individuals quit smoking or vaping. 

The Colorado QuitLine has expanded free access to digital services and medications and created more inclusive content to meet diverse needs, according to Woodard. The program is free to all eligible Colorado residents and includes free coaching and support. Residents 18 and over can also qualify for free nicotine patches, gum or lozenges to help smoking cessation. QuitLine has online and phone support for program members.

My Life, My Quit is a similar program to the QuitLine, specifically tailored to youth with access via text, phone or web. The program is free and confidential, with a focus on people aged 12 to 17. The program will not provide cessation medications to anyone under 18, instead referring them to a medical professional.