Why do gays and lesbians smoke more?

Matt Galang, 20, says he started smoking to cope with stress over coming out as gay.
Matt Galang, 20, says he started smoking to cope with stress over coming out as gay.
Adrian Florido/KPCC
Matt Galang, 20, says he started smoking to cope with stress over coming out as gay.
An advertisement for American Spirit cigarettes, targeting the gay community.
Source: National LGBT Tobacco Control Network
Matt Galang, 20, says he started smoking to cope with stress over coming out as gay.
One of the anti-smoking posters Los Angeles County public health officials have placed in gay bars in West Hollywood
Adrian Florido/KPCC

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Gays, lesbians and bisexuals smoke at a rate more than double that of the heterosexual population in California, according to the state Department of Public Health. In L.A. County, the disparity is not as large, but gay and bisexual adults still smoke at a rate more than 50 percent higher than their straight counterparts, according to the Los Angeles County Health Survey. 

Troubled by those rates, L.A. County recently launched a campaign to drive down smoking rates in the gay and lesbian communities, with a particular focus on gay bars in West Hollywood and Long Beach.

"We have to be more targeted in our efforts," said Linda Aragon, who runs the county public health department's Tobacco Control and Prevention Program and is in charge of the campaign, called Break Up With Tobacco.

Researchers and advocates believe several factors contribute to higher smoking rates among gays, lesbians and bisexuals. 

For one thing, gays and lesbians may smoke to cope with the stress of being discriminated against because of their sexual orientation, said Susan Cochran, a UCLA professor who studies smoking in the LGBT community. An American Lung Association report also cites the stress of dealing with homophobia as a factor.

For some gays and lesbians, taking up smoking may be part of the coming-out process, said Cochran.

"That process involves, oftentimes, some disengagement from other people around them, and trying different behaviors, and smoking might be one of those behaviors they try out," said Cochran, an epidemiologist and psychologist who teaches at UCLA's School of Public Health.

Matt Galang, a 20-year-old who was sitting on the patio of a bar in West Hollywood one recent night, said that was the case for him.

"I think I started smoking because of stress. At the time it was because of grades, family, but also a lot because of my sexuality," he said.

He said smoking relieved the anxiety he felt over coming out to his conservative, religious family. In time, his family came to accept his homosexuality. Now he wishes he’d never started smoking.

Another factor contributing to gay and lesbian smoking is bar culture, where smoking is seemingly everywhere, said Cochran.

A 25-year-old man smoking outside a West Hollywood bar who identified himself only as Pej said the West Hollywood bar scene lured him into smoking when he was 19.

"Every time I would go out with my friends and we were on the dance floor having a good time, they would be like, let’s go outside and have a cigarette," he recalled. "I’d be like, that’s not me, but I’ll go outside with you guys. And then when I’d go outside I’d see them all smoking. And I’d end up doing it myself."

Now, Pej said, he’s the one who suggests that his friends join him for a smoke.

L.A. county’s new anti-smoking campaign is trying to refute the notion that smoking is socially acceptable, even though it’s so prevalent within the gay community, said Aragon.

The campaign features posters in bathrooms at gay clubs that use edgy, sexualized double entendres to get across the dangers of smoking. The county also has a squad of young men who are trying to spread the word in bars. The squad even sends personalized video messages via Twitter when someone tweets that they’ve quit smoking.

The goal, Aragon said, is to keep up the pressure, while not having the messaging come off as patronizing.

Having a consistent stream of anti-smoking messaging is especially important, she said, because the tobacco industry aggressively targets the gay community.

It runs ads in gay publications, like one by American Spirit that likens the freedom to marry with the freedom to smoke. Some gay people see the ads as a point of pride, Aragon said.

"Because for so long the gay community has been ignored, so now they’re finally part of the normal culture. Corporations are targeting them," she said.

UCLA’s Susan Cochran said targeting the gay and lesbian community presents other challenges, too.

"The [lesbian, gay, and bisexual] community is very diverse," she said. "It’s ethnically and racially diverse. And West Hollywood, for as much diversity as it has, not all of LGB Los Angeles goes there."

Aragon said one way the county plans to address this is by featuring gays and lesbians in anti-smoking campaigns that target the general population.