Sexual and gender minorities in the U.S. smoke at higher rates than their non-LGBTQ peers. The tobacco industry is known for using marketing tactics to attract new smokers and retain existing customers. They use strategies that specifically target the LGBTQ community, such as sponsorship of Pride events and advertising in LGBTQ publications. This week, ASHES reviews a study by Juhan Lee and colleagues that investigated how LGBTQ young adults are exposed to both general and LGBTQ-targeted tobacco marketing.
What were the research questions?
Where are U.S. young adults exposed to tobacco marketing, and does exposure differ by LGBTQ identity? Is frequency of exposure to marketing associated with tobacco use?
What did the researchers do?
The researchers recruited 1,378 young adults (ages 18–30) living in the U.S. through Prolific to complete an online survey. The researchers specifically targeted LGBTQ-identity participants by oversampling those individuals during recruitment. In addition to reporting their sexual and gender identity, participants reported on current tobacco use. They also indicated whether they had participated in 12 general activities in the past year (e.g., using a dating app), and if so, whether they were exposed to tobacco marketing while doing each activity. LGBTQ participants answered additional questions about their exposure to tobacco marketing for 12 parallel, LGBTQ-specific activities—like using an LGBTQ-focused dating app. The researchers used chi-square tests to assess exposure to tobacco marketing, and logistic regressions to examine the association between frequency of exposure and current tobacco use.
What did they find?
Compared to non-LGBTQ participants, LGBTQ participants had significantly higher exposure to tobacco marketing in any general venue—especially in physical stores and on dating apps. In contrast, non-LGBTQ participants reported greater exposure to marketing on social media (see Figure). Thirty percent of LGBTQ participants had been exposed to LGBTQ-targeted tobacco marketing, most commonly through LGBTQ-focused websites and social media/apps, and streaming shows with LGBTQ content. LGBTQ participants who had more frequent exposure to targeted marketing in LGBTQ-oriented stores, newspapers and magazines, and at events like Pride festivals were more likely to report current tobacco use.
Figure. Percentage of U.S. young adult participants exposed to tobacco marketing in the past year while participating in various activities. Only activities with significant differences by sexual and gender identity (i.e., LGBTQ identity versus non-LGBTQ identity) are shown. Click image to enlarge.
Why do these findings matter?
These findings suggest that LGBTQ young adults are exposed to both general and LGBTQ-targeted marketing, in physical places and online. This is concerning because exposure to tobacco marketing is associated with tobacco use. Strategies to counter tobacco marketing are needed. Public awareness campaigns—like This Free Life and Outlast Tobacco—should be promoted in the same places these young adults are seeing tobacco marketing, such as LGBTQ-focused websites and social media apps, and at Pride events. Broader actions, like banning all flavored tobacco products, are needed to reduce tobacco use overall, including among LGBTQ populations.
Every study has limitations. What are the limitations of this study?
The researchers used convenience sampling, so these findings may not be generalizable to the broader U.S. population. The data were cross-sectional, meaning we cannot determine causal relationship of exposure to tobacco marketing and smoking. Finally, this study relied on self-reported data, which can be affected by recall bias.
For more information:
The Centers for Disease Control and Prevention provides information about smoking for LGBTQ+ people. SmokeFree offers tools and tips for quitting and maintaining abstinence from tobacco use. For additional self-help tools, please visit the BASIS Addiction Resources page.
— Kira Landauer, MPH
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