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Tobacco Action Plan

The top 5 priorities

  1. Create One National Campaign: One Logo/Name and Message
  2. Develop Clearinghouse on LGBT Tobacco Efforts
  3. Identify Data Sets for Analysis and Conduct New Research
  4. Enhance Connectivity with Larger Anti-Smoking Organizations
  5. Build Resources for Development Programs and Initiatives

see full action plan (PDF)

Resource Library

Articles

  • "We'd Be Free": Narratives of Life Without Homophobia, Racism, or Sexism

    Ilan H. Meyer, Suzanne C. Ouellette, Rahwa Haile & Tracy A. McFarlane

    Sexuality Research and Social Policy
    ISSN 1868-9884
    Sex Res Soc Policy
    DOI 10.1007/s13178-011-0063-0

    Abstract Stigma and social inequality deprive disadvantaged social groups of a sense of social well-being. Stress researchers have focused on prejudice-related events and conditions but have not described more intangible stressors experienced by sexual minorities. We use narrative methods to examine how sexual minorities experience stigma and social inequality as we focus on the more intangible stressors that are both pervasive and difficult to measure. Three themes emerged in the narratives of our ethnically diverse sample of 57 adult sexual minority women and men: (a) stigma deprived them of access to critical possibilities and opportunities; (b) stigma deprives them of safety and acceptance; and (c) despite this, the experience of stigma is also related to the adoption of a positive and collective orientation towards their stigmatized identities. Recognizing these stressors and related resilience can direct policy makers toward interventions that go even beyond eliminating prejudice by including goals to strengthen minority communities.

    Keywords: Sexual minorities, Stigma, Prejudice, Stress, Social well-being

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  • 2012 Summit Abstract Submission Packet

    Email submissions to summitabstracts@gmail.com

    download file
  • 2012 Summit Registration Form

    Registration form for the 8th annual LGBTQ Health Equity Summit
    August 14, 2012
    Kansas City, MO


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  • 2012 Summit Sponsorship Packet

    The 2012 LGBTQ Health Equity Summit provides a great sponsorship opportunity for your company or organization! The Summit will be held on August 14th, in Kansas City, Missouri marking the eighth anniversary of the event. Convening one day before the National Conference on Tobacco or Health, the one-day Summit is an interactive, educational, and networking event where your company or organization can reach a diverse group of individuals from across the United States, all working on health equity issues and battling tobacco use, the leading preventable cause of death in the United States. The Summit brings together more than 100 community-based gay, lesbian, bisexual, and transgender leaders, along with allies, for lively panel discussions, hands-on workshops, and strategic planning sessions.

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  • A Blueprint for Meeting LGBT health and Human Services Needs in NYS

    Frazer and Warren, 2010

    Estimates of the size of the LGBT population in New York State vary. In 2004, the New York State Department of Health’s Adult Tobacco Survey included questions on sexual orientation and gender identity. It suggested that 2.6% of adults in New York State are lesbian, gay or bisexual, while 2.1% are transgender. In 2007, the New York City Department of Health and Mental Hygiene’s Community Health Survey estimated that 4.1% of people in New York City identify as lesbian, gay, or bisexual; however, this survey did not ask about transgender identities. National estimates suggest that 4.1% of the population identifies as lesbian, gay, or bisexual. However, a larger number have had sex with someone of the same gender or experience same-sex attractions.

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  • Aboriginal Two-Spirit and LGBTQ Migration, Mobility, and Health Research Project

    Description

    This qualitative, community-based research project explored the trajectories of migration of Aboriginal people who identify as Two-Spirit, lesbian, gay, bisexual, transgender and/or queer (LGBTQ) and the impact of mobility on health and wellness. Our focus on migration included movement from First Nation reserve communities to urban centres or rural communities (and back and forth) as well as staying or moving within one place. We were interested in the intersection between sexual and gender identities with cultural/Nation and other identities within the historical and present context of colonization in Canada.

    More specifically this research project had the following objectives:

    * To explore the migration paths and experiences of Aboriginal Two-Spirit and LGBTQ peoples, their experiences of health/wellness in that context, and their interactions with health and social services (including mainstream, Aboriginal and LGBTQ services).

    * To generate new knowledge that may lead to future research that will be of direct benefit to LGBTQ and Aboriginal communities, Aboriginal service providers and health/social service agencies.

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  • Adding Sexual Orientation Questions to Statewide Public Health Surveillance: New Mexico's Experience

    Authors: Vankim NA, Padilla JL, Lee JG, Goldstein AO.

    By Chronic Disease Prevention and Control Bureau, New Mexico Department of Health

    Abstract

    We examined refusal rates for sensitive demographic questions to determine whether questions on sexual orientation are too sensitive for routine use on public health surveys. We compared the percentage of active refusals in New Mexico for a sexual orientation question and 6 other sensitive demographic questions. In 2007 and 2008, refusal rates for sexual orientation questions were similar to rates for questions on race/ethnicity and weight and significantly lower than rates for questions on household income. Perceptions that sexual orientation is too controversial a topic to be included on state surveys may be unfounded. (Am J Public Health. Published online ahead of print October 21, 2010: e8-e12. doi:10. 2105/AJPH.2009.186270).



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  • Addressing Tobacco in Colorado’s Socio-Economically Disadvantaged Communities: A Community Blueprint for Action

    A report prepared by the Colorado Community Coalition for Health Equity
    July 201

    To embrace the goal of reducing high tobacco use rates among SED Coloradans, 11 Colorado nonprofit and local health agency organizations came together with the intention of creating a strong, diverse coalition having the capacity to better serve SED tobacco users across Colorado. To increase their understanding of the SED tobacco users, a needs assessment and inventories of community assets were developed to gain insight and knowledge about the motivations, attitudes, beliefs, existing resources and service access points of the SED populations. This base of knowledge enabled the Coalition and community stakeholders to develop a plan for addressing tobacco-related health
    disparities that exists in SED communities, and to provide a blueprint for building the capacity of the communities involved.
    Project Overview Process evaluation measures were designed to ensure stakeholder satisfaction throughout the project, as well as, to assess organizational knowledge of the SED populations and confidence to meet education, cessation and service needs. Data for the project was collected using focus groups comprised of participants from SED populations; interviews with local and national experts; meetings with local Community Advisory Committees made up of SED service providers who developed community asset inventories; and a literature review to provide lessons learned and promising practices. The review also assisted in the development of cultural considerations for the diverse
    segments of the SED population. All data collection methods were assessed for cultural competency. This report includes cultural considerations of LGBT, Black/African American, American Indian, Latino/Hispanic and Rural Communities.

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  • American Lung Association Cessation Report

    Quitting Smoking Saves Lives and Money:
    New American Lung Association Report Finds Most States
    Failing to Adequately Protect Residents and Their Bottom Line

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  • AN ASSESSMENT FOR A BETTER UNDERSTANDING OF TOBACCO USE BY LGBT METRO ATLANTANS - April 2011

    Submitted to
    The DeKalb County, Georgia Board of Health Office of Chronic Disease Prevention

    In partnership with the Georgia Tobacco Use Prevention Program, Georgia Department of Community Health, Georgia Division of Public Health

    April 15, 2011

    By The Atlanta Lesbian Health Initiative
    Linda Ellis, Med, MDiv, LPC, Executive Director
    Lawrence Bryant, RRT, MPH, PhD, Principal Investigator


    The findings of this research project underscore important implications related to tobacco use, cessation and prevention in the metro Atlanta LGBT community. First, a lack of awareness of the LGBT smoking disparity demonstrates a tremendous need for an LGBT specific educational program. Audience-appropriate and tested programs should be created to raise awareness of this public health issue. Second, while most survey respondents do not smoke, there seems to be a variety of opinions about LGBT organizations taking money from tobacco companies. The public health community, however, is in total agreement that this practice should be discouraged. There were several surprises that emanated from this research project; they were:
    * Some participants were reserved in their recommendations of increasing taxes on tobacco products.
    * There is a sense of resignation that smoking is going to happen in LGBT spaces, no matter what we do. This supports some literature which states that LGBTs view smoking as normal in a community besieged by homophobia, stigma, and discrimination.
    * Smoking is an issue of rebellion and identity.
    * Many in the LGBT community do not see tobacco control as a relevant issue. This is exemplified by survey respondents ranking tobacco use 8th out of 10 priority health issues for the LGBT community.

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  • An Examination of Smoking Behavior and Opinions About Smoke-free Environments in a Large Sample of Sexual and Gender Minority Community Members

    Authors: Jane A. McElroy, Ph.D., Kevin D. Everett, Ph.D. and Isabella Zaniletti, M.A.

    Corresponding Author: Jane A McElroy, Ph.D., Family and Community Medicine Department, University of Missouri, MA 306 Medical Science Building, Columbia, MO 65212, USA. Telephone: 573-882-4993; Fax: 573-884-6172; E-mail: mcelroyja@health.missouri.edu

    Received March 22, 2010.
    Accepted January 24, 2011

    Introduction: The purpose of this study is to more completely quantify smoking rate and support for smoke-free policies in private and public environments from a large sample of self-identified sexual and gender minority (SGM) populations.

    Methods: A targeted sampling strategy recruited participants from 4 Missouri Pride Festivals and online surveys targeted to SGM populations during the summer of 2008. A 24-item survey gathered information on gender and sexual orientation, smoking status, and questions assessing behaviors and preferences related to smoke-free policies.

    Results: The project recruited participants through Pride Festivals (n = 2,676) and Web-based surveys (n = 231) representing numerous sexual and gender orientations and the racial composite of the state of Missouri. Differences were found between the Pride Festivals sample and the Web-based sample, including smoking rates, with current smoking for the Web-based sample (22%) significantly less than the Pride Festivals sample (37%; p < .0001). The SGM group (n = 2,162) was 1.49 times more likely to be current smokers compared with the study's heterosexual group (n = 436; p = .005). Statistically fewer SGM racial minorities (33%) are current smokers compared with SGM Whites (37%; p = .04). Support and preferences for public and private smoke-free environments were generally low in the SGM population.

    Conclusions: The strategic targeting method achieved a large and diverse sample. The findings of high rates of smoking coupled with generally low levels of support for smoke-free public policies in the SGM community highlight the need for additional research to inform programmatic attempts to reduce tobacco use and increase support for smoke-free environments.


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  • Association of cigarette smoking with HIV prognosis among women in the HAART era: a report from the women's interagency HIV study

    Am J Public Health. 2006 Jun;96(6):1060-5. Epub 2006 May 2

    Feldman JG, Minkoff H, Schneider MF, Gange SJ, Cohen M, Watts DH, Gandhi M, Mocharnuk RS, Anastos K.
    SourceSUNY Downstate Medical Center, 450 Clarkson Ave, Brooklyn, NY 11203, USA. joseph.feldman@downstate.edu

    OBJECTIVE: We assessed the association of cigarette smoking with the effectiveness of highly active antiretroviral therapy (HAART) among low-income women.

    METHODS: Data were analyzed from the Women's Interagency HIV Study, a multisite longitudinal study up to 7.9 years for 924 women representing 72% of all women who initiated HAART between July 1, 1995, and September 30, 2003.

    RESULTS: When Cox's regression was used after control for age, race, hepatitis C infection, illicit drug use, previous antiretroviral therapy, and previous AIDS, smokers on HAART had poorer viral responses (hazard ratio [HR]=0.79; 95% confidence interval [CI]=0.67, 0.93) and poorer immunologic response (HR=0.85; 95% CI=0.73, 0.99). A greater risk of virologic rebound (HR=1.39; 95% CI=1.06, 1.69) and more frequent immunologic failure (HR=1.52; 95% CI=1.18, 1.96) were also observed among smokers. There was a higher risk of death (HR=1.53; 95% CI=1.08, 2.19) and a higher risk of developing AIDS (HR=1.36; 95% CI=1.07, 1.72) but no significant difference between smokers and nonsmokers in the risk of death due to AIDS.

    CONCLUSIONS: Some of the benefits provided by HAART are negated in cigarette smokers.



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  • Asthma Diagnosis Among Individuals in Same-Sex Relationships

    2006, Vol. 43, No. 8 , Pages 579-584 (doi:10.1080/02770900600878289)
    HTML PDF (59 KB) PDF Plus (61 KB)
    E. Heck, Ph.D., M.P.H. and Judith S. Jacobson, Dr.


    Read More: http://informahealthcare.com/doi/abs/10.1080/02770900600878289?journalCode=jas

    This study examined ever and current asthma diagnosis among persons in same-sex relationships (SSRs) using data from the pooled 1997–2004 National Health Interview Surveys. Among SSRs, 13.5% of men and 14.3% of women reported ever diagnosis of asthma, compared to 7.6% and 10.2% opposite-sex relationship (OSR) men and women. SSRs had higher rates of smoking, stress, and among women, obesity. In regression analyses, male SSRs had a significantly elevated risk of ever asthma diagnosis (adjusted OR = 1.51), while 12-month asthma was elevated among SSR women (adjusted OR = 2.48). SSRs may be at higher risk for asthma due to a spectrum of risk factors.


