LGBTQ youth say they smoke or vape to relieve stress

Smoking and using e-cigarettes, commonly known as vaping, carries many health risks. Yet, adolescents and young adults still smoke and vape, despite knowing these risks. Research into adolescent tobacco use has informed anti-smoking campaigns, but this research and the resulting interventions have focused mostly on heterosexual and cisgender teens and young adults. Studies have found higher rates of smoking and vaping among LGBTQ adolescents, but less is known about their reasons for smoking and how they view anti-tobacco campaigns.

A new study published in the journal LGBT Health takes aim at this knowledge gap. Christopher Owens, PhD, assistant professor at the Texas A&M University School of Public Health, and colleagues from San Diego State University, Northwestern University and the University of Chicago, analyzed data from an online survey of adolescent sexual minority males and gender-diverse teens to better understand rates of smoking and vaping for different demographic groups, motivations for smoking and vaping, and how these youth view anti-smoking campaigns aimed at young people.

LGBTQ youth are about twice as likely to smoke or vape as their heterosexual and cisgender peers. Part of this could be due to influence by the tobacco industry, which has focused marketing efforts on the LGBTQ community. Despite this, there has been little focus on smoking cessation in LGBTQ people, with only one adult-focused campaign launching in 2016 and none aiming at youth. Unique social pressures that LGBTQ youth face could influence decisions to smoke and keep smoking. Any intervention aimed at this population would thus need to consider the factors contributing to their smoking and vaping decisions.

Owens and colleagues used data from a July 2019 online survey of adolescent sexual and gender minority males. Of the 215 youth surveyed, 85 had smoked or vaped. The researchers found that teens who were open about their sexual and gender identity to their mothers were less likely to smoke. A common response among the respondents was that they smoked or vaped to relief stress. This differs from previous work on cisgender and heterosexual teens that found that experimentation and having fun were motivations. The survey did not specifically look into stresses due to discrimination, but the researchers note that such stresses may play a role as youth who conceal their identity from their mothers were more likely to smoke.

The respondents noted that they found existing anti-tobacco campaigns, which often focus on the health risks of smoking and vaping, to be largely ineffective. They also reported that existing campaigns were uninteresting. These views on anti-tobacco campaigns and the possible role that minority stress could play in smoking point to the need for anti-smoking interventions aimed at LGBTQ youth. Such campaigns would likely need to include advice on healthier ways of coping with stress and use testimonials from LGBTQ youth to be more relatable. In addition, such campaigns would likely benefit from heavier promotion on social media and involving LGBTQ youth in campaign design and implementation.

The findings of this study highlight differences in smoking and vaping behaviors in LGBTQ youth and how people in this population view anti-smoking campaigns. Having a better understanding of why LGBTQ youth smoke and what might be more effective in getting them to quit would inform interventions to address the health risks posed by smoking and vaping.