Quick—what’s the biggest health risk for gay men? No, it’s not AIDS. And no, it’s not being clubbed by a horde of knuckle-dragging, tobacco-juice-chin-dribbling, conservative troglodytes. Good guess, but the correct answer is smoking.
The latest Center for Disease Control (CDC) statistics show that 20.5 percent of heterosexuals and 30.8 percent of LGBT community use some form of tobacco product. The statistics from the American Lung Association show a similar disparity. Even the satirical news organization, The Onion, seems to have noticed the connection. Its parodies of CDC anti-smoking TV ads warn heterosexual teens: “it’s gay to smoke.”
“We’re missing the pink elephant in the room,” Scout, the director of the Network for LGBT Health Equity at CenterLink who goes only by that name, tells National Review Online. “It’s the biggest thing on our health plate and we’re somehow not seeing it.”
While about 490,000 LGBT Americans have HIV, 2.3 million are smokers, Scout says. Of these, one million will have their lives shortened because of tobacco use. Medical advances have extended the lives of those with HIV, but have not appreciably forestalled the fatal consequences of smoking. A graphic provided by the Network of LGBT Health shows that while having HIV as a non-smoker takes an average of 5.1 years off one’s life, the combination of having HIV and being a smoker takes off a whopping 12.3 years.
The government, tobacco control groups, and LGBT organizations are beginning to take action. Last year, the CDC issued its first ad campaign targeting LGBT smokers. A new installment of ads featuring tips from recent LGBT tobacco-quitters will begin Monday, July 7, a CDC spokesperson tells National Review Online.
The CDC also partnered with the Office of the Surgeon General to launch an anti-smoking video featuring Scout. The video’s June release coincided with two festive occasions: Pride Week and the fiftieth anniversary of the first Surgeon General’s report on smoking. The two are not intuitively related, but the Network for LGBT Health Equity connects the dots with the slogan “Saving 1 million lives for pride.”
Nor is the initiative purely governmental. One California-based LGBT organization called the Coalition of Lavender Americans on Smoking Health (CLASH) has long been concerned with the problem. They are currently taking enrollments for a free 7-session tobacco cessation class in San Francisco called “The Last Drag.”
The American Legacy Foundation, the organization that used the hard-hitting “truth®” anti-tobacco advertisements, is also discussing the LGBT smoking problem and working together with LGBT activists.
Scout is happy to see the issue is finally getting some attention, but is galled by how long it has taken.
“If you think about it, 2012 was the first year that we had an LGBT question in the National Adult Tobacco Survey,” Scout says, referring to the primary tobacco-consumption surveillance effort in the U.S. “Can you imagine if they’d waited until 2012 to ask if people were men who’d had sex with men in HIV studies?”
There are several interrelated reasons for the pronounced LGBT smoking problems. Most smoking begins in teenage years. “If you make it to adulthood without smoking, you’re basically Scott-free,” says Scout. This is the time at which gay teens realize they are different from their peers, complicating the normal difficulties of adolescence. Tobacco provides these teens with a stress-reliever and a social lubricant.
Gays of yesteryear met in bars, before widespread smoking bans. Many who are considered role models of the LGBT community picked up the habit and now pass it on to younger gays “like a socially transmitted disease,” Scout said.
Tobacco companies saw the flourishing gay bar subculture as a niche market for the picking and quickly moved in. Advertising that portrays tobacco companies as friends of gays in a hostile world, even as private communications showed that industry leaders held little but disdain for gays, and the rest of their customers.
Big tobacco employed a similar strategy for African American customers in decades past, a source of continuing controversy and resentment. But Scout said many gays still have lingering feelings of gratitude for tobacco companies’ support in the 1990s.
“There’s this whole discussion from way back in the nineties when the civil rights leaders were like, ‘You know, the LGBT community doesn’t really like to support tobacco per se, but on the other hand we do like this idea: keep your hands off our bodies, keep your laws off our bodies,’” Scout says.
But the romance between LGBT and big tobacco could be coming to an end. The CLASH website includes a page called “Clean Money,” which lists LGBT organizations and elected officials who refuse to take money from tobacco companies.
Scout is encouraged by the attention given to the issue, but is eager to see more. He argues that a problem produced in part by decades of targeted ads requires a sustained targeted response. He hopes to see every state government’s counter-tobacco program produce material tailored for the LGBT community, and every LGBT organization spend some time addressing tobacco control.
“I feel like with tobacco, it’s like a big tablecloth seems to be covering the whole thing,” Scout said, “and I just want to whip it off and do this big reveal and have everybody suddenly realize, ‘Oh my gosh, you’re right. Why have we not been paying attention?’”
— Spencer Case is a philosophy graduate student at the University of Colorado. He is a U.S. Army veteran of Iraq and Afghanistan and an Egypt Fulbright alumnus.