    Read More: http://informahealthcare.com/doi/abs/10.1080/02770900600878289?journalCode=jas

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  • Attitudes Toward Tobacco Use and Clean Air Advocacy in the LGBT Communities of Monroe and Baton Rouge, Louisiana

    Caroline Cottingham
    Roger Schimberg, MPH
    24 August 2010

    The data from this study offered information which will hopefully help to improve public health campaigns for tobacco cessation and campaigns for Clean Air acts. Participants in the focus groups in Baton Rouge and Monroe, Louisiana, offered a wealth of responses on why they believe LGBT individuals use tobacco and methods which can help them quit. Unfortunately, the participants‟ responses to basic knowledge questions about tobacco use in the LGBT community, tobacco company targeting, and cessation resources suggests there may be a lack of education concerning the high rates of LGBT tobacco use, the way tobacco companies target LGBT people, and how to find resources to help themselves and/or other LGBT smokers quit. Participants also offered reasons why they support Clean Air acts and barriers to supporting these regulations on tobacco use, along with reasons why they would advocate for Clean Air acts and barriers to advocacy. Coupled with the marketing survey, which offered data on how participants receive information about the LGBT community, this information may help campaigns looking to build support and increase advocacy to pass more regulations on tobacco use in the state of Louisiana. Though some barriers must be addressed, data from the focus groups suggested that most participants already supported these laws, though they did not have the means to advocate for the laws.

    Though research on tobacco use in the LGBT community has increased exponentially over the past ten years, many gaps still remain. More research would be helpful in providing comparisons between states and national LGBT tobacco use data. The narrow focus and sample of this study unfortunately limits this data, but comparisons between other state-focused studies suggests that some of the trends identified in this report may apply to more than simply Baton Rouge and Monroe, Louisiana. This study will be most helpful in addressing the direct tobacco cessation and Clean Air advocacy needs of these cities, though more research might show that this data could be used to inform tobacco cessation programs and Clean Air advocacy in other Louisiana cities and possibly other states.

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  • Best Practices for Asking Questions about Sexual Orientation on Surveys

    Created by the Sexual Minority Assessment Research Team (SMART), a multidisciplinary and multi-institutional collaboration

    November 2009

    In 2003 the Ford Foundation began funding a multi-year project that sought to increase the quantity and quality of data on gay, lesbian, and bisexual people, and, by extension, on heterosexual people. Over a five-year period, many researchers participated in the expert panel funded by he grant, thus contributing to the knowledge embodied in this report. This multidisciplinary expert panel pooled decades of knowledge and experience, conducted new methodological research, and met with many survey specialists to identify the best scientific approaches to gathering data on sexual orientation. This panel, known collectively as the Sexual Minority Assessment Research Team (SMART), met regularly to discuss these data issues. By “sexual minority,” we mean people who are attracted to or have had experience with same-sex sex partners, or someone who identifies as lesbian, gay, or bisexual.

    This document is the culmination of the work of this expert panel.

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  • Beyond the Health Fair: Using Strategic Events to Enhance Policy Efforts

    By Blue Cross Blue Shield MN

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  • Burning Love: Big Tobacco Takes Aim at LGBT Youth

    Outlines big tobacco's campaign tactics towards minority populations who are frequently discriminated against, in particular African Americans; uncovers the sly tactics of targeting LGBT adults and youth; and the detrimental effects this has had and continues to have on the LGBT community.

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  • CA Minority Smoking - Press Release

    Press Release on California's smoking rates among ethnic and LGBT groups, 2003.

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  • California - Lesbians, Gays, Bisexuals and Transgender Tobacco Use Survey 2004

    California Department of Health Services
    Tobacco Control Section


    In 2003-04, Field Research Corporation conducted a statewide household survey of the California lesbian, gay, bisexual, and transgender (LGBT) population for the Tobacco Control Section (TCS), Department of Health Services (DHS). The purpose was to assess tobacco-related behaviors, attitudes, and knowledge within the LGBT population; identify disparities between the LGBT and general adult populations of the State; and explore possible explanations for the most important differences.


    Prepared by
    Field Research Corporation

    The Tobacco Control Section
    Cancer Control Branch
    Division of Chronic Disease and Injury Control
    California Department of Health Services
    1616 Capitol Avenue, Suite 74.516
    MS 7206
    P.O. Box 997413
    Sacramento, CA 95899-7413

    Suggested citation:
    Bye L, Gruskin E, Greenwood, G, Albright V, Krotki K. California Lesbians, Gays, Bisexuals, and Transgender (LGBT) Tobacco Use Survey – 2004. Sacramento, CA: California Department of Health Services, 2005.

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  • Cancer-related risk indicators and preventive screening behaviors among lesbians and bisexual women

    Am J Public Health. 2001 Apr;91(4):591-7
    Cochran SD, Mays VM, Bowen D, Gage S, Bybee D, Roberts SJ, Goldstein RS, Robison A, Rankow EJ, White J.
    SourceDepartment of Epidemiology, School of Public Health, Center for Health Sciences, University of California, Los Angeles, Box 951772, Los Angeles, CA 90095-1772, USA. cochran@ucla.edu

    OBJECTIVES: This study examined whether lesbians are at increased risk for certain cancers as a result of an accumulation of behavioral risk factors and difficulties in accessing health care.

    METHODS: Prevalence estimates of behavioral risk factors (nulliparity, obesity, smoking, and alcohol use), cancer screening behaviors, and self-reported breast cancer histories derived from 7 independently conducted surveys of lesbians/bisexual women (n = 11,876) were compared with national estimates for women.

    RESULTS: In comparison with adjusted estimates for the US female population, lesbians/bisexual women exhibited greater prevalence rates of obesity, alcohol use, and tobacco use and lower rates of parity and birth control pill use. These women were also less likely to have health insurance coverage or to have had a recent pelvic examination or mammogram. Self-reported histories of breast cancer, however, did not differ from adjusted US female population estimates.

    CONCLUSIONS: Lesbians and bisexual women differ from heterosexual women in patterns of health risk. These women would be expected to be at especially greater risk for chronic diseases linked to smoking and obesity.



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  • CDC National Tobacco Control Networks for Priority Populations: Evaluation Final Report July 2008

    A detailed report by The Center for Tobacco Policy Research highlighting the work done by the National LGBT Tobacco Control Network in specific areas such as Partner Engagement, Technical Assistance, Network Resources, and other areas key to the Network's success.

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  • Changing the Game: Affordable Care Act and the LGBT Community

    What Health Care Reform Means for Gay, Lesbian, Bisexual, and Transgender Americans

    Kellan Baker, National Coalition for LGBT Health
    Jeff Krehely, Center for American Progress
    March 2011

    (From Introduction and Summary) In the pages that follow, we first provide an overview of the need for health care reform, including the health disparities experienced by gay and transgender Americans that the law must address. This is followed by a brief discussion of several provisions of the Affordable Care Act that hold particular promise for improving the health and well-being of the LGBT community. Next, we investigate four major areas where efforts by LGBT advocates and their allies in each state will be key to ensuring that the new health law delivers the largest possible positive results for the LGBT community when the law is fully implemented by 2014.

    Specifically, these areas are:
    • Achieving comprehensive nondiscrimination protections in health insurance
    exchanges
    • Establishing LGBT-inclusive data collection policies
    • Recognizing and including LGBT families in all health reform activities
    • Supporting community-based health interventions that are LGBT-inclusive

    In each of these four areas we include recommendations for federal officials and state governments. Briefly, those recommendations include:
    • Establish comprehensive and LGBT-inclusive nondiscrimination policies and practices in health insurance exchanges
    • Improve our knowledge base on LGBT health disparities, by including sexual orientation and gender identity demographic questions in federal health surveys
    • Recognize and include gay and transgender families in the new health law, by making sure that definitions of family are not solely based upon marriage and adoption laws that automatically exclude LGBT families
    • Create community-based healthcare interventions that are responsive to the needs of gay and transgender people

    We will examine these recommendations in more detail at the end of the paper.
    But first we discuss why our nation’s healthcare system has been badly in need of reform, and the barriers to good, affordable care that LGBT people currently face.

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  • Cigarette smoking among gay and bisexual men

    Am J Public Health. 1999 Dec;89(12):1875-8.
    Cigarette smoking among gay and bisexual men.
    Stall RD, Greenwood GL, Acree M, Paul J, Coates TJ.
    SourceCenter for AIDS Prevention Studies, University of California, San Francisco 94105, USA. rstall@psg.ucsf.edu


    OBJECTIVES: This study measured the prevalence of cigarette smoking among gay men and identified associations with smoking.

    METHODS: Household-based (n = 696) and bar-based (n = 1897) sampling procedures yielded 2593 gay male participants from Portland, Ore, and Tucson, Ariz, in the spring of 1992.

    RESULTS: Forty-eight percent of the combined sample reported current smoking, a rate far above prevalence estimates for men in Arizona (z = 14.11, P < .001) or Oregon (z = 24.24, P < .001). Significant associations with smoking included heavy drinking, frequent gay bar attendance, greater AIDS-related losses, HIV seropositivity, lower health rating than members of same age cohort, lower educational attainment, and lower income.

    CONCLUSIONS: Rates of cigarette smoking are very high among gay men. Tobacco prevention and cessation campaigns should be designed to reach the gay male community.



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  • Cigarette Smoking Among Gay, Lesbian, and Bisexual Residents of the Inland Empire
    Gardner, A; Mockus, D; Meconis, K.

    Riverside County Department of Public Health, Epidemiology and Program Evaluation, 2007.

    Trends in smoking among the LGBT community- disparities in gender, lifetime smoking and sexual orientation; alcohol use and smoking; future directions.

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  • Effect of smoking on the clinical progression of HIV-1 infection

    J Acquir Immune Defic Syndr Hum Retrovirol. 1997 Apr 15;14(5):451-8.
    Galai N, Park LP, Wesch J, Visscher B, Riddler S, Margolick JB.

    Department of Epidemiology, Johns Hopkins University School of Public Health, Baltimore, MD 21205, USA.

    Abstract
    Cigarette smoking as a risk factor in progression of HIV-1 disease was investigated in the Multicenter AIDS Cohort Study of homosexual men. Longitudinal data for T-cell subsets, HIV-related clinical symptoms, smoking behavior, and AIDS medication use were collected semiannually from 2,499 HIV-1-seropositive men for up to 9 years. Survival methods, including Kaplan-Meier analysis and multivariate Cox regression models, were used to assess the effect of cigarette smoking on development of Pneumocystis carinii pneumonia (PCP), AIDS, death, and self-reported oral thrush. After adjustment for CD4+ lymphocyte count and use of antiretroviral and anti-PCP medications, smoking was not significantly associated with progression to PCP, AIDS, or death in either the HIV-seroprevalent or-seroincident cohort members. Among men who had baseline CD4+ cell counts > 200/microliter, smoking was associated with a 40% increase in the hazard of oral thrush (p < or = 0.01). These data indicate that cigarette smoking does not have a major effect on the progression of HIV-1 infection to AIDS or death but may affect the incidence of oral thrush.

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  • Effects of at-school victimization and sexual orientation on lesbian, gay, or bisexual youths' health risk behavior

    J Adolesc Health. 2002 May;30(5):364-74.
    Bontempo DE, D'Augelli AR.
    SourceDepartment of Human Development and Family Studies, The Pennsylvania State University, University Park, Pennsylvania 16802, USA. deb193@psu.edu



    PURPOSE: To examine the link between victimization at school and health risk behaviors using representative data comparing lesbian, gay, and bisexual (LGB) youths and heterosexual youths.

    METHODS: Data from the 1995 Youth Risk Behavior Survey taken in Massachusetts and Vermont were examined. This sample included 9188 9th through 12th grade students; 315 of these students were identified as LGB. Analyses of variance were used to examine health risk behaviors by sexual orientation by gender by victimization level.

    RESULTS: The combined effect of LGB status and high levels of at-school victimization was associated with the highest levels of health risk behaviors. LGB youths reporting high levels of at-school victimization reported higher levels of substance use, suicidality, and sexual risk behaviors than heterosexual peers reporting high levels of at-school victimization. Also, LGB youths reporting low levels of at-school victimization reported levels of substance use, suicidality, and sexual-risk behaviors that were similar to heterosexual peers who reported low at-school victimization.

    CONCLUSIONS: The findings provide evidence that differences in health risks among LGB youth are mediated by victimization at school. Such victimization of LGB youth is associated with health risk behaviors.



