Research has long shown that lesbian, gay, and bisexual individuals use tobacco products at higher rates than their heterosexual peers, due, in part, to decades of tobacco industry efforts to target this population.
New Truth Initiative® research identifies that this trend is worsening — and extends to e-cigarettes.
Between 2020 and 2021, e-cigarette use rates rose at higher rates among lesbian, gay, and bisexual youth compared to heterosexual youth. These disparate increases in vaping threaten to widen the gap in nicotine addiction and physical and mental health concerns in a population already burdened by discrimination and stigma.
E-CIGARETTE USE ACCELERATES AMONG LESBIAN, GAY, AND BISEXUAL YOUNG PEOPLE
Lesbian, gay, and bisexual youth and young adults use and try e-cigarettes at a higher rate than their heterosexual peers, according to an analysis of Truth Initiative surveys conducted in 2020 and 2021. The analysis uses data from the 2020 and 2021 Truth Longitudinal Cohort survey, a national cohort established in 2014 to evaluate truth®, one of the largest and most successful youth tobacco prevention campaigns in the United States. Because the survey asked about sexual orientation but not gender identity, results from this survey focus only on lesbian, gay, and bisexual individuals — referred to in this report as LGB. Truth Initiative aims to update future data collections to include transgender individuals.
The survey was administered in 2020 to 7,003 15-30-year-olds, of whom 1,018 were LGB, and in 2021 to 6,411 14-33-year-olds, 1,037 of whom identified as LGB. Survey results indicate that rates of LGB youth and young adults ever trying and currently using e-cigarettes increased between 2020 and 2021:
- Higher rates of trying e-cigarettes: Young people who identify as LGB reported that they had ever vaped at much higher rates than their heterosexual peers (52.1% vs 38.6%).
- Higher rates of currently using e-cigarettes: In 2021, LGB young people currently vaped at higher rates than their heterosexual peers (19.8% vs. 13.2%).
- Rates increase over time: Between 2020 and 2021, the difference between LGB and heterosexual young people who currently vape increased by 32%, and those who had ever tried e-cigarettes increased by 26%.
While current and ever e-cigarette use increased over time among Truth Initiative’s entire survey sample, LGB e-cigarette use increased more than heterosexual e-cigarette use, effectively widening the gap between vaping rates based on sexual orientation, pointing to growing problems with vaping use in this population.
Expanding decades of targeted tobacco marketing to e-cigarettes
The tobacco industry has a well-documented history of targeting the LGBT community since the 1990s, including advertising in LGBT publications, using corporate philanthropy as “evidence” of its support of the LGBT community, and hosting community outreach efforts. In 1995, Tobacco giant R.J. Reynolds’ created “Project SCUM” (Sub-Culture Urban Marketing) to boost cigarette sales by targeting gay men and homeless individuals with advertisements and displays placed in communities and stores. Tactics continue to evolve, extending to corporate efforts to be named LGBT-friendly workplaces. For example, Reynolds American Inc. was designated a “Best Place to Work for LGBTQ Equality” by the Human Rights Campaign in 2020, despite its history of targeted marketing.
Now, e-cigarette companies continue to target the LGBT community by sponsoring events, including the e-cigarette company VaporFi’s sponsorship of an annual gay pride festival in Miami. As a result, LGBT adults have seen and heard more e-cigarette ads than non-LGBT adults, and there is evidence that this trend affects LGBT youth. Further research is needed to determine the effect of Big Tobacco’s marketing on LGBT e-cigarette use.
WHY ARE LGB VAPING RATES INCREASING FASTER THAN HETEROSEXUAL VAPING?
Sexual minorities have used tobacco at higher rates than their heterosexual counterparts for years. Past research has shown that lesbian, gay, and bisexual adults smoked cigarettes at rates significantly higher than straight adults and were nearly twice as likely to use e-cigarettes and little cigars as their straight peers. Widening disparities in LGB tobacco use rates may be intertwined with myriad issues facing this community, including sustained minority stress and deteriorating mental health exacerbated by the COVID-19 pandemic and an increasingly hostile political environment that has fueled increased violence, hate speech, and discriminatory legislation against the LGBT community.
MINORITY STRESS INCREASES E-CIGARETTE USE AMONG LGB INDIVIDUALS
Research shows that stress related to homophobia and transphobia increases e-cigarette use among LGBT youth. Violence, harassment, bullying, and discrimination contribute to more stress among LGBT youth.
- Gender- and sexuality-based harassment has been linked to increased e-cigarette use among LGBT high school students.
- LGB young adults report rates of physical and sexual abuse two to three times higher than their non-sexual minority peers. These adverse childhood experiences have been linked to increased odds of e-cigarette use among sexual minorities.
Truth Initiative – 2022-06-29.
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