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Tobacco Use in the LGBT Community: A Public Health Issue

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Cigarette smoking in the United States is responsible for 480,000 deaths per year, and certain populations are more likely to smoke than others. One population especially at risk for engaging in tobacco use is the lesbian, gay, bisexual, transgender LGBT community.

Although LGBT individuals make up a small percentage of the total U.S. population, according to the National Health Information Survey nearly 21 percent of lesbian, gay, or bisexual adults (transgender identity was not specifically recorded in this survey) reported being current cigarette smokers. In comparison, about 15 percent of non-LGB adults were current smokers.1 Among young adults — ages 18-24 — the rates are even higher. LGBT young adults are nearly twice as likely to use tobacco as their non-LGBT counterparts, and over 40 percent of LGBT young adults are occasional cigarette smokers, meaning they have smoked at least one cigarette in their lifetime, but have not smoked daily in the last 30 days.

Risk Factors

LGBT couple

Causes of this disparity may include both psychological and environmental risk factors. LGBT individuals experience risk factors like internalized homophobia, stress due to societal stigma, and negative reactions to their disclosure of sexual orientation or “coming out” that may contribute to increased smoking rates.2

In addition to these risk factors, higher rates of tobacco use among LGBT individuals can also be attributed — at least in part — to targeted marketing by the tobacco industry. Tobacco companies will often advertise at Gay Pride parties and other events specific to the LGBT community.3, 4 In LGBT lifestyle publications and media, tobacco ads often portray tobacco use as normal and widely accepted behavior.5 This strategic marketing plays a part in the initiation and continued use of tobacco products among LGBT young adults.3

Health Impacts

Tobacco use remains the leading cause of preventable disease and death in the United States. The LGBT community may be at higher risk for health conditions that are related to smoking cigarettes, such as heart disease,6 and every year tens of thousands of LGBT lives are cut short by tobacco.7

“This Free Life” Campaign

LGBT couple

As part of FDA’s ongoing efforts to reduce the public health burden of tobacco use in the United States, the agency launched the “This Free Life” campaign, which aims to positively affect tobacco-related knowledge, attitudes, and beliefs of LGBT young adults (ages 18-24) who are occasional smokers. The campaign, whose tagline is “Freedom to Be, Tobacco-Free,” enforces the message that even a cigarette now and then can have adverse consequences to one’s health and educates LGBT young adults on the:

  • toxic mix of chemicals in cigarette smoke;
  • negative health effects and addiction risks of tobacco use; and
  • ways in which tobacco use adversely impacts aspects of health and life that the LGBT community values

Find more information about “This Free Life” and FDA’s other tobacco prevention campaigns.

Additional Resources

Note: The LGBT acronym is used as an umbrella term, and may include individuals whose sexual orientation and/or gender identity are not represented by any letter-- for example, individuals identifying as pansexual and/or non-binary.

1. 2016 NHIS: Centers for Disease Control and Prevention. Current Cigarette Smoking Among Adults—United States, 2016. Morbidity and Mortality Weekly Report 2018;67(2):53-9 [accessed 2018 Jun 1].
2. Blosnich J, Lee JGL, Horn K. A systematic review of the aetiology of tobacco disparities for sexual minorities. Tobacco Control. 2013; 22(2): 66-73.
3. Stevens P, Carlson LM, Hinman JM. An analysis of tobacco industry marketing to lesbian, gay, bisexual, and transgender (LGBT) populations: strategies for mainstream tobacco control and prevention. Health Promotion Practice. 2004; 5(3 Suppl): 129S-134S.
4. Stevens P, Carlson LM, Hinman JM. An analysis of tobacco industry marketing to lesbian, gay, bisexual, and transgender (LGBT) populations: strategies for mainstream tobacco control and prevention. Health Promotion Practice. 2004; 5(3 Suppl): 129S-134S.
5. American Lung Association. The LGBT Community: A Priority Population for Tobacco Control [PDF–367 KB]. Greenwood Village (CO): American Lung Association, Smokefree Communities Project [accessed 2016 Mar 17].
6. Caceres BA, Brody A, Luscombe RE, et al. A systematic review of cardiovascular disease in sexual minorities. American Journal of Public Health. 2017; 107(4):e:13-e21.
7. Gates GJ, Newport F. Special Report: 3.4% of U.S. Adults Identify as LGBT. Washington, D.C.: Gallup, Inc.; 2012.


Audience: Public Health Professionals, Educators

Topics: E-Cigarettes & Vaping, Science & Research, cigarettes, prevention