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  • Eo na Mahu o Hawai'i: the extraordinary health needs of Hawai'i's Mahu

    Pac Health Dialog. 2001 Sep;8(2):327-34.
    Eo na Mahu o Hawai'i: the extraordinary health needs of Hawai'i's Mahu.
    Odo C, Hawelu A.
    Source: Ke Ola Mamo, Honolulu, Hawai'i 96817, USA. codo@lava.net



    An overview of health and social issues is presented here regarding Native Hawaiian transgenders. Perhaps due to relatively greater tolerance of gender diversity among Polynesian cultures, approximately 70% of all male-to-female transgenders in Hawai'i are Native Hawaiian. However, the overall climate is one of discrimination and harassment such that transgenders--who tend to be under-educated, under-employed, and medically underserved--may be the most severely impacted of all Native Hawaiians. Lei Anuenue, human immunodeficiency virus (HIV) prevention program for Native Hawaiians, has provided a variety of services for transgenders, including outreach, educational workshops, support groups, HIV testing, and case management. All services are provided by peer leaders who are employed by the program. Data for this article are based on case management, including client self-disclosures and reports of peer staff who knew details of clients' lives having shared with them both generic experiences and specific activities. Information from 100 transgender clients and their case managers indicated that the transgender health profile is far more serious than that of mainstream Native Hawaiians. For example, 74% smoke, 31% use illegal drugs (excluding marijuana), more than 50% have been involved in street or domestic violence, and few individuals over age 50 have been found during three years of outreach. To some extent, employment options limit transgenders to prostitution, drug dealing, and minimum-wage jobs. In addition, a lifestyle of multiple sex partners and lack of opportunities for stable relationships place transgenders at much greater risk for HIV, sexually transmitted diseases (STD), and other infectious and non-infectious diseases as compared to the mainstream Native Hawaiian community. Clients in this study were from O'ahu, primarily from downtown Honolulu, Chinatown, and Wai'anae. Future studies should compare the results of this sample to transgenders from the neighbor islands (especially in rural Hawaiian areas), as well as utilize a structured prospective longitudinal approach.



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  • Ethical Funding for LGBT Organizations

    The Ethics of Tobacco, Alchohol, and Pharmeceutical Funding for LGBT Organizations. This article provides useful background information and specific sample guidelines will facilitate adoption of written policies to guide and support the fundraising efforts of LGBT and HIV/AIDS organizations.

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  • Film-Flam: How MPAA/NATO movie labels hide the biggest media risk to kids

    Center for Tobacco Control Research and
    Education, UC San Francisco Publication:
    Authored by Polansky, Jonathan R., OnBeyond LLC
    Mitchell, Shelley, Breathe California of Sacramento - Emigrant Trails
    Glantz, Stanton A., University of California, San Francisco

    Smoking in youth-rated films accounts for 90,000 new smokers each year. A study on all films between May 2007 and May 2010 revealed that half of films with tobacco imagery were youth-rated (PG, PG-13, G). However, only 15% were labeled with smoking descriptions, and those with labels are downplayed with such descriptions as "brief smoking."

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  • From adversary to target market: the ACT-UP boycott of Philip Morris

    Tob Control. 2003 Jun;12(2):203-7.
    Offen N, Smith EA, Malone RE.
    University of California, San Francisco, USA.

    Background: In 1990, the AIDS Coalition to Unleash Power (ACT-UP) sparked a year long boycott of Philip Morris’s Marlboro cigarettes and Miller beer. The boycott protested the company’s support of Senator Jesse Helms (R-North Carolina), a leading opponent of AIDS funding and civil rights for lesbian, gay, bisexual and transgender (LGBT) people. ACT-UP demanded that Philip Morris sever its ties with Helms and acknowledge its responsibility to the LGBT community and to people with AIDS.

    Objective: To assess the impact of the boycott on the LGBT community, the tobacco industry, and the tobacco control movement; and to determine what lessons tobacco control advocates can extract from this case.

    Data sources: Internal tobacco industry documents and newspaper archives.

    Methods: Search of tobacco industry documents websites using “boycott”, “ACT-UP”, “gay”, and other terms.

    Results: Philip Morris used the boycott to its own advantage. It exploited differences within the community and settled the boycott by pledging large donations to combat AIDS. Through corporate philanthropy, Philip Morris gained entrée to the LGBT market without appearing gay friendly. Many LGBT organisations, thirsty for recognition and funding from mainstream corporations, welcomed Philip Morris’s overtures without considering the health hazards of tobacco.

    Conclusions: Unless the goal of a boycott is to convince the tobacco industry to abandon tobacco altogether, such actions invite the industry to expand its marketing under the guise of philanthropy. Tobacco control advocates should be clear about goals and acceptable settlement terms before participating in a boycott of a tobacco company.

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  • Gay adults willing to pay extra for smoke-free bars and clubs

    An article in the Texas Triangle, 2003. Bars and officials worked on a compromise only to end up without enough votes to ban smoking in bars or clubs, only in restaurants.

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  • Gay community has higher rate of smoking than other groups
    Erin Allday, Chronicle Staff Writer

    Sunday, August 6, 2006
    Sasn Francisco Chronicle

    Smoking and the LGBT community. Why they start: Stress, targeted ads, the bar and club scene are all factors.

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  • Gay-Specific Marketing Practices May Influence Brand Loyalty and Purchase Decisions of Gays, Lesbians and Bisexuals

    Harris Interactive survey

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  • Gay/Lesbian sexual orientation increases risk for cigarette smoking and heavy drinking among members of a large Northern California health plan

    BMC Public Health
    Authors: Elisabeth P Gruskin and Nancy Gordon
    Published: 03 October 2006
    BMC Public Health 2006, 6:241

    Background and significance: Tobacco and alcohol use and related morbidity and mortality are critical public health problems. Results of several, but not all, studies suggest that lesbians and gay men are at elevated risk for smoking tobacco and alcohol misuse.

    Methods: Data from random sample general health surveys of adult members of a large Northern California Health Plan conducted in 1999 and 2002 were analyzed using gender-based multivariate logistic regression models to assess whether lesbians (n = 210) and gay men (n = 331) aged 20–65 were more likely than similarly aged heterosexual women (n = 12,188) and men (n = 9342) to be smokers and heavy drinkers.

    Results: After adjusting for age, race/ethnicity, education, and survey year, lesbians were significantly more likely than heterosexual women to be heavy drinkers (OR 2.14, 95% CI 1.08, 4.23) and current smokers (OR 1.60, 95% CI 1.02, 2.51). Among men, gays were significantly more likely than heterosexuals to be current smokers (OR 2.40, 95% CI 1.75, 3.30), with borderline significant increased risk for heavy drinking (OR 1.54, 95% CI 0.96, 2.45).

    Conclusion: Lesbians and gay men may be at increased risk for morbidity and mortality due to higher levels of cigarette and alcohol use. More population-based research is needed to understand the nature of substance use in these communities so that appropriate interventions can be developed.

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  • Gays, Lesbians, Bisexuals Smoke More than General Population in California (June 28, 2007)

    By Joan Hennessy, Contributing Writer
    Women and men in California's general population were less likely to be smokers than a sample of Californians who identified themselves as lesbian, gay or bisexual (LGB), according to a study published in the August issue of the American Journal of Public Health.

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  • Health status, behavior, and care utilization in the Geneva Gay Men's Health Survey

    Prev Med. 2007 Jan;44(1):70-5. Epub 2006 Sep 25.
    Health status, behavior, and care utilization in the Geneva Gay Men's Health Survey.
    Wang J, Häusermann M, Vounatsou P, Aggleton P, Weiss MG.
    SourceInstitute for Social and Preventive Medicine, University of Zurich, Switzerland. jwang@ifspm.unizh.ch





    BACKGROUND: Recent reviews and studies suggest distinctive health needs among gay men.

    METHODS: Swiss residents in the Geneva Gay Men's Health Survey (GGMHS, n=477) were matched with controls from the Swiss Health Survey (SHS, n=477) along sex, age, nationality, and region of residence and compared along standard indicators of health status, health behaviors, and health care utilization. Both health surveys were conducted in 2002 using probability sampling--i.e., time-space sampling (GGMHS) and household probability telephone sampling (SHS).

    RESULTS: Although gay men were significantly less likely to be overweight (adjusted odds ratio (AOR)=0.54), they reported significantly more and severe physical symptoms (AOR ranged from 1.72 to 9.21), short-term disability (AOR=2.56), risk factors for chronic disease--i.e., high cholesterol, high blood pressure, high glucose, and smoking (AOR ranged from 1.67 to 3.89), and greater health services utilization (AOR ranged from 1.62 to 4.28), even after adjustment for differences in socio-demographic characteristics and health behaviors.

    CONCLUSIONS: Evidence of greater morbidity among a community sample of gay men along standard health indicators underlines the relevance of sexual orientation as a socio-demographic indicator in public health in general and in the health inequalities discourse in particular.



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  • High Tobacco Use among Lesbian, Gay, and Bisexual Populations in West Virginian Bars and Community Festivals

    Joseph G. L. Lee, Adam O. Goldstein, Leah M. Ranney, Jeff Crist, and Anna McCullough

    International Journal of Environmental Research and Public Health. 2011; 8(7):2758-2769.



    Abstract: With no information on tobacco use for lesbian, gay, or bisexual (LGB) populations in West Virginia (WV), it is unclear if nationally-identified LGB tobacco disparities also exist in this State. To address this data gap, we conducted a community tobacco survey in bars and events associated with the WV Pride Parade and Festival. Trained community surveyors used electronic and paper survey instruments in bars (n = 6 ) in three WV cities and community events associated with the WV Pride Parade and Festival. We analyzed results from 386 completed surveys from self-identified LGB individuals. Tobacco use among LGB bar patrons and LGB attendees at Pride-affiliated events was elevated (45%), as was current cigarette use (41%). Users of cigars and chewing tobacco were frequently dual users of cigarettes, with 80% and 60% reporting dual use, respectively. A substantial disparity likely exists in tobacco use among LGB West Virginians. Targeted interventions addressing tobacco use among LGB West Virginians are warranted in these venues, and the addition of a demographic question on sexual orientation would improve data collection and monitoring of this disparity.

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  • Holding A Strategic Event

    By Blue Cross Blue Shield MN

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  • How Secondhand Smoke Affects the Brain

    Secondhand smoke has a direct, measurable impact on the brain similar to what’s seen in the person doing the smoking, according to a new study. The finding highlights the importance of limiting exposure to secondhand smoke in cars and other enclosed spaces.

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  • Idaho Tobacco Prevention and Control Program

    LGBT Health Assessment Survey

    Final Survey Report 2004

    During the Spring of 2003, the Idaho Tobacco Prevention and Control Program (TPCP) contracted with United Vision for Idaho (UVI) to conduct a statewide survey of lesbian, gay, bisexual, and transgender individuals to assess the impact of tobacco use within this community. In addition to asking about tobacco-use related behaviors, the survey collected data on a wide range of health-related issues that are of concern to the LGBT community at large.

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  • Internalized Homophobia and Substance Use Among Lesbian, Gay, and Bisexual Persons

    Authors: Dean M. Amadio & Y. Barry Chung

    Journal of Gay and Lesbian Social Services, Vol. 17(1) 2004

    The purpose of the study was to determine the relationship between internalized homophobia and use of alcohol, marijuana, and cigarettes, as well as problems associated with alcohol and general substance use. Participants were 207 lesbian, gay, and bisexual persons recruited at a gay pride festival in Atlanta, GA. Significant negative correlations were found for females between internalized homophobia and lifetime use of alcohol, marijuana, and cigarettes, as well as monthly use of marijuana. No significant relationships were found for males. Research and practical implications are discussed.



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  • Is smoking tobacco an independent risk factor for HIV infection and progression to AIDS? A systemic review

    Furber AS, Maheswaran R, Newell JN, Carroll C.

    Sex Transm Infect. 2007 Feb;83(1):41-6. Epub 2006 Aug 21.


    OBJECTIVES: To systematically review the evidence of the relation between smoking tobacco and HIV seroconversion and progression to AIDS.

    METHODS: A systematic review was undertaken of studies to look at tobacco smoking as a risk factor for either HIV seroconversion or progression to AIDS.

    RESULTS: Six studies were identified with HIV seroconversion as an outcome measure. Five of these indicated that smoking tobacco was an independent risk factor after adjusting for important confounders with adjusted odds ratios ranging from 1.6 to 3.5. 10 studies were identified using progression to AIDS as an end point of which nine found no relation with tobacco smoking.

    CONCLUSIONS: Tobacco smoking may be an independent risk factor for HIV infection although residual confounding is another possible explanation. Smoking did not appear to be related to progression to AIDS although this finding may not be true in developing countries or with the longer life expectancies seen with highly active antiretroviral therapy.



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  • Lesbians and Gays Face Tobacco Targeting

    Article on how LGBT's are targeted by big tobacco, 1994

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  • Letters to the Editor in response to a pro-tobacco commentary in the Vital Voice

    The Feb. 22 Vital Voice had a side-by-side commentary section about "Is it time for a smoking ban in MO?" Chip Schloss of Atomic Cowboy wrote the pro side, and Bill Hannegan of "Keep Missouri Free" wrote the con side. Hannegan quotes many of the discredited studies and Big Tobacco funded reports that we have been combating for some time.

    Here's a link to what Schloss Wrote:
    http://www.thevitalvoice.com/cgi-script/csArticles/articles/000022/002296.htm

    Here's a link to Hannegan's:
    http://www.thevitalvoice.com/cgi-script/csArticles/articles/000022/002295.htm

    The file attached are the letters sent to the editor in response to Hannegan's pro-tobacco commentary.

