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• Tobacco use among sexual minorities, USA, 1987-2007 (May): A Systematic Review 

CONCLUSION

Increased attention to smoking among sexual minority populations is warranted in clinical practice and in the creation of prevention and treatment programs. In examining the ample evidence of disparities in suicidal ideation among sexual minority adolescents, Morrison and L'Heureux noted that the “[p]revention of GLBQ [gay, lesbian, bisexual, and queer] adolescent suicide thus could entail treating the environments that interface with GLBQ youth in addition to treating the adolescents themselves.”[87] The same may well be true for elevated prevalence of smoking among sexual minorities. Moreover, there are specific evidence-based steps that can be taken to reduce the impact of smoking on sexual minority communities.

Prevalence could be assessed and monitored through Youth Risk Behaviour Surveillance Surveys, Youth Tobacco Surveys, Behavioural Risk Factor Surveillance Surveys, and Adult Tobacco Surveys. Many states, however, do not include sexual orientation, thus hindering monitoring efforts despite the fact that sampling methodology has been crucial in researchers’ understanding of gay and lesbian health and wellbeing.[88] Population-based interventions like increasing taxes on tobacco products and banning advertising should be combined with approaches that seek to reduce disparities in vulnerable populations.[9] These might include social marketing efforts, mass media campaigns in the gay and lesbian press, community recognition of tobacco as a problem,[89, 90] extra efforts for smoke-free gay and lesbian venues, targeted cessation services,[91] community rejection of tobacco industry sponsorship of events, and ongoing collaboration with the National LGBT Tobacco Control Network (http://www.lgbttobacco.org/). Given the leitmotiv of smoking as a health inequality in sexual minorities’ lives, local, state, and federal tobacco programs should target LGBT populations in tobacco prevention and cessation interventions and include priority population indicators in the evaluation of program outcomes.

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WHAT THIS PAPER ADDS?

• There is compelling evidence that an elevated prevalence of tobacco use among lesbian, gay, and bisexual men and women exists.

• National and state surveillance systems should incorporate sexual minority status to monitor the elevated use of tobacco by gays and lesbians.

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