LGBT Tobacco Disparities: State-level successes, opportunities, and challenges

In 2007, the National LGBT Tobacco Control Network convened professionals from states doing advanced LGBT tobacco disparity work to create a set of best practices for work in this arena. The resulting document presents a set of 5 large scale best practices for any state or region to implement to maximize impact of this work. These best practices, not yet evidence-based, are wisdom-based and supported by a broad cross-section of community leaders who have signed on to support the recommendations. We will explore these best practices in detail, with examples of how states have successfully implemented different steps and a discussion of the impacts gained as states/regions have moved to higher levels of sophistication on this issue. These recommendations are presented at an interesting juncture, because a record number of states, seeing the dramatic tobacco disparity research for LGBT communities, are expanding their mainstream tobacco control work to target disparity groups, especially LGBTs. In 2006, 35 states expressed a need for technical assistance to expand their LGBT tobacco control work. We will supplement the best practice information with an overview of state-level activity, including an update from a 2008 reassessment, to demonstrate the rapid expansion of this work across the country. This expansion creates opportunities at many levels and sometimes creates challenges as state policymakers and community-level advocates forge new working relationships.