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  • Letters to the Editors of the Journal of Gay and Lesbian Mental Health on article: "Butch/Femme, F2M, Pregnant Man, TrannyBoi: Gender Issues in the Lesbian Community"

    Here is a published Letter to the Editors that Scout and others responded to in the Journal of Gay & Lesbian Mental Health. The title of the original article was "Butch/Femme, F2M, Pregnant Man, TrannyBoi: Gender Issues in the Lesbian Community" and contained problematic language regarding transgender people which was addressed in the letter. Attached are the published letters of Scout as well as reassuring responses from the original author and editors.



    Scout, Emilia Lombardi, and Bali White. "Letters to the Editors RE: Butch/Femme, F2M, Pregnant Man, TrannyBoi: Gender Issues in the Lesbian Community." Journal of Gay & Lesbian Mental Health,14.3 (2010): 257-58. Print.


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  • LGBT community has higher rate of smoking than other groups
    By Jennifer Medvin, RN

    Article on GaylinkContent.com about smoking and the LGBT community- culture, quitting, hazards,

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  • LOS ANGELES COUNTY DEPT. OF HEALTH SERVICES TOBACCO CONTROL AND PREVENTION PROGRAM

    HIV and Tobacco Use Factsheet

    Elevated rates of smoking and negative health consequences of smoking have been documented specifically for the HIV positive community. These findings and the promis-ing levels of interest in smoking cessation are evidence that the time has come for greater smoking cessation efforts focused on people living with HIV.

    Topics in Factsheet
    *Higher Smoking Rates
    *Consequences of Smoking
    *Good News for Cessation

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  • National Disparities Networks Joint Statement

    Joint Statement of the National Networks Consortium for Priority Populations and Tobacco Control

    March 12, 2009

    To John Ruffin, Ph.D.
    Director, National Center on Minority Health and Health Disparities
    National Institutes of Health



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  • National Lesbian Health Care Survey: Implications for Mental Health Care

    J Consult Clin Psychol. 1994 Apr;62(2):228-42.

    Bradford J, Ryan C, Rothblum ED.
    Center for Public Service, Virginia Commonwealth University, Richmond 23284.

    Abstract
    This article presents demographic, lifestyle, and mental health information about 1,925 lesbians from all 50 states who participated as respondents in the National Lesbian Health Care Survey (1984-1985), the most comprehensive study on U.S. lesbians to date. Over half the sample had had thoughts about suicide at some time, and 18% had attempted suicide. Thirty-seven percent had been physically abused as a child or adult, 32% had been raped or sexually attacked, and 19% had been involved in incestuous relationships while growing up. Almost one third used tobacco on a daily basis, and about 30% drank alcohol more than once a week, 6% daily. About three fourths had received counseling at some time, and half had done so for reasons of sadness and depression. Lesbians in the survey also were socially connected and had a variety of social supports, mostly within the lesbian community. However, few had come out to all family members and coworkers. Level of openness about lesbianism was associated with less fear of exposure and with more choices about mental health counseling.

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  • Occasional smoking in college: Who, what, when and why?
    by Amy E. Browna, Matthew J. Carpentera, Erin L. Sutfin

    The majority of college students who smoke do so on an occasional basis and generally do not define themselves as smokers. This represents a considerable challenge for public health efforts to prevent escalation of use and to promote cessation. Strengthening such efforts will require further examination of the motivations behind occasional smoking within this vulnerable group.

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  • Ohio health department to study tobacco habits of gay teens

    COLUMBUS (AP) - Ohio health officials will use a federal grant aimed at preventing tobacco use among minorities to study why gay and lesbian teenagers smoke at a higher rate than their straight peers.

    Health officials are allocating $60,000 to identify the smoking habits of those teens and develop a tobacco-prevention campaign for them.

    Ohio Department of Health spokesman Kristopher Weiss says gay, lesbian, bisexual and transgendered community has a smoking rate at about 40 to 60%.

    As part of the Lesbian, Bisexual, Gay and Transgender Community Youth and Young Adults Anti-Tobacco Social Marketing Project, officials will form focus groups among youths ages 12 through 20 at an LBGT center in Columbus.

    Angie Wellman, director of the Kaleidoscope Youth Center, a drop-in venue for LBGT youths here, estimated that 60 to 70% of the center's teen visitors smoke regularly.


    On the Net:

    http://www.lgbttobacco.org



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  • Oregon Pride Smoking Survey by Breathe Free

    This article describes information about and the data collected by the 2007 Tobacco Survey regarding attitudes and behaviors regarding tobacco use within the LGBT community. The survey was conducted by Breathe Free at Oregon Pride and the article was printed in JustOut (page 23) in June 2007.

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  • Organizing for Policy, Systems and Environmental Change through Strategic Community Events

    By Blue Cross Blue Shield MN

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  • Patterns of cigarette smoking and alcohol use among lesbians and bisexual women enrolled in a large health maintenance organization

    Am J Public Health. 2001 June; 91(6): 976–979.
    E P Gruskin, S Hart, N Gordon, and L Ackerson


    OBJECTIVES: This study compared the prevalence of cigarette smoking and alcohol use among lesbians and bisexual women with that among heterosexual women. METHODS: Logistic regression models were created with data from an extensive member health survey at a large health maintenance organization. Sexual orientation was the primary predictor, and alcohol consumption and cigarette smoking were outcomes. RESULTS: Lesbians and bisexual women younger than 50 years were more likely than heterosexual women to smoke cigarettes and drink heavily. Lesbians and bisexual women aged 20 to 34 reported higher weekly alcohol consumption and less abstinence compared with heterosexual women and older lesbians and bisexual women. CONCLUSIONS: Lesbians and bisexual women aged 20 to 34 years are at risk for alcohol use and cigarette smoking.

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  • Perceived risk for cancer in an urban sexual minority

    Burkhalter JE, Hay JL, Coups E, Warren B, Li Y, Ostroff JS. Perceived risk for cancer in an urban sexual minority. J Behav Med. 2010 Sep 25.


    Abstract
    Lesbians, gay men, and bisexuals are a sexual minority experiencing elevated cancer risk factors and health disaparites, e.g., elevated tobacco use, disproportionate rates of infection with human immunodeficiency virus. Little attention has been paid to cancer prevention, education, and control in sexual minorities. This study describes cancer risk perceptions and their correlates so as to generate testable hypotheses and provide a foundation for targeting cancer prevention and risk reduction efforts in this high risk population. A cross-sectional survey of affiliates of a large urban community center serving sexual minority persons yielded a study sample of 247 anonymous persons. The survey assessed demographics, absolute perceived cancer risk, cancer risk behaviors, desired lifestyle changes to reduce cancer risk, and psychosocial variables including stress, depression, and stigma. Univariate and multivariate nonparametric statistics were used for analyses. The sample was primarily white non-Hispanic, middle-aged, and > 80% had at least a high school education. Mean values for absolute perceived cancer risk (range 0-100% risk), were 43.0 (SD = 25.4) for females, and for males, 49.3 (SD = 24.3). For females, although the multivariate regression model for absolute perceived cancer risk was statistically significant (P < .05), no single model variable was significant. For men, the multivariate regression model was significant (P < .001), with endorsement of "don't smoke/quit smoking" to reduce personal cancer risk (P < .001), and greater number of sexual partners (P = .054), positively associated with absolute perceived risk for cancer. This study provides novel data on cancer risk perceptions in sexual minorities, identifying correlates of absolute perceived cancer risk for each gender and several potential foci for cancer prevention interventions with this at-risk group.


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  • Philip Morris to push brands on gay media

    An article from the Wall Street Journal, 1992

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  • Preemption: Tobacco Control's #1 Enemy

    August 2004

    Americans for Non-Smokers Rights

    Preemption, as most tobacco control advocates know, is a dirty tactic that removes communities’ right to enact local smokefree air laws. In other words, if a preemption law passes at the state level, your decision-making body (city council, board of health) will lose the power to enact a smokefree law. Sound like a raw deal? It is for us, but the tobacco industry wants nothing more.

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  • Promoting Health for Transgender Women: Transgender Resources and Neighborhood Space (TRANS) Program in San Francisco

    Am J Public Health. 2005 March; 95(3): 382–384.
    doi: 10.2105/AJPH.2004.040501
    Copyright American Journal of Public Health 2005

    Tooru Nemoto, PhD, Don Operario, PhD, JoAnne Keatley, MSW, Hongmai Nguyen, BS, and Eiko Sugano, MPH

    Transgender women are at high risk for HIV, substance abuse, and mental health problems. We describe a health promotion intervention program tailored to transgender women in San Francisco. The program creates a safe space for providing transgender-sensitive education about HIV risk reduction, substance abuse prevention, and general health promotion. Transgender health educators conduct workshops and make referrals to appropriate substance abuse treatment programs and other services in the community. Evaluation findings indicate that this community-tailored intervention may be an effective way to reach transgender women and reduce sexual risk behaviors, depression, and perceived barriers to substance abuse treatment.

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  • Racial and Ethnic Differences in Current Use of Cigarettes, Cigars, and Hookahs Among Lesbian, Gay, and Bisexual Young Adults

    John R. Blosnich, M.P.H., Traci Jarrett, M.P.H., & Kimberly Horn, Ed.D.

    Introduction:
    Research demonstrates that lesbians, gays, and bisexuals (i.e., LGBs or sexual minorities) smoke more than their heterosexual peers, but relatively less is known about the heterogeneity within LGB populations, namely racial/ethnic differences. Moreover, smoking research on sexual minorities has focused mainly on cigarette smoking, with little attention to other forms of smoking, such as hookahs/water pipes.

    Methods: Using a large national sample of college students, we examined differences by race and sexual orientation in prevalence of smoking cigarettes, cigars/cigarillos/clove cigarettes, and hookahs.

    Results: All LGB racial groups had higher cigarette smoking prevalence than their heterosexual racial group counterparts. Significantly more White and Hispanic LGBs smoked hookahs when compared, respectively, with White and Hispanic heterosexuals.

    Conclusions: Given the higher prevalence of multiple forms of smoking among sexual minorities, the heterogeneity within sexual minority populations and the nuances of multiple identities (i.e., racial, ethnic, and sexual minority), targeted—if not tailored—prevention and cessation efforts are needed to address smoking disparities in these diverse communities. Prevention, intervention, and epidemiological research on smoking behaviors among college attending young adults should take into account other forms of smoking, such as hookah use.


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  • Rates and reasons: disparities in low intentions to use a state smoking cessation quitline.

    Burns EK, Deaton EA, Levinson AH.
    SourceColorado School of Public Health, Aurora, Colorado,

    Abstract
    PURPOSE: Little is known about population-level rates and reasons for low intentions to call the quitline, a widely available evidence-based smoking cessation treatment.

    DESIGN: This study is a secondary analysis of the 2008 Colorado Adult Tobacco Attitudes and Behavior Survey.

    SETTING: This is a population-based telephone survey of adults in Colorado.

    SUBJECTS: Study respondents (N = 1662) included current adult smokers who had heard of the Colorado QuitLine (QL) and did not report that they never intend to quit.

    MEASURES: Outcome measures included intent to call the QL, self-reported reasons for not intending to call the QL, and knowledge of QL services.

    ANALYSIS: Descriptive and multivariate logistic regression analyses were used for each outcome variable. All analyses were weighted for complex survey design to represent the population of Colorado.

    RESULTS: Overall 45.6% of smokers intend never to call the QL. In multivariate analysis, Latinos (odds ratio [OR] = 2.5; 95% confidence intervals [CI], 1.4, 4.7), gay/lesbian/bisexuals (OR = 5.2; 95% CI, 2.4, 11.4), and those with no insurance compared with Medicaid (OR = 3.8; 95% CI, 1.1, 13.0) were most likely to intend never to call the QL. Perceiving no need for assistance (34.8%) was the most common reason for not calling.

    CONCLUSIONS: A majority of smokers have no or weak intentions of ever calling the QL, with variation by subgroup. Reasons for not intending to call can inform targeted media campaigns to increase QL reach.



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  • Romantic attraction and adolescent smoking trajectories

    Addict Behav. 2011 Dec;36(12):1275-81. Epub 2011 Aug 5.
    Romantic attraction and adolescent smoking trajectories.
    Pollard MS, Tucker JS, Green HD, P Kennedy D, Go MH.

    Abstract
    Research on sexual orientation and substance use has established that lesbian, gay, and bisexual (LGB) individuals are more likely to smoke than heterosexuals. This analysis furthers the examination of smoking behaviors across sexual orientation groups by describing how same- and opposite-sex romantic attraction, and changes in romantic attraction, are associated with distinct six-year developmental trajectories of smoking. The National Longitudinal Study of Adolescent Health dataset is used to test our hypotheses. Multinomial logistic regressions predicting smoking trajectory membership as a function of romantic attraction were separately estimated for men and women. Romantic attraction effects were found only for women. The change from self-reported heterosexual attraction to lesbian or bisexual attraction was more predictive of higher smoking trajectories than was a consistent lesbian or bisexual attraction, with potentially important differences between the smoking patterns of these two groups.

