Tobacco Use and Cessation among Lesbian, Gay, and Bisexual (LGB) Adults in the United States

Evidence from small studies suggests that smoking prevalence in the LGB community is nearly double that of the general population. The higher prevalence of cigarette use in this group has been attributed to targeted marketing by the tobacco industry and stress related to prejudice and social stigma. This study seeks to provide the first estimates of cigarette and smokeless tobacco use and cessation-related behaviors among LGB adults from a national tobacco survey. Data were obtained from the 2009-2010 National Adult Tobacco Survey (NATS), a nationally representative telephone survey of tobacco use and behaviors among non-institutionalized adults aged 18 years and older. Consistent with previous findings, analyses showed that current cigarette smoking prevalence among gay/lesbian adults (29.5%; 95% CI: 25.1, 34.3) and bisexual adults (40.9%; 95% CI: 33.4, 48.9) was significantly higher than the prevalence among heterosexual adults (19.5%; 95% CI: 19.0, 20.1). The prevalence of current smokeless tobacco use was significantly lower for gay/lesbian adults (0.9%; 95% CI: 0.4, 2.0) and bisexual adults (1.4%; 95% CI: 0.8, 2.5) than heterosexual adults (3.5%; 95% CI: 3.3, 3.8). Among current cigarette smokers, there were no significant differences in the desire to quit smoking or the prevalence of quit attempts in the last 12 months by sexual orientation. The prevalence of receiving physician advice in the last 12 months to quit the use of any tobacco product did not differ by sexual orientation. Given the high prevalence of cigarette smoking in the LGB community, additional culturally-appropriate strategies to increase cessation may be needed.