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Tobacco Use in the LGBT Community: A Public Health Issue

LGBT couple

Cigarette smoking in the United States is responsible for 480,000 deaths per year, and certain populations are more likely to smoke than others. One population especially at risk for engaging in tobacco use is the lesbian, gay, bisexual, transgender LGBT community.

Although LGBT individuals make up a small percentage of the total U.S. population, according to the National Health Information Survey nearly 20 percent of lesbian, gay, or bisexual adults (transgender identity was not specifically recorded in this survey) reported being current cigarette smokers. In comparison, about 14 percent of non-LGB adults were current smokers.1 Among young adults — ages 18-24 — the rates are even higher. LGBT young adults are nearly twice as likely to use tobacco as their non-LGBT counterparts, and over 40 percent of LGBT young adults are occasional cigarette smokers, meaning they have smoked at least one cigarette in their lifetime, but have not smoked daily in the last 30 days.


Risk Factors

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Causes of this disparity may include both psychological and environmental risk factors. LGBT individuals experience risk factors like internalized homophobia, stress due to societal stigma, and negative reactions to their disclosure of sexual orientation or “coming out” that may contribute to increased smoking rates.2

In addition to these risk factors, higher rates of tobacco use among LGBT individuals can also be attributed — at least in part — to targeted marketing by the tobacco industry. Tobacco companies will often advertise at Gay Pride parties and other events specific to the LGBT community.3, 4 In LGBT lifestyle publications and media, tobacco ads often portray tobacco use as normal and widely accepted behavior.5 This strategic marketing plays a part in the initiation and continued use of tobacco products among LGBT young adults.3


Health Impacts

Tobacco use remains the leading cause of preventable disease and death in the United States. The LGBT community may be at higher risk for health conditions that are related to smoking cigarettes, such as heart disease,6 and every year tens of thousands of LGBT lives are cut short by tobacco.7


Additional Resources

Note: The LGBT acronym is used as an umbrella term, and may include individuals whose sexual orientation and/or gender identity are not represented by any letter-- for example, individuals identifying as pansexual and/or non-binary.


1. 2016 NHIS: Centers for Disease Control and Prevention. Current Cigarette Smoking Among Adults—United States, 2016. Morbidity and Mortality Weekly Report 2018;67(2):53-9 [accessed 2018 Jun 1].
2. Blosnich J, Lee JGL, Horn K. A systematic review of the aetiology of tobacco disparities for sexual minorities. Tobacco Control. 2013; 22(2): 66-73.
3. Stevens P, Carlson LM, Hinman JM. An analysis of tobacco industry marketing to lesbian, gay, bisexual, and transgender (LGBT) populations: strategies for mainstream tobacco control and prevention. Health Promotion Practice. 2004; 5(3 Suppl): 129S-134S.
4. Stevens P, Carlson LM, Hinman JM. An analysis of tobacco industry marketing to lesbian, gay, bisexual, and transgender (LGBT) populations: strategies for mainstream tobacco control and prevention. Health Promotion Practice. 2004; 5(3 Suppl): 129S-134S.
5. American Lung Association. The LGBT Community: A Priority Population for Tobacco Control [PDF–367 KB]. Greenwood Village (CO): American Lung Association, Smokefree Communities Project [accessed 2016 Mar 17].
6. Caceres BA, Brody A, Luscombe RE, et al. A systematic review of cardiovascular disease in sexual minorities. American Journal of Public Health. 2017; 107(4):e:13-e21.
7. Gates GJ, Newport F. Special Report: 3.4% of U.S. Adults Identify as LGBT. Washington, D.C.: Gallup, Inc.; 2012.


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