Public Health Issues

• Tobacco product use is the cause of diminished quality of life for millions of people each year. Worldwide, tobacco product use causes nearly 6 million deaths per year and in the U.S., more than 16 million Americans are living with a disease caused by tobacco product use, such as cancer, heart disease, stroke, lung disease, diabetes, and chronic obstructive pulmonary disease (COPD).
• Tobacco product use among LGBTQIA+ emerging adults (ages 18-29) is particularly high. According to national analysis, emerging adults reported the highest prevalence of use of “emerging tobacco products”, and even higher use was observed among lesbian, gay, or bisexual (LGB) persons. Compared to their heterosexual, cisgender peers, LGBTQIA+ emerging adults experience a younger age of smoking initiation, have higher frequency of smoking, score higher on nicotine dependence, and have higher rates of using multiple substances.
• While the higher rates of tobacco product use among LGB groups compared to heterosexual, cisgender populations are documented, the drivers of these disparities and between group differences remain unclear.
• Less is known about cigarette smoking among transgender populations; however, recent data indicate even higher smoking rates among transgender people. One national study that surveyed 17,332 U.S. adults (cisgender, n=17,164; transgender, n=168) found that 39.7% of transgender participants reported past 30 day use of cigarette/cigar/e-cigarettes.
• Cannabis product use is also highly prevalent in LGBTQIA+ communities and stands to potentially become more prevalent throughout California since Proposition 64 was enacted in January 2018.
• While literature clearly documents disparities in cigarette smoking among SGM people, few studies have tested risk factors associated with tobacco product outcomes among LGBTQIA+ people. Similarly, few studies have documented correlates of cannabis product use among LGBTQIA+ emerging adults. Like the majority of research on LGBTQIA+ people, subgroups are often aggregated for analysis and so the differences between these unique communities are overlooked. This has resulted in limited research to guide culturally-tailored tobacco interventions that meet the needs of all LGBTQIA+ people.

Study Purpose

This study seeks to understand factors contributing to higher rates of tobacco and cannabis product use within LGBTQIA+ communities living in California compared to the general population in California, with the hopes of forming a culturally-tailored prevention and intervention resource that is relevant and helpful for LGBTQIA+ communities.

Publications and Products From This Research

• Manuscript – Prevalence of Nicotine and Tobacco Use by Sexual Identity, Gender Identity, and Sex Assigned at Birth Among Emerging Adult Tobacco Users in California, United States (June 2023)
• Infographic – Tobacco Use and Tobacco Marketing Exposure among Transgender and Gender Non-Conforming Young Adults in California (March 2022)
• Infographic – Tobacco Use and Cessation Efforts among Sexual and Gender Minority Young Adults in California (November 2021)

Funder

Tobacco-Related Disease Research Program (TRDRP)