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  • Sacred Tobacco — Ho-Chunk Nation wants military authorities to stop confiscating it

    From: Arizona Native Scene
    Vol. 17 No. 3, p.12-13
    April 2011
    www.nativescene.com


    Article Reprinted by Permission
    by American Legion Magazine
    By Philip M. Callaghan
    February 1, 2011

    Full Native Scene Edition available at link: http://nativescene.com/downloads/file.php?file=NativeScene1102.pdf

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  • Sexual Identity, Sex of Sexual Contacts, and Health-Risk Behaviors Among Students in Grades 9-12 -- Youth Risk Behavior Surveillance, Selected Sites, United States, 2001-2009 (CDC Morbidity and Mortality Weekly Report (MMWR), June 6th, 2011)

    Laura Kann, PhD
    Emily O'Malley Olsen, MSPH
    Tim McManus, MS
    Steve Kinchen
    David Chyen, MS
    William A. Harris, MM
    Howell Wechsler, EdD

    Division of Adolescent and School Health, National Center for Chronic Disease Prevention and Health Promotion, CDC

    Problem: Sexual minority youths are youths who identify themselves as gay or lesbian, bisexual, or unsure of their sexual identity or youths who have only had sexual contact with persons of the same sex or with both sexes. Population-based data on the healthrisk behaviors practiced by sexual minority youths are needed at the state and local levels to most effectively monitor and ensure the effectiveness of public health interventions designed to address the needs of this population.

    Reporting Period Covered: January 2001-June 2009

    Description of the System: The Youth Risk Behavior Surveillance System (YRBSS) monitors priority health-risk behaviors (behaviors that contribute to unintentional injuries, behaviors that contribute to violence, behaviors related to attempted suicide, tobacco use, alcohol use, other drug use, sexual behaviors, dietary behaviors, physical activity and sedentary behaviors, and weight management) and the prevalence of obesity and asthma among youths and young adults. YRBSS includes state and local schoolbased Youth Risk Behavior Surveys (YRBSs) conducted by state and local education and health agencies. This report summarizes results from YRBSs conducted during 2001–2009 in seven states and six large urban school districts that included questions on sexual identity (i.e., heterosexual, gay or lesbian, bisexual, or unsure), sex of sexual contacts (i.e., same sex only, opposite sex only, or both sexes), or both of these variables. The surveys were conducted among large population-based samples of public school students in grades 9-12.

    Interpretation: Sexual minority students, particularly gay, lesbian, and bisexual students and students who had sexual contact with both sexes, are more likely to engage in health-risk behaviors than other students.

    Public Health Action: Effective state and local public health and school health policies and practices should be developed to help reduce the prevalence of health-risk behaviors and improve health outcomes among sexual minority youths. In addition, more state and local surveys designed to monitor health-risk behaviors and selected health outcomes among population-based samples of students in grades 9-12 should include questions on sexual identity and sex of sexual contacts.

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  • Sexual Orientation and Mental and Physical Health Status: Findings From a Dutch Population Survey

    Am J Public Health. 2006 June; 96(6): 1119–1125.
    doi: 10.2105/AJPH.2004.058891
    Copyright American Journal of Public Health 2006

    Objectives. We sought to determine whether sexual orientation is related to mental and physical health and health behaviors in the general population.

    Methods.
    Data was derived from a health interview survey that was part of the second Dutch National Survey of General Practice, carried out in 2001 among an all-age random sample of the population. Of the 19685 persons invited to participate, 65% took part in the survey. Sexual orientation was assessed in persons aged 18 years and older and reported by 98.2% of 9684 participants. The respondents’ characteristics are comparable with those of the Dutch general population.

    Results.
    Gay/lesbian participants reported more acute mental health symptoms than heterosexual people and their general mental health also was poorer. Gay/lesbian people more frequently reported acute physical symptoms and chronic conditions than heterosexual people. Differences in smoking, alcohol use, and drug use were less prominent.

    Conclusions.
    We found that sexual orientation was associated with mental as well as physical health. The causal processes responsible for these differences by sexual orientation need further exploration.

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  • Sexual orientation and tobacco use in a cohort study of US adolescent girls and boys

    Arch Pediatr Adolesc Med. 2004 Apr;158(4):317-22.
    Austin SB, Ziyadeh N, Fisher LB, Kahn JA, Colditz GA, Frazier AL.
    Division of Adolescent and Young Adult Medicine, Children's Hospital, Channing Laboratory, Boston, Massachusetts 02115, USA. bryn.austin@tch.harvard.edu



    OBJECTIVE: To examine sexual-orientation group disparities in tobacco use in adolescent girls and boys.

    DESIGN: Survey data from 10685 adolescent girls and boys participating in 1999 in the Growing Up Today Study were examined cross-sectionally.

    SETTING: Community-based population of adolescents living throughout the United States. Main Outcome Measure Prevalence of tobacco use.

    RESULTS: Ninety-two percent of the participants described themselves as heterosexual (n = 9296), 5% as mostly heterosexual (n = 511), 1% as lesbian/gay/bisexual (n = 103), and 2% as unsure (n = 226). Ages ranged from 12 to 17 years. Compared with heterosexuals, mostly heterosexual girls were 2.5 (95% confidence interval, 1.8-3.5), lesbian/bisexual girls were 9.7 (95% confidence interval, 5.1-18.4), and mostly heterosexual boys were 2.5 (95% confidence interval, 1.4-4.6) times more likely to smoke at least weekly. In contrast, gay/bisexual boys were not more likely to smoke. Findings persisted even when controlling for multiple sociodemographic and psychosocial covariates.

    CONCLUSION: Our findings indicate that mostly heterosexual adolescents of both sexes and lesbian/bisexual girls are at heightened risk for tobacco use.



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  • SMOKE-FREE LAWS: REBUTTALS TO SEVEN COMMON CLAIMS BY THE OPPOSITION

    Contents: Opposition Claims, Rebuttals, and Suggested Talking Points
    1) Economic Loss
    2) Not the Government’s Role
    3) Requires Approval by Planning Commission vs. Local Government
    4) Employees Can Decide Where to Work
    5) Smoking Tobacco is Legal
    6) Smoking Laws Divert Attention from More Critical Issues
    7) The Dangers of Secondhand Smoke are Based on Junk Science

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  • SmokeLess LGBT DC Fact Sheet on Smoking and Tobacco

    Tobacco causes 30,000 LGBT deaths in the United States each year. That’s far more than are caused by suicide, far more than hate crimes. Mautner Project invites you to join a renewed coalition, SmokeLess LGBT DC.

    The goal of SmokeLess LGBT DC is to build support in our community and among our allies for improved public policies in the District to help people stop smoking, and to help our young people never start.

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  • Smoking Cessation Among Women with and at Risk for HIV: Are They Quitting?

    HIV-infected and at-risk women in this cohort have lower smoking cessation rates than the general population. Given the high prevalence of smoking, the high risk of adverse health events from smoking, and low rates of cessation, it is imperative that we increase efforts and overcome barriers to help these women quit smoking.

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  • Smoking in the Lesbian Community:
    What Research Tells Us

    by Helen Smith
    Lesbian Health and Research Center

    Statistics for the Lesbian community and smoking, how to reduce the numbers of Lesbian smokers,

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  • Smoking, HIV Infections, and Gay Men in the US

    (1993) This article looks at three important questions: Is cigarette smoking more prevalent among homosexual men than it is among heterosexual men? Does smoking increase the risk of acquiring HIV infection? Does smoking enhance the progression of HIV disease?

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  • Social ecology of tobacco surveillance data for sexual and gender minority populations

    Nicotine & Tobacco Research, Volume 11, Number 7 (July 2009) 908–909

    Joseph Lee

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  • SOMOS: evaluation of an HIV prevention intervention for Latino gay men

    The Latino Commission on AIDS is proud of the SOMOS home-grown intervention. Unlike other HIV prevention interventions, SOMOS was designed specifically to arm Latino gay men with the tools to understand and combat homophobia. Participants went through work groups focused on culture, stigma, masculinity, identity and community. After the sessions, the participants produced a public event – an ad in a newspaper, a theater event, or a presentation at a community forum – rooted in their awareness and experience. After ten cycles, the 113 participants reported increased social connectedness, increased knowledge about HIV and STDs, and less HIV risk behaviors.



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  • Surgeon General 2010 Full Report: How Tobacco Smoke Causes Disease

    The Biology and Behavioral Basis for Smoking-Attributable Disease

    U.S. Department of Health and Human Services

    A Report of the Surgeon General

    Thursday, December 9, 2010, U.S. Surgeon General Regina M. Benjamin, MD, MBA, released a comprehensive scientific report that details new findings on how tobacco smoke damages the human body and leads to disease and death.

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  • Targeting smoking cessation to high prevalence communities: outcomes from a pilot intervention for gay men

    Targeting smoking cessation to high prevalence communities: outcomes from a pilot intervention for gay men
    Richard Harding, James Bensley and Nick Corrigan
    BMC Public Health 2004, 4:43doi:10.1186/1471-2458-4-43



    Background
    Cigarette smoking prevalence among gay men is twice that of population levels. A pilot community-level intervention was developed and evaluated aiming to meet UK Government cessation and cancer prevention targets.

    Methods
    Four 7-week withdrawal-oriented treatment groups combined nicotine replacement therapy with peer support. Self-report and carbon monoxide register data were collected at baseline and 7 weeks. N = 98 gay men were recruited through community newspapers and organisations in London UK.

    Results
    At 7 weeks, n = 44 (76%) were confirmed as quit using standard UK Government National Health Service monitoring forms. In multivariate analysis the single significant baseline variable associated with cessation was previous number of attempts at quitting (OR 1.48, p = 0.04).

    Conclusions
    This tailored community-level intervention successfully recruited a high-prevalence group, and the outcome data compares very favourably to national monitoring data (which reports an average of 53% success). Implications for national targeted services are considered.



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  • The Health Consequences of Involuntary Exposure to Tobacco Smoke

    A report of the Surgeon General, 2006.

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  • The Health of Lesbian, Gay, Bisexual, and Transgender People: Building a Foundation for Better Understanding

    Institute of Medicine of the National Academes

    Report Brief
    March 2011

    Report brief discusses the following LGBT health concerns:

    Conducting Research on LGBT Populations

    Implementing a Research Agenda

    LGBT Health Status Throughout the Life Course

    view link | download file
  • The health of people classified as lesbian, gay and bisexual attending family practitioners in London: a controlled study

    BMC Public Health. 2006; 6: 127.
    Michael King and Irwin Nazareth

    Background
    The morbidity of gay, lesbian or bisexual people attending family practice has not been previously assessed. We compared health measures of family practice attendees classified as lesbian, gay and bisexual.

    Methods
    We conducted a cross-sectional, controlled study conducted in 13 London family practices and compared the responses of 26 lesbian and 85 bisexual classified women, with that of 934 heterosexual classified women and 38 gay and 23 bisexual classified men with that of 373 heterosexual classified men. Our outcomes of interest were: General health questionnaire; CAGE questionnaire; short form12; smoking status; sexual experiences during childhood; number of sexual partners and sexual function and satisfaction.

    Results
    In comparison to people classified as heterosexuals: men classified as gay reported higher levels of psychological symptoms (OR 2.48, CI 1.05–5.90); women classified as bisexual were more likely to misuse alcohol (OR 2.73, 1.70–4.40); women classified as bisexual (OR 2.53, 1.60–4.00) and lesbian (OR 3.13, 1.41–6.97) and men classified as bisexual (OR 2.48, 1,04, 5.86) were more likely to be smokers and women classified as bisexual (OR 3.27, 1.97–5.43) and men classified as gay (OR 4.86, 2.28–10.34) were much more likely to report childhood sexual experiences in childhood. Psychological distress was associated with reporting sexual experiences in childhood in men classified as gay and bisexual and women classified as heterosexual. Men classified as bisexual (OR 5.00, 1.73–14.51) and women classified as bisexual (OR 2.88, 1.24- 6.56) were more likely than heterosexuals to report more than one sexual partner in the preceding four weeks. Lesbian, gay and bisexual classified people encountered no more sexual function problems than heterosexuals but men classified as bisexual (OR 2.74, 1.12–6.70) were more dissatisfied with their sex lives.

    Conclusion
    Bisexual and lesbian classified people attending London general practices were more likely to be smokers and gay classified men were at increased risk of psychological distress in comparison to heterosexual classified people. Increased awareness of the sexuality of people seen in primary care can provide opportunities for health promotion.

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  • The Trouble With "MSM" and "WSW": Erasure of the Sexual-Minority Person in Public Health Discourse

    Am J Public Health. 2005 July; 95(7): 1144–1149.
    doi: 10.2105/AJPH.2004.046714
    Copyright © American Journal of Public Health 2005

    Rebecca M. Young, PhD and Ilan H. Meyer, PhD

    Men who have sex with men (MSM) and women who have sex with women (WSW) are purportedly neutral terms commonly used in public health discourse. However, they are problematic because they obscure social dimensions of sexuality; undermine the self-labeling of lesbian, gay, and bisexual people; and do not sufficiently describe variations in sexual behavior.MSM and WSW often imply a lack of lesbian or gay identity and an absence of community, networks, and relationships in which same-gender pairings mean more than merely sexual behavior. Overuse of the terms MSM and WSW adds to a history of scientific labeling of sexual minorities that reflects, and inadvertently advances, heterosexist notions.Public health professionals should adopt more nuanced and culturally relevant language in discussing members of sexual-minority groups.

