Tobacco Control as an LGBTQ+ Issue: Knowledge, Attitudes, and Recommendations from LGBTQ+ Community Leaders.

Veronica Acosta-Deprez,Mike Ai,Carolyn Chu,Judy Jou,Marisa London,Nhi Cermak,Shannon Kozlovich

doi:10.3390/ijerph18115546

Abstract

Tobacco companies use price discounts, including coupons and rebates, to market their products. Lesbian, gay, bisexual, transgender, and queer (LGBTQ+) communities are targeted by these marketing strategies, contributing to inequitably high tobacco use. Some localities have adopted policies restricting tobacco price discounts; for successful implementation, community buy-in is crucial. From July–October 2018, Equality California staff conducted semi-structured interviews with seven participants in Los Angeles, CA. Themes included familiarity with tobacco price discounts, their perceived impact on tobacco use in LGBTQ+ communities, and attitudes toward potential policy restrictions. Interview notes were analyzed using a deductive approach to qualitative analysis. Awareness of tobacco price discounts varied; some interviewees were familiar, while others expressed surprise at their ubiquity. Price discounts were seen to disproportionately impact LGBTQ+ individuals, especially those who additionally identify with other vulnerable groups, including young people and communities of color. Support for policy restrictions was unanimous; however, interviewees expressed concern over political opposition and emphasized a need for culturally competent outreach to LGBTQ+ communities. Community organizations are essential in mobilizing support for policy reform. Understanding the perceptions and recommendations of community leaders provides tools for policy action, likely improving outcomes to reduce LGBTQ+ tobacco use through restricting tobacco price discounts.

Highlights

Cigarette smoking is the leading cause of preventable disease, disability, and death in the United States (US) [1]
The aim of this paper is to examine in greater depth the knowledge and attitudes of community leaders from various community agencies in Los Angeles County, California (CA), around tobacco use and marketing within LGBTQ+ communities
This aligns with prior research showing that up to half of current adult smokers in the US have used some type of price discount when purchasing tobacco products [37,38,39,40], and that younger adults and LGBTQ+ individuals tend to be more prolifically targeted by these marketing strategies [41,42,43]

Summary

Introduction

Cigarette smoking is the leading cause of preventable disease, disability, and death in the United States (US) [1]. The number of deaths attributable to cigarette smoking still totals over 480,000 each year—equivalent to one in five deaths in the US [2,3]. 90% of all lung cancer deaths and 80% of deaths from chronic obstructive pulmonary disease, as well as increasing the risk of coronary heart disease; stroke; and many cancer types, including oral and digestive tract cancers [5,6]. Economic losses associated with tobacco use are estimated at over $300 billion per year in direct medical costs and lost productivity [3,7]. Significant socio-demographic disparities in cigarette smoking and, more broadly, the use of tobacco products, persist across the US.

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