Page 22 - 2023-Jan-Feb-Journal-Final

Reducing Tobacco Disparities Among LGBTQ2IA+ Communities

Era Steinfeld, MA
Shimarah Mehrotra, MPH, CPH
Desmar Walkes, MD
Ashley LeMaistre, MPH
Trent Daugherty, MPH
Austin Public Health

T obacco use remains the leading preventable

cause of death in Travis County. While rates of
smoking have declined overall, tobacco-related
health disparities continue to exist within certain disparity
populations, including the LGBTQ2IA+ community.
By implementing tobacco prevention and cessation
programs and policies in clinical and community settings,
we can increase health equity for LGBTQ2IA+ communities
and ensure that we support LGBTQ2IA+ individuals in
improving their overall mental and physical health and
wellbeing.
LGBTQ2IA+ Tobacco Use Data
In order to examine tobacco use among the Minority Stress and Access to Care
LGBTQ2IA+ community in Travis County, data from During the CHNA focus groups, 52% of participants
the Texas Behavioral Risk Factor Surveillance System mentioned stress as a trigger for tobacco use. These
(BRFSS) survey from 2015-2020 were analyzed. From stressors may feel more salient for non-cisgender tobacco
2015-2020, rates of tobacco use were nearly 1.5 times users, as 40% of non-cisgender respondents named
higher among the LGBTQ2IA+ community than the stress as a tobacco trigger, compared to 24% of
general population of Travis County. For those identifying cisgender respondents. 1
as “LGB”, 16.9% identified as current tobacco users “Minority stress is particularly relevant to tobacco use because
and 25.5% identified as former tobacco users. For those tobacco use has been established as a stress-induced behavior for
identifying as “Straight” the rates are lower: 11.4% LGBTQ2IA+ populations. Some minority stress experiences
identified as current tobacco users and 22.9% as former mentioned by focus group participants were harassment, conflict
tobacco users. The tobacco use rates are also higher for with or rejection by family, and microaggressions such as being
those identifying as “Transgender”, with 16.7% identified misgendered by family and coworkers.” 1
as current tobacco users, compared to 11.8% of those
identifying as “Not Transgender.” 2 The CHNA also highlights barriers that prevent
In 2021, researchers at the University of Texas at LGBTQ2IA+ populations from accessing tobacco
Austin wrote and published a report titled “LGBTQ2IA+ cessation resources and treatments. Named amongst
Community Health Needs Assessment (CHNA): Findings these barriers were tobacco withdrawal side effects,
from a Mixed Methods Assessment of the Health Needs perceived cost of tobacco cessation programs and
and Tobacco Use of LGBTQ2IA+ Communities in nicotine replacement therapies (NRT), and a lack of
Austin and Travis County.” For this report, researchers awareness about tobacco cessation programs. Just two
analyzed quantitative data from the QWELL Wellbeing out of 25 focus group participants were able to name a
Surveys of Greater Austin from 2019 (n=1,551) and tobacco cessation program or resource that was available
2020 (n=660) and conducted seven focus groups, which to them locally. 1
engaged a total of 25 LGBTQ2IA+ community members CHNA findings also demonstrate that LGBTQ2IA+
in the Greater Austin Area. Almost half (48%) of the community members in the Greater Austin Area
focus group participants stated that they felt that tobacco experience barriers that prevent them from seeking and
use is prevalent in LGBTQ2IA+ communities. accessing healthcare services. Only about half (47.6%)
These higher use rates may be attributed to several of QWELL Wellbeing Survey respondents indicated they
known factors, including the tobacco industry’s documented had a physical exam within the last year and an additional
history of targeting LGBTQ2IA+ communities, minority 26.5% had a physical exam one to two years ago. More
stress, and lack of access to quality, affirming healthcare. than half (59%) of respondents reported at least one
2
22 2023 January • February TCMS