Engaging the LGBTQ+ Community in Tobacco Cessation
In September 2023, the Biden-Harris Administration announced a series of initiatives being undertaken by non-profit organizations to deliver on the promise of the White House Cancer Moonshot: to end cancer as we know it. One of those initiatives is a campaign to make tobacco cessation education materials more readily available to LGBTQ+ communities, an effort spearheaded by the National LGBT Cancer Network.
Building on its community-tailored website and a series of social media shareables, the National LGBT Cancer Network will create a series of LGBTQ+ tailored tobacco cessation materials and will launch a print-on-demand store for the materials. They will work with stakeholders like the North American Quitline Consortium, NCI-Designated Cancer Centers, and community members to ensure the materials are compelling and motivational and will widely promote their availability.
Tobacco: The Winner of a Gruesome Race
According to National LGBT Cancer Network Executive Director, Scout, PhD, LGBTQ+ communities use commercial tobacco products (including combustible and alternative products) at rates 49 percent higher than the general population. LGBTQ+ youth are especially vulnerable to the lure of tobacco; many use it as a bad coping mechanism for the discrimination they face in their daily lives.
Dr. Scout
“When compared to other health conditions like mental health issues or even HIV, tobacco is one of the biggest factors that takes years off the lives of LGBTQ+ communities,” Dr. Scout says. “It is the unlikely winner of a gruesome race.”
Prior to last September’s announcement from the White House, Dr. Scout says he was encouraged to learn that the relaunched Cancer Moonshot program would seek to include the voices and expertise of diverse populations from the outset. He notes that LGBTQ+ communities are particularly underserved populations in the larger universe of those facing health disparities.
“Eliminating disparities in cancer risks, detection, and treatment will help to significantly reduce the impact of the disease,” he says. “However, health disparities are not created with a one-size-fits-all approach, and they can’t be eliminated that way.”
To that end, the National LGBT Cancer Network focuses heavily on educating its communities about the pernicious effects of tobacco industry marketing designed to keep them “hooked” on their products. For example, LGBTQ+ people are three times more likely to be exposed to tobacco coupon messages on video streaming websites, and menthol tobacco products are heavily marketed to LGBTQ+ communities. In part because of these marketing activities, LGBTQ+ adults spend over $2.6 billion on cigarettes every year.
One way the Network is educating LGBTQ+ communities is through its Out Proud Free campaign, which aims to ensure that tobacco industry marketing and “myths” don’t unduly influence behavior.
“We see lots of tobacco flavors that appeal to young queer folks, like cotton candy and cherry starburst,” says Dr. Scout. “We need our communities to be aware that product ‘tricks’ like these are creating an addiction they will be fighting for decades.”
Mistrust Affects Access to Care
Dr. Scout notes that LGBTQ+ communities tend to mistrust both the medical system and programs from government bodies like state departments of health – especially considering the recent surge in anti-transgender legislation across the country. They are therefore less likely to be aware of tobacco cessation resources and quit lines, feel less welcome by them, and less likely to use them.
“When reaching out to a tobacco quit line or other smoking cessation services, it’s incredibly difficult to talk about the stressors and triggers that may lead you to smoke while also trying to hide a huge portion of your life,” he says. “It is critical that these programs provide a space and approach through which we can see ourselves represented.”
To address this issue, The Network created OutLast Tobacco, an online portal designed to help smoking cessation service providers create a safe and welcoming space for LGBTQ+ individuals and help them increase their use of quit line services. It also works directly with various quit lines, providing expert training around how to be more welcoming, engaging, and offer more tailored advice to LGBTQ+ callers.
The National LGBT Cancer Network is also home to the CDC-funded Tobacco Related Cancer Project, which aims to reduce tobacco and cancer-related disparities in LGBTQ+ populations by:
- Administering a national network of partners, including CDC-funded tobacco and cancer programs, national organizations, and state and local departments of health
- Providing training and technical assistance to network members and CDC grantees
- Increasing the reach of national, state, tribal, territorial, and local interventions
- Increasing the reach of mass health communications through tailored messaging
As an example of this effort, the Network helped New York State create its first queer-focused smoking cessation advertising campaign, providing relevant evidence to support the campaign, and working with creative designers to tailor the ads for the most effective impact.
The Network’s training and technical assistance services are not limited to tobacco-related health concerns. Its Welcoming Spaces program, developed in collaboration with the Society for Gynecologic Oncology, provides LGBTQ+ Cultural Humility training for health care professionals. The free program, available for continuing education credits, consists of eight online modules, each of which are 45 minutes long and can be viewed on demand.
“If providers are interested in doing a better job caring for their LGBTQ+ patients, they don’t have to wait for training to come to them. They can use this to up their game,” Dr. Scout says.
Importantly, the LGBT Cancer Network also provides its own welcoming spaces for LGBTQ+ cancer patients, through free online peer-support groups and a list of welcoming cancer screening and treatment professionals.
“Lack of social support is one of the top problems facing LGBTQ+ cancer patients and survivors,” Dr. Scout concludes. “We are honored to provide these services to offer a baseline of support for queer people who are facing this difficult life challenge.”
