Helping LGBTQ+ People Live Smoke Free

Helping LGBTQ+ People Live Smoke Free

Despite general knowledge of its dangers, tobacco use is a major issue in the LGBTQ+ communities. According to Holly Giardina, project coordinator True to You Coalition at Wheeler Health in Plainville, members of these communities are more than twice as likely to turn to the products—cigarettes, cigar, snuff, vapes, etc.—than the general population.

Giardina says that one of the main reasons LGBTQ+ individuals, and youth in particular, turn to tobacco consumption is as a means of managing stress. As she explains, it’s the nicotine in all of these products that is so addictive. “Within ten seconds, nicotine hits the brain,” she says. “The brain releases dopamine, a chemical that creates a surge of pleasure and calm, and temporarily reduces feelings of stress. But those feelings of pleasure don’t last long. Some people continue to smoke or vape to ‘manage’ feelings of stress; the risk is their brains can become dependent on nicotine.” 

Giardina also notes that stressors that make people turn to tobacco products are particularly pronounced in the LGBTQ+ communities. These include peer pressure, discrimination, stigma, possible rejection by families, and more. In addition, she adds many in these communities may have limited access to healthcare providers—and healthcare that is affirming and equitable—whether they are uninsured or under-insured. This is amplified by, in some cases, distrust of healthcare providers.

Giardina runs the True to You (T2U) coalition, which is dedicated to helping people in the LGBTQ+ communities stop smoking. The organization received funds in 2023 from the Connecticut Department of Public Health, under the CDC prevention funding program. Over its first two years, finished in April of last year, the coalition initiated a three-tiered program, which raised awareness about the harms of tobacco and encouraged prevention or cessation. The program, delivered through digital platforms focused on reasons for not using tobacco products, including relationships and mental health. 

Key in these communications was helping people understand that the people who answer the telephone Quit Line are not medical professionals but real people who have extensive experience helping people through the process of quitting. 

The coalition also prepared materials that were distributed to 111 healthcare providers in more than 50 facilities around the state. Waiting room cards encouraged LGBTQ+ patients to ask about quitting and make it more comfortable for them to do so.

The organization has also been visible in the communities. Lawn signs, in five communities last year, encouraged people not to smoke. As Giardina explains “one of the harms we were looking at is secondhand smoke.”  In addition, T2U has been highly visible at Pride events around the state, supporting event sponsors in migrating towards tobacco-free events.

The coalition is currently moving into its second phase with new funding through the Tobacco and Health Trust Fund through a contract  from the Connecticut Department of Public Health. Over the next three years, Giradina says, “What we’re hoping to do now is to promote tobacco-free living as the norm. What we want to do is promote ‘whole person health.’” Along those lines, she adds that while many people understand the risks with traditional tobacco, the don’t consider vapes in the same category, but they are. They are considered tobacco products because of the nicotine content. 

It’s not necessarily an easy task. Giardina cites work by The Truth Initiative, an anti-smoking organization, that cites the increasing presence of tobacco products in entertainment and the aggressive push by tobacco marketers into the LGBTQ+ communities. The organization cites research that shows that use of tobacco by LGBTQ+ youth is often twice the incidence of use among cis-gender youth. When trans youth alone are considered, incidence of use is even greater versus other cohorts.

What Giardina calls “positive social norming” can be effective—and makes sense. As she explains if 22 percent of people are smoking, that means 78 percent are not. However, she acknowledges that over and above the physical dependence, this can be a hard habit to break. So, as it moves into its next phase, T2U will be talking about why people would not want to smoke and to help them develop alternative behaviors and practices to deal with the stress and anxiety that triggers the desire to consume tobacco products.  T2U is also planning to develop community presentations and create Freedom From Smoking groups where people can share their experiences and get support on their journeys.

For today, if you would like help quitting, call 1-800-QUIT-NOW (800-784-8669). It’s a national number, but it’s answered by people in your area.

Giardina knows it’s not easy—as does anyone who has tried to quit. But she says, the goal is to keep trying and not give up.