Members of the LGBTQ+ community have faced a history of oppression and discrimination that directly translates to disproportionate health risks. This includes having a greater risk of substance abuse and mental health issues, as well as higher rates of tobacco and vaping in comparison to the heterosexual/cisgender community. In fact, Big Tobacco was one of the first major consumer industries to target the LGBTQ+ community, a group that had been largely ignored by mainstream advertising. Discriminatory tactics that normalized smoking and linked the LBGTQ+ community and tobacco use have benefitted the tobacco industry while leading to higher smoking rates among LBGTQ+ populations.
Currently, about 1 in 5 LGB adults smoke cigarettes, compared with about 1 in 7 heterosexual/straight adults. When looking at transgender adults the percentage of cigarette smokers is 35% higher than that of straight adults. A 2019 Centers for Disease Control and Prevention (CDC) Youth Risk Behavior survey saw that over 10% of lesbian, gay or bisexual high school students smoke cigarettes—more than twice the percentage of their straight peers. These higher smoking and vaping rates only further hurt the community, as this puts our LGBTQ+ friends and family at higher risk for chronic lung disease.
According to FDA, the causes of this disparity include both psychological and environmental factors, such as:
- Internalized homophobia
- Stress due to societal stigma
- Negative reactions to their disclosure of sexual orientation1
Smoking-related diseases claim more than 480,000 lives in the U.S. each year, making smoking the number one cause of preventable disease and death worldwide. But, according to the CDC, LGB individuals are 5 times less likely to call a smoking cessation quitline2. So, it is up to healthcare providers to help their LBGTQ+ patients by providing education on tobacco and nicotine cessation.
Further consideration needs to be given to the transgender community and those on estrogen hormone therapy around smoking cessation. Smoking while on estrogen therapy increases the risk of blood clots that can lead to stroke, or a heart attack3.
The higher prevalence of tobacco use makes it even more essential to raise lung cancer awareness among LGBTQ+ communities. The CDC states that 20.5% of LGB adults smoke cigarettes compared to 15.3% of straight adults. While anyone with lungs can get lung cancer, smoking is a main cause of both small cell and non-small cell lung cancer, contributing to 80% and 90% of lung cancer deaths in women and men, respectively.
One reason that lung cancer is so deadly is because most cases are diagnosed at a later stage, after the disease has spread. Thankfully, lung cancer screening is available for high-risk individuals which can help catch lung cancer earlier when it is most treatable. If you are 50-80 years old, have a 20 pack-year history of smoking (1 pack a day for 20 years, 2 packs a day for 10 years), and are a current smoker, or have quit within the past 15 years, you’re considered at high risk and qualify for lung cancer screening. The American Lung Association offers “Saved By The Scan,” a free resource to help guide those who may be at a high risk of developing lung cancer. To see if you’re eligible for a low-dose CT scan, visit SavedByTheScan.org.
While this simple screening test has been available since 2015, not enough people who are eligible are getting screened. In fact, only 5.7% of those eligible in the United States have been screened, according to the 2020 State of Lung Cancer report.
More information about lung cancer, lung cancer screening and resources to quit smoking are available at Lung.org/quit-smoking. Additional featured information on LGBTQ+ History month and resources are also available on our website.
Blog last updated: August 25, 2023