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  • Tobacco Control in Low SES Populations

    A document of Legacy: For Longer Healthier Lives

    September 2010



    The report addresses tobacco use and prevention and cessation resources in low-SES populations. It explores promising evidence-based practices that address tobacco-related disparities. It also features five LEGACY-funded case studies that demonstrate how organizations are addressing these issues: 1) Culturally Tailored Tobacco Cessation and Prevention for Asian America Men (International Community Health Services, Seattle, Washington); 2) Youth Social Media Campaign to Reduce Cultural Tolerance for Tobacco in Rural Maine (CUT the Habit Project, Franklin County); 3) Adapting the 5As Model for Pregnant Smokers in Rural Tribal Communities (Inter-Tribal Council of Michigan, Keweenaw Bay Area); 4) Putting the Spotlight on Commercial Tobacco Use (Indian Health Service Change Tobacco project); and 5) Tobacco Cessation for the Low Income Population (Newark Beth Israel Medical Center, STRIDE-Strategies to Reduce Tobacco Related Illness in the Emergency Department, New Jersey).


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  • Tobacco use and cessation among a household-based sample of US urban men who have sex with men

    Am J Public Health. 2005 Jan;95(1):145-51.
    Greenwood GL, Paul JP, Pollack LM, Binson D, Catania JA, Chang J, Humfleet G, Stall R.
    SourceCenter for AIDS Prevention Studies, University of California-San Francisco, 74 New Montgomery St, Suite 600, San Francisco, CA 94105, USA. ggreenwood@psg.ucsf.edu

    Abstract
    OBJECTIVES: We examined tobacco use and cessation among a probability sample of urban men who have sex with men (MSM) living in 4 large US cities.

    METHODS: Of the 2402 men who were eligible for follow-up from a previously recruited probability sample, 1780 (74%) completed tobacco surveys between January and December 1999.

    RESULTS: Current smoking rates were higher for urban MSM (31.4%; 95% confidence interval [CI]=28.6%, 34.3%) than for men in the general population (24.7%; 95% CI=21.2%, 28.2%). Among MSM, 27% were former smokers. A complex set of sociodemographic, tobacco-related, and other factors were associated with cessation.

    CONCLUSIONS: Results support earlier reports that smoking rates are higher for MSM compared with men in the general population. Findings related to cessation underscore the need to target tobacco control efforts for MSM.



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  • Tobacco Use and Readiness to Quit in Low Income HIV Infected Persons

    Jack E. Burkhalter, Carolyn M. Springer, Rosy Chhabra, Jamie S. Ostroff, Bruce D. Rapkin

    Nicotine & Tobacco Research, Vol. 7, Number 4 (August 2005)

    This article examines the impact of sociodemographic factors on smoking cessation such as HIV impact, age, income, drug use, etc.



    download file
  • Trickets and Trash Surveillance Update 2011

    Trinkets & Trash is a surveillance project and archive at the UMDNJ¨C School of Public Health that monitors tobacco industry marketing in magazines, direct mail, e©\mail, websites, and other channels. For more images, visit us online at trinketsandtrash.org.

    If you have examples youˇŻd like to share or would like to be added to our mailing list, e©\mail us at trinketsandtrash@umdnj.edu.


    Discussed in this report are:
    Camel Snus targets NYC smokers

    Camel Switch Challenge 2, Hump Day & Dissolvable Fans

    NewportˇŻs Persistent Ads

    Other Smokeless News.

    view link | download file
  • Variations in Amenable Mortality--Trends in 16 High-Income Nations

    Background: There has been growing interest in the comparison of health system performance within and between countries, using a range of different indicators. This study examines trends in amenable mortality, as one measure of health system performance, in sixteen high-income countries.

    Methods: Amenable mortality was defined as premature death from causes that should not occur in the presence of timely and effective health care. We analysed age-standardised rates of amenable mortality under age 75 in 16 countries for 1997/1998 and 2006/2007.

    Results: Amenable mortality remains an important contributor to premature mortality in 16 high-income countries, accounting for 24% of deaths under age 75. Between 1997/1998 and 2006/2007, amenable mortality fell by between 20.5% in the US and 42.1% in Ireland (average decline: 31%). In 2007, amenable mortality in the US was almost twice that in France, which had the lowest levels.

    Conclusions: Amenable mortality continues to fall across high-income nations although the USA is lagging increasingly behind other high income countries. Despite its many limitations, amenable mortality remains a useful indicator to monitor progress of nations.

    September 23, 2011
    Authors: Ellen Nolte, Ph.D., and Martin McKee, M.D., D.Sc.
    Journal: Health Policy, published online Sept. 12, 2011
    Contact: Ellen Nolte, Ph.D., RAND Europe, enolte@rand.org
    Summary Writers: Deborah Lorber
    Access to full article: View Article

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  • Ways the Tobacco Industry Markets to Lesbians and gays

    An article by Perry Stevens, 2001

    view link | download file
  • West Virginia Lesbian, Gay, and Bisexual Tobacco Survey

    Final Report: August 11, 2010 

    Prepared for: West Virginia Covenant House  

    Prepared by: UNC School of Medicine Tobacco Prevention and Evaluation Program

    This report provides an independent assessment of evidence for a LGB tobacco disparity in WV. This is one of the first and most comprehensive studies of LGB tobacco use in Appalachia.  To identify rates of tobacco use for LGB West Virginians, the UNC Tobacco Prevention and Evaluation Program conducted two pilot surveys of tobacco use in LGB populations at bars and community events.

    view link | download file
  • What makes an ad a cigarette ad? Commercial tobacco imagery in the lesbian, gay, and bisexual press

    J Epidemiol Community Health. 2005 December; 59(12): 1086–1091.
    doi: 10.1136/jech.2005.038760

    E. Smith, N. Offen, and R. Malone

    Objectives: To determine the extent of commercial tobacco imagery in the lesbian, gay, and bisexual (LGB) press.

    Methods: Content analysis of all advertising containing tobacco related text or imagery in 20 LGB community periodicals, published between January 1990 and December 2000.

    Results: 3428 ads were found: 689 tobacco product ads, 1607 ads for cessation products or services, 99 ads with a political message about tobacco, and 1033 non-tobacco ads that showed tobacco (NAST). Although cessation ads were numerically dominant, tobacco product ads and NAST occupied more space and were more likely to use images. NAST almost never had an anti-tobacco message. Formal sponsorship between tobacco and other companies was very rare. Lesbian periodicals had proportionally more NAST and fewer cessation ads.

    Conclusions: Cigarette ads were outnumbered by NAST. Although these ads do not usually show brands, and are unlikely to be the result of formal sponsorship agreements, they may be "selling" smoking. Tobacco control advocates should persuade editors to refuse tobacco product ads and those with gratuitous tobacco imagery.

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  • WPATH Standards of Care for the Health of Transsexual, Transgender, and Gender Nonconforming People

    The overall goal of the SOC is to provide clinical guidance for health professionals to assist transsexual, transgender, and gender nonconforming people with safe and effective pathways to achieving lasting personal comfort with their gendered selves, in order to maximize their overall health, psychological well-being, and self-fulfillment. This assistance may include primary care, gynecologic and urologic care, reproductive options, voice and communication therapy, mental health services (e.g., assessment, counseling, psychotherapy), and hormonal and surgical treatments. While this is primarily a document for health professionals, the SOC may also be used by individuals, their families, and social institutions to understand how they can assist with promoting optimal health for members of this diverse population.

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Research/Studies/Literature Reviews

  • "Qualitative Investigation of Smokers and Non-Smokers in the LGBT Market" Executive Summary

    Here is a executive summary of a "Qualitative Investigation of Smokers and Non-Smokers in the LGBT Market" by Winston Stuart Associates, LTD. Included is the respondent screener and discussion guides from LGBT focus groups conducted in 2001, smokers and nonsmokers, in Sacramento and San Francisco.


    download file
  • "We'd Be Free": Narratives of Life Without Homophobia, Racism, or Sexism

    Ilan H. Meyer, Suzanne C. Ouellette, Rahwa Haile & Tracy A. McFarlane

    Sexuality Research and Social Policy
    ISSN 1868-9884
    Sex Res Soc Policy
    DOI 10.1007/s13178-011-0063-0

    Abstract Stigma and social inequality deprive disadvantaged social groups of a sense of social well-being. Stress researchers have focused on prejudice-related events and conditions but have not described more intangible stressors experienced by sexual minorities. We use narrative methods to examine how sexual minorities experience stigma and social inequality as we focus on the more intangible stressors that are both pervasive and difficult to measure. Three themes emerged in the narratives of our ethnically diverse sample of 57 adult sexual minority women and men: (a) stigma deprived them of access to critical possibilities and opportunities; (b) stigma deprives them of safety and acceptance; and (c) despite this, the experience of stigma is also related to the adoption of a positive and collective orientation towards their stigmatized identities. Recognizing these stressors and related resilience can direct policy makers toward interventions that go even beyond eliminating prejudice by including goals to strengthen minority communities.

    Keywords: Sexual minorities, Stigma, Prejudice, Stress, Social well-being

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  • 2007 Oregon Pride Smoking Survey Report by Breathe Free

    Youth, adult volunteers and staff members of the Sexual Minority Youth Resource Center (SMYRC) conducted a convenience sample survey in Oregon during the summer and early fall of 2007 at Pride and other LGBTQQ community events. In this document, LGBTQQ refers to lesbian, gay, bisexual, transgender, queer, or questioning individuals. A total of 326 Oregon residents completed the survey in 2007, compared with 582 in 2006. In both years, 89% of respondents self identified as lesbian, gay, bisexual, transgender, queer, or questioning. In 2007, 80% of LGBTQQ respondents described their race/ethnicity as Caucasian.

    download file
  • 2007: Disparities in Smoking Between the Lesbian, Gay, and Bisexual Population and the General Population in California

    A large, population-based study to assess tobacco use in California's lesbian, gay, and bisexual (LGB) population. Smoking prevalence rates were higher in the sample of lesbians, bisexual women, and women who have sex with women than among women in the general California population. In the case of men, the only significant difference was that rates were higher among gay men than among men in the general population. Disparities in tobacco use between the LGB population and the general population were still evident after they controlled for key demographic variables and in comparisons with other tobacco use indicators such as average cigarette consumption. Tobacco control efforts targeting the LGB population are needed to reduce this group's high rate of cigarette smoking.

    view link
  • 2012 Summit Abstract Submission Packet

    Email submissions to summitabstracts@gmail.com

    download file
  • 2012 Summit Registration Form

    Registration form for the 8th annual LGBTQ Health Equity Summit
    August 14, 2012
    Kansas City, MO


    view link | download file
  • 2012 Summit Sponsorship Packet

    The 2012 LGBTQ Health Equity Summit provides a great sponsorship opportunity for your company or organization! The Summit will be held on August 14th, in Kansas City, Missouri marking the eighth anniversary of the event. Convening one day before the National Conference on Tobacco or Health, the one-day Summit is an interactive, educational, and networking event where your company or organization can reach a diverse group of individuals from across the United States, all working on health equity issues and battling tobacco use, the leading preventable cause of death in the United States. The Summit brings together more than 100 community-based gay, lesbian, bisexual, and transgender leaders, along with allies, for lively panel discussions, hands-on workshops, and strategic planning sessions.

    download file
  • A Blueprint for Meeting LGBT health and Human Services Needs in NYS

    Frazer and Warren, 2010

    Estimates of the size of the LGBT population in New York State vary. In 2004, the New York State Department of Health’s Adult Tobacco Survey included questions on sexual orientation and gender identity. It suggested that 2.6% of adults in New York State are lesbian, gay or bisexual, while 2.1% are transgender. In 2007, the New York City Department of Health and Mental Hygiene’s Community Health Survey estimated that 4.1% of people in New York City identify as lesbian, gay, or bisexual; however, this survey did not ask about transgender identities. National estimates suggest that 4.1% of the population identifies as lesbian, gay, or bisexual. However, a larger number have had sex with someone of the same gender or experience same-sex attractions.

    view link | download file
  • Aboriginal Two-Spirit and LGBTQ Migration, Mobility, and Health Research Project

    Description

    This qualitative, community-based research project explored the trajectories of migration of Aboriginal people who identify as Two-Spirit, lesbian, gay, bisexual, transgender and/or queer (LGBTQ) and the impact of mobility on health and wellness. Our focus on migration included movement from First Nation reserve communities to urban centres or rural communities (and back and forth) as well as staying or moving within one place. We were interested in the intersection between sexual and gender identities with cultural/Nation and other identities within the historical and present context of colonization in Canada.

    More specifically this research project had the following objectives:

    * To explore the migration paths and experiences of Aboriginal Two-Spirit and LGBTQ peoples, their experiences of health/wellness in that context, and their interactions with health and social services (including mainstream, Aboriginal and LGBTQ services).

    * To generate new knowledge that may lead to future research that will be of direct benefit to LGBTQ and Aboriginal communities, Aboriginal service providers and health/social service agencies.

    download file
  • Adding Sexual Orientation Questions to Statewide Public Health Surveillance: New Mexico's Experience

    Authors: Vankim NA, Padilla JL, Lee JG, Goldstein AO.

    By Chronic Disease Prevention and Control Bureau, New Mexico Department of Health

    Abstract

    We examined refusal rates for sensitive demographic questions to determine whether questions on sexual orientation are too sensitive for routine use on public health surveys. We compared the percentage of active refusals in New Mexico for a sexual orientation question and 6 other sensitive demographic questions. In 2007 and 2008, refusal rates for sexual orientation questions were similar to rates for questions on race/ethnicity and weight and significantly lower than rates for questions on household income. Perceptions that sexual orientation is too controversial a topic to be included on state surveys may be unfounded. (Am J Public Health. Published online ahead of print October 21, 2010: e8-e12. doi:10. 2105/AJPH.2009.186270).



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  • American Lung Association's Smoking Out a Deadly Threat: Tobacco Use in the LGBT Community

    The American Lung Association's latest health disparity report, Smoking Out a Deadly Threat: Tobacco Use in the LGBT Community, examines the trend of higher tobacco use among the lesbian, gay, bisexual and transgender (LGBT) community and the need for additional research specific to this community.

    download file
  • AN ASSESSMENT FOR A BETTER UNDERSTANDING OF TOBACCO USE BY LGBT METRO ATLANTANS - April 2011

    Submitted to
    The DeKalb County, Georgia Board of Health Office of Chronic Disease Prevention

    In partnership with the Georgia Tobacco Use Prevention Program, Georgia Department of Community Health, Georgia Division of Public Health

    April 15, 2011

    By The Atlanta Lesbian Health Initiative
    Linda Ellis, Med, MDiv, LPC, Executive Director
    Lawrence Bryant, RRT, MPH, PhD, Principal Investigator


    The findings of this research project underscore important implications related to tobacco use, cessation and prevention in the metro Atlanta LGBT community. First, a lack of awareness of the LGBT smoking disparity demonstrates a tremendous need for an LGBT specific educational program. Audience-appropriate and tested programs should be created to raise awareness of this public health issue. Second, while most survey respondents do not smoke, there seems to be a variety of opinions about LGBT organizations taking money from tobacco companies. The public health community, however, is in total agreement that this practice should be discouraged. There were several surprises that emanated from this research project; they were:
    * Some participants were reserved in their recommendations of increasing taxes on tobacco products.
    * There is a sense of resignation that smoking is going to happen in LGBT spaces, no matter what we do. This supports some literature which states that LGBTs view smoking as normal in a community besieged by homophobia, stigma, and discrimination.
    * Smoking is an issue of rebellion and identity.
    * Many in the LGBT community do not see tobacco control as a relevant issue. This is exemplified by survey respondents ranking tobacco use 8th out of 10 priority health issues for the LGBT community.

    download file
  • An Examination of Smoking Behavior and Opinions About Smoke-free Environments in a Large Sample of Sexual and Gender Minority Community Members

    Authors: Jane A. McElroy, Ph.D., Kevin D. Everett, Ph.D. and Isabella Zaniletti, M.A.

    Corresponding Author: Jane A McElroy, Ph.D., Family and Community Medicine Department, University of Missouri, MA 306 Medical Science Building, Columbia, MO 65212, USA. Telephone: 573-882-4993; Fax: 573-884-6172; E-mail: mcelroyja@health.missouri.edu

    Received March 22, 2010.
    Accepted January 24, 2011

    Introduction: The purpose of this study is to more completely quantify smoking rate and support for smoke-free policies in private and public environments from a large sample of self-identified sexual and gender minority (SGM) populations.

    Methods: A targeted sampling strategy recruited participants from 4 Missouri Pride Festivals and online surveys targeted to SGM populations during the summer of 2008. A 24-item survey gathered information on gender and sexual orientation, smoking status, and questions assessing behaviors and preferences related to smoke-free policies.

    Results: The project recruited participants through Pride Festivals (n = 2,676) and Web-based surveys (n = 231) representing numerous sexual and gender orientations and the racial composite of the state of Missouri. Differences were found between the Pride Festivals sample and the Web-based sample, including smoking rates, with current smoking for the Web-based sample (22%) significantly less than the Pride Festivals sample (37%; p < .0001). The SGM group (n = 2,162) was 1.49 times more likely to be current smokers compared with the study's heterosexual group (n = 436; p = .005). Statistically fewer SGM racial minorities (33%) are current smokers compared with SGM Whites (37%; p = .04). Support and preferences for public and private smoke-free environments were generally low in the SGM population.

    Conclusions: The strategic targeting method achieved a large and diverse sample. The findings of high rates of smoking coupled with generally low levels of support for smoke-free public policies in the SGM community highlight the need for additional research to inform programmatic attempts to reduce tobacco use and increase support for smoke-free environments.


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  • An Overview of U.S. Trans Health Priorities:
    A Report by the Eliminating Disparities Working Group
    August 2004 Update

    National Coalition for LGBT Heatlh

    This overview is based upon a meta-analysis of the available research on U.S. transgender populations, not all of which has been published in journals. Many of the following issues are inter-related, and most are related to access to health care – to Trans Health services, behavioral health services (including substance abuse treatment and smoking cessation treatment), HIV/AIDS/STD care, and routine health and wellness care.

    view link | download file
  • Annotated Bibliography

    An updated version of Dr. Heather Ryan's annotated bibliography of all LGBT tobacco articles ever published! 146 citations, updated March 2010.

    download file
  • Annotated Bibliography of Notable LGBT Health Disparity Studies

    This bibliography includes citations and abstracts from peer-reviewed LGBT Health Disparity articles among the following categories: Access to Health Services, Cancer, General Health, Health Risk Behaviors, Mental Health and Mental Disorders, Nutrition and Obesity, Social Determinants of Health, Substance Use and Tobacco Use


    Compiled on 7/12/10 by the Network for LGBT Tobacco
    Control through input from the following LGBT health
    researchers:

    Alicia Matthews, Ph.D., University of Illinois at Chicago
    Deborah Bowen, Ph.D., Boston University
    Don Operario, Ph.D., Brown University
    Emilia Lombardi, Ph.D. University of Pittsburgh
    Francisco Buchting, Ph.D., ETR Associates
    Joseph Lee, M.P.H., CPH, University of North Carolina
    Judith Bradford, Ph.D., The Fenway Institute
    Ron Stall, Ph.D., University of Pittsburgh
    Scout, Ph.D., The Fenway Institute
    Tonda Hughes, Ph.D., University of Illinois at Chicago
    Assistance was provided via the resources of the LGBT
    Population Research Center.
    Additional thanks to Dwyer Deighan

    Many thanks to the contributors to this important work!


    download file
  • Annotated Bibliography, January 2011

    This Annotated Bibliography of 323 LGBT tobacco references was updated on January 24, 2011 by Emilia Dunham of The Network for LGBT Health Equity.

    Special thanks to the following Network members and staff for their assistance:

    Heather Ryan, Office on Smoking and Health-CDC
    Joseph Lee, UNC School of Medicine
    Sasha Kaufmann, former Network staff
    Vanesso Oddo, former Network staff
    Aimee Van Wagenen, LGBT Population Research Center
    Scout, Ph.D., Network staff
    Gustavo Torrez, Network staff



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  • Association of cigarette smoking with HIV prognosis among women in the HAART era: a report from the women's interagency HIV study

    Am J Public Health. 2006 Jun;96(6):1060-5. Epub 2006 May 2

    Feldman JG, Minkoff H, Schneider MF, Gange SJ, Cohen M, Watts DH, Gandhi M, Mocharnuk RS, Anastos K.
    SourceSUNY Downstate Medical Center, 450 Clarkson Ave, Brooklyn, NY 11203, USA. joseph.feldman@downstate.edu

    OBJECTIVE: We assessed the association of cigarette smoking with the effectiveness of highly active antiretroviral therapy (HAART) among low-income women.

    METHODS: Data were analyzed from the Women's Interagency HIV Study, a multisite longitudinal study up to 7.9 years for 924 women representing 72% of all women who initiated HAART between July 1, 1995, and September 30, 2003.

    RESULTS: When Cox's regression was used after control for age, race, hepatitis C infection, illicit drug use, previous antiretroviral therapy, and previous AIDS, smokers on HAART had poorer viral responses (hazard ratio [HR]=0.79; 95% confidence interval [CI]=0.67, 0.93) and poorer immunologic response (HR=0.85; 95% CI=0.73, 0.99). A greater risk of virologic rebound (HR=1.39; 95% CI=1.06, 1.69) and more frequent immunologic failure (HR=1.52; 95% CI=1.18, 1.96) were also observed among smokers. There was a higher risk of death (HR=1.53; 95% CI=1.08, 2.19) and a higher risk of developing AIDS (HR=1.36; 95% CI=1.07, 1.72) but no significant difference between smokers and nonsmokers in the risk of death due to AIDS.

    CONCLUSIONS: Some of the benefits provided by HAART are negated in cigarette smokers.



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  • Asthma Diagnosis Among Individuals in Same-Sex Relationships

    2006, Vol. 43, No. 8 , Pages 579-584 (doi:10.1080/02770900600878289)
    HTML PDF (59 KB) PDF Plus (61 KB)
    E. Heck, Ph.D., M.P.H. and Judith S. Jacobson, Dr.


    Read More: http://informahealthcare.com/doi/abs/10.1080/02770900600878289?journalCode=jas

    This study examined ever and current asthma diagnosis among persons in same-sex relationships (SSRs) using data from the pooled 1997–2004 National Health Interview Surveys. Among SSRs, 13.5% of men and 14.3% of women reported ever diagnosis of asthma, compared to 7.6% and 10.2% opposite-sex relationship (OSR) men and women. SSRs had higher rates of smoking, stress, and among women, obesity. In regression analyses, male SSRs had a significantly elevated risk of ever asthma diagnosis (adjusted OR = 1.51), while 12-month asthma was elevated among SSR women (adjusted OR = 2.48). SSRs may be at higher risk for asthma due to a spectrum of risk factors.


    Read More: http://informahealthcare.com/doi/abs/10.1080/02770900600878289?journalCode=jas

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  • Attitudes Toward Tobacco Use and Clean Air Advocacy in the LGBT Communities of Monroe and Baton Rouge, Louisiana

    Caroline Cottingham
    Roger Schimberg, MPH
    24 August 2010

    The data from this study offered information which will hopefully help to improve public health campaigns for tobacco cessation and campaigns for Clean Air acts. Participants in the focus groups in Baton Rouge and Monroe, Louisiana, offered a wealth of responses on why they believe LGBT individuals use tobacco and methods which can help them quit. Unfortunately, the participants‟ responses to basic knowledge questions about tobacco use in the LGBT community, tobacco company targeting, and cessation resources suggests there may be a lack of education concerning the high rates of LGBT tobacco use, the way tobacco companies target LGBT people, and how to find resources to help themselves and/or other LGBT smokers quit. Participants also offered reasons why they support Clean Air acts and barriers to supporting these regulations on tobacco use, along with reasons why they would advocate for Clean Air acts and barriers to advocacy. Coupled with the marketing survey, which offered data on how participants receive information about the LGBT community, this information may help campaigns looking to build support and increase advocacy to pass more regulations on tobacco use in the state of Louisiana. Though some barriers must be addressed, data from the focus groups suggested that most participants already supported these laws, though they did not have the means to advocate for the laws.

    Though research on tobacco use in the LGBT community has increased exponentially over the past ten years, many gaps still remain. More research would be helpful in providing comparisons between states and national LGBT tobacco use data. The narrow focus and sample of this study unfortunately limits this data, but comparisons between other state-focused studies suggests that some of the trends identified in this report may apply to more than simply Baton Rouge and Monroe, Louisiana. This study will be most helpful in addressing the direct tobacco cessation and Clean Air advocacy needs of these cities, though more research might show that this data could be used to inform tobacco cessation programs and Clean Air advocacy in other Louisiana cities and possibly other states.

    download file
  • Bisexual Health: An introduction and model practices for HIV/STI prevention programming

    2007 The National Gay and Lesbian Task Force Policy Institute
    When referencing this document, we recommend the following citation:

    Miller, M., André, A., Ebin, J., and Bessonova, L. (2007). Bisexual health: An introduction and model practices for HIV/STI prevention programming. New York: National Gay and Lesbian TaskForce Policy Institute, the Fenway Institute at Fenway Community Health, and BiNet USA.

    The National Gay and Lesbian Task Force Policy Institute, the Fenway Institute at Fenway Community Health in Boston, Mass., and BiNet USA created this report to answer these questions and offer a model practice HIV/STI prevention program that successfully educates bisexuals and those who have sex with both men and women but do not identify as bisexual.

    We created this publication because sexual health issues affecting bisexuals have been largely ignored and under-represented in discussions of heterosexual and/or lesbian, gay and transgender health. Bisexual men and women are expected to have the same health concerns as either heterosexuals or gay men and lesbians, and therefore their unique concerns are seldom addressed.

    This publication is designed to meet the needs of many populations. For journalists, researchers, counselors and anyone seeking to better understand bisexuality and HIV/STI prevention, we describe bisexuality and HIV/STI transmission, and offer language for understanding and explaining these trends clearly and accurately. For staff of HIV/STI prevention programs, bisexual activists, public health departments and funders we detail existing programs’ challenges and offer solutions.

    download file
  • California - Lesbians, Gays, Bisexuals and Transgender Tobacco Use Survey 2004

    California Department of Health Services
    Tobacco Control Section


    In 2003-04, Field Research Corporation conducted a statewide household survey of the California lesbian, gay, bisexual, and transgender (LGBT) population for the Tobacco Control Section (TCS), Department of Health Services (DHS). The purpose was to assess tobacco-related behaviors, attitudes, and knowledge within the LGBT population; identify disparities between the LGBT and general adult populations of the State; and explore possible explanations for the most important differences.


    Prepared by
    Field Research Corporation

    The Tobacco Control Section
    Cancer Control Branch
    Division of Chronic Disease and Injury Control
    California Department of Health Services
    1616 Capitol Avenue, Suite 74.516
    MS 7206
    P.O. Box 997413
    Sacramento, CA 95899-7413

    Suggested citation:
    Bye L, Gruskin E, Greenwood, G, Albright V, Krotki K. California Lesbians, Gays, Bisexuals, and Transgender (LGBT) Tobacco Use Survey – 2004. Sacramento, CA: California Department of Health Services, 2005.

    download file
  • Cancer-related risk indicators and preventive screening behaviors among lesbians and bisexual women

    Am J Public Health. 2001 Apr;91(4):591-7
    Cochran SD, Mays VM, Bowen D, Gage S, Bybee D, Roberts SJ, Goldstein RS, Robison A, Rankow EJ, White J.
    SourceDepartment of Epidemiology, School of Public Health, Center for Health Sciences, University of California, Los Angeles, Box 951772, Los Angeles, CA 90095-1772, USA. cochran@ucla.edu

    OBJECTIVES: This study examined whether lesbians are at increased risk for certain cancers as a result of an accumulation of behavioral risk factors and difficulties in accessing health care.

    METHODS: Prevalence estimates of behavioral risk factors (nulliparity, obesity, smoking, and alcohol use), cancer screening behaviors, and self-reported breast cancer histories derived from 7 independently conducted surveys of lesbians/bisexual women (n = 11,876) were compared with national estimates for women.

    RESULTS: In comparison with adjusted estimates for the US female population, lesbians/bisexual women exhibited greater prevalence rates of obesity, alcohol use, and tobacco use and lower rates of parity and birth control pill use. These women were also less likely to have health insurance coverage or to have had a recent pelvic examination or mammogram. Self-reported histories of breast cancer, however, did not differ from adjusted US female population estimates.

    CONCLUSIONS: Lesbians and bisexual women differ from heterosexual women in patterns of health risk. These women would be expected to be at especially greater risk for chronic diseases linked to smoking and obesity.



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  • CDC Mortality and Mortality Weekly Report (MMWR)
    Health Disparities and Inequalities Report — United States, 2011

    The Network worked to include LGBT people in this report, however with little data, there was barely mention of LGBTs. However, CDC is calling for LGBT data collection, and hopefully policy makers will follow suit.

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  • CDC National Tobacco Control Networks for Priority Populations: Evaluation Final Report July 2008

    A detailed report by The Center for Tobacco Policy Research highlighting the work done by the National LGBT Tobacco Control Network in specific areas such as Partner Engagement, Technical Assistance, Network Resources, and other areas key to the Network's success.

    download file
  • Cigarette smoking among gay and bisexual men

    Am J Public Health. 1999 Dec;89(12):1875-8.
    Cigarette smoking among gay and bisexual men.
    Stall RD, Greenwood GL, Acree M, Paul J, Coates TJ.
    SourceCenter for AIDS Prevention Studies, University of California, San Francisco 94105, USA. rstall@psg.ucsf.edu


    OBJECTIVES: This study measured the prevalence of cigarette smoking among gay men and identified associations with smoking.

    METHODS: Household-based (n = 696) and bar-based (n = 1897) sampling procedures yielded 2593 gay male participants from Portland, Ore, and Tucson, Ariz, in the spring of 1992.

    RESULTS: Forty-eight percent of the combined sample reported current smoking, a rate far above prevalence estimates for men in Arizona (z = 14.11, P < .001) or Oregon (z = 24.24, P < .001). Significant associations with smoking included heavy drinking, frequent gay bar attendance, greater AIDS-related losses, HIV seropositivity, lower health rating than members of same age cohort, lower educational attainment, and lower income.

    CONCLUSIONS: Rates of cigarette smoking are very high among gay men. Tobacco prevention and cessation campaigns should be designed to reach the gay male community.



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  • Coming Out about Smoking: Tobacco Use in the LGBTQ Young Adult Community

    NYAC has long been the go to group for some great resources for pushing back against LGBTQ youth tobacco use, and they've done it again here. Please take a gander at their fascinating new report on LGBTQ youth tobacco attitudes, complete with smart and savvy recommendations. There's lots to learn from in this report. Two things I found especially fascinating were that 20% of people who said they were 'nonsmokers' admitted to smoking socially; and that only 63% of LGBTQ youth said their sexual orientation was LGB (I know at least a dozen survey researchers who'll wail and gnash their teeth at this news). But mostly, let's get this out far and wide, because LGBTQ youth tobacco control is severely underfunded and powered. Unless we want to be doing this work in 20 more years, please help us spread these findings and strategies to all the groups that can make them happen. Great job NYAC!

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  • Effect of smoking on the clinical progression of HIV-1 infection

    J Acquir Immune Defic Syndr Hum Retrovirol. 1997 Apr 15;14(5):451-8.
    Galai N, Park LP, Wesch J, Visscher B, Riddler S, Margolick JB.

    Department of Epidemiology, Johns Hopkins University School of Public Health, Baltimore, MD 21205, USA.

    Abstract
    Cigarette smoking as a risk factor in progression of HIV-1 disease was investigated in the Multicenter AIDS Cohort Study of homosexual men. Longitudinal data for T-cell subsets, HIV-related clinical symptoms, smoking behavior, and AIDS medication use were collected semiannually from 2,499 HIV-1-seropositive men for up to 9 years. Survival methods, including Kaplan-Meier analysis and multivariate Cox regression models, were used to assess the effect of cigarette smoking on development of Pneumocystis carinii pneumonia (PCP), AIDS, death, and self-reported oral thrush. After adjustment for CD4+ lymphocyte count and use of antiretroviral and anti-PCP medications, smoking was not significantly associated with progression to PCP, AIDS, or death in either the HIV-seroprevalent or-seroincident cohort members. Among men who had baseline CD4+ cell counts > 200/microliter, smoking was associated with a 40% increase in the hazard of oral thrush (p < or = 0.01). These data indicate that cigarette smoking does not have a major effect on the progression of HIV-1 infection to AIDS or death but may affect the incidence of oral thrush.

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  • Effects of at-school victimization and sexual orientation on lesbian, gay, or bisexual youths' health risk behavior

    J Adolesc Health. 2002 May;30(5):364-74.
    Bontempo DE, D'Augelli AR.
    SourceDepartment of Human Development and Family Studies, The Pennsylvania State University, University Park, Pennsylvania 16802, USA. deb193@psu.edu



    PURPOSE: To examine the link between victimization at school and health risk behaviors using representative data comparing lesbian, gay, and bisexual (LGB) youths and heterosexual youths.

    METHODS: Data from the 1995 Youth Risk Behavior Survey taken in Massachusetts and Vermont were examined. This sample included 9188 9th through 12th grade students; 315 of these students were identified as LGB. Analyses of variance were used to examine health risk behaviors by sexual orientation by gender by victimization level.

    RESULTS: The combined effect of LGB status and high levels of at-school victimization was associated with the highest levels of health risk behaviors. LGB youths reporting high levels of at-school victimization reported higher levels of substance use, suicidality, and sexual risk behaviors than heterosexual peers reporting high levels of at-school victimization. Also, LGB youths reporting low levels of at-school victimization reported levels of substance use, suicidality, and sexual-risk behaviors that were similar to heterosexual peers who reported low at-school victimization.

    CONCLUSIONS: The findings provide evidence that differences in health risks among LGB youth are mediated by victimization at school. Such victimization of LGB youth is associated with health risk behaviors.



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  • Eo na Mahu o Hawai'i: the extraordinary health needs of Hawai'i's Mahu

    Pac Health Dialog. 2001 Sep;8(2):327-34.
    Eo na Mahu o Hawai'i: the extraordinary health needs of Hawai'i's Mahu.
    Odo C, Hawelu A.
    Source: Ke Ola Mamo, Honolulu, Hawai'i 96817, USA. codo@lava.net



    An overview of health and social issues is presented here regarding Native Hawaiian transgenders. Perhaps due to relatively greater tolerance of gender diversity among Polynesian cultures, approximately 70% of all male-to-female transgenders in Hawai'i are Native Hawaiian. However, the overall climate is one of discrimination and harassment such that transgenders--who tend to be under-educated, under-employed, and medically underserved--may be the most severely impacted of all Native Hawaiians. Lei Anuenue, human immunodeficiency virus (HIV) prevention program for Native Hawaiians, has provided a variety of services for transgenders, including outreach, educational workshops, support groups, HIV testing, and case management. All services are provided by peer leaders who are employed by the program. Data for this article are based on case management, including client self-disclosures and reports of peer staff who knew details of clients' lives having shared with them both generic experiences and specific activities. Information from 100 transgender clients and their case managers indicated that the transgender health profile is far more serious than that of mainstream Native Hawaiians. For example, 74% smoke, 31% use illegal drugs (excluding marijuana), more than 50% have been involved in street or domestic violence, and few individuals over age 50 have been found during three years of outreach. To some extent, employment options limit transgenders to prostitution, drug dealing, and minimum-wage jobs. In addition, a lifestyle of multiple sex partners and lack of opportunities for stable relationships place transgenders at much greater risk for HIV, sexually transmitted diseases (STD), and other infectious and non-infectious diseases as compared to the mainstream Native Hawaiian community. Clients in this study were from O'ahu, primarily from downtown Honolulu, Chinatown, and Wai'anae. Future studies should compare the results of this sample to transgenders from the neighbor islands (especially in rural Hawaiian areas), as well as utilize a structured prospective longitudinal approach.



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  • Evaluation of Smoking Cessation and the GLBT
    community in Canada

    Evaluation by Gentium Consulting on behalf of the Program Training and Consultation Centre
    January 2005.
    The project's underpinning is that it is important to provide all smokers, from all communities and backgrounds, with a cessation environment where they feel comfortable and confident to express their own personal issues. This project's main objective was to provide and further develop gay-specific smoking cessation programs designed for men and women in both French and English within the City of Ottawa.

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  • Executive Summary: How Tobacco Smoke Causes Disease

    December 9, 2010, U.S. Surgeon General Regina M. Benjamin, MD, MBA, released a comprehensive scientific report that details new findings on how tobacco smoke damages the human body and leads to disease and death.

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  • Film-Flam: How MPAA/NATO movie labels hide the biggest media risk to kids

    Center for Tobacco Control Research and
    Education, UC San Francisco Publication:
    Authored by Polansky, Jonathan R., OnBeyond LLC
    Mitchell, Shelley, Breathe California of Sacramento - Emigrant Trails
    Glantz, Stanton A., University of California, San Francisco

    Smoking in youth-rated films accounts for 90,000 new smokers each year. A study on all films between May 2007 and May 2010 revealed that half of films with tobacco imagery were youth-rated (PG, PG-13, G). However, only 15% were labeled with smoking descriptions, and those with labels are downplayed with such descriptions as "brief smoking."

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  • Final Report Sexual Identity Design October 2011, Development and Testing of the NHIS Sexual Identity Question

    Kristen Miller
    J. Michael Ryan
    Questionnaire Design Research Laboratory, Office of Research and Methodology, National Center for Health Statistics
    October 2011


    This report describes research to develop and evaluate a sexual identity question for the National Health Interview Survey. Development and then evaluation of the question is based on findings from cognitive testing studies conducted by the Questionnaire Design Research Laboratory (QDRL), specifically, 7 previous testing projects as well as this current study which, taken together, consisted of a total of 386 in-depth cognitive interviews.

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  • Flavored Disease and Death for Minorities: Why the FDA Must Ban Menthol Cigarettes

    Center for American Progress Brief - May 2011

    by Aisha C. Moodie-Mills

    Introduction: The U.S. Food and Drug Administration is currently considering a ban on the sale and distribution of menthol cigarettes in the United States—a measure that could save thousands of lives each year and drastically cut elevated smoking-related health problems experienced by African Americans as well as lesbian, gay, bisexual, and transgender
    Americans who often bear the brunt of smoking-related diseases.

    This further continues to discuss the background of this problