Abstract
The reasons for higher rates of smoking among lesbian, gay, and bisexual (LGB) people than among heterosexual people are not well known. Research on internal migration and neighborhood selection suggests that LGB people are more likely to live in neighborhoods where the tobacco industry has historically targeted their marketing efforts (lower income, more racial/ethnic diversity). We used multi-level models to assess the relationship between the rate of same-sex couples per 1000 coupled households and 2012 marketing characteristics of tobacco retailers (n = 2231) in 1696 census tracts in 97 U.S. counties. We found no evidence of tobacco marketing at retailers differing by same-sex couple rates in census tracts with the exception of three findings in the opposite direction of our hypotheses: a small, significant positive relationship for the rate of same-sex male couples and the price of Newport Green (mentholated) cigarettes. For male and female same-sex couples, we also found a small negative relationship between tobacco advertisements and same-sex household rate. Tobacco retailers’ tobacco marketing characteristics do not differ substantially by the rate of same-sex couples in their neighborhood in ways that would promote LGB health disparities. Further work is needed to determine if these patterns are similar for non-partnered LGB people.
Highlights
Lesbian, gay, and bisexual (LGB) people are at much higher risk of tobacco use than their straight counterparts [1]
We found few significant relationships between the rate of same-sex couples in census tracts and eight measures of tobacco marketing in tobacco retailers within those tracts
Our study did find small but significant relationships in unexpected directions, including higher Newport prices for same-sex male couples and fewer ads for both male and female same-sex couples. These finding should be replicated in other data sources, it provides no evidence that the origin of LGB tobacco disparities lies in store-level differences in POS tobacco marketing
Summary
Gay, and bisexual (LGB) people are at much higher risk of tobacco use than their straight counterparts [1]. In addition to more than 50% higher smoking prevalence than for straight people [2], LGB people are more likely to smoke menthol cigarettes, flavored little cigars, filtered little cigars, and use e-cigarettes than heterosexual people [2,3,4,5]. Data for transgender populations are scarce [6], similar disparities likely exist [7]. The reasons for these disparities are only partially known, and research has focused primarily on the role of discrimination, stigma, and stress [8]. Researchers have suggested that the role of LGB bars as safe community spaces may promote tobacco use [9,10], that the media environment may contribute as tobacco use is normative in the LGB print press and in LGBT-themed movies [11,12,13], and that tobacco industry marketing targeted directly at LGB communities contributes to disparities [14,15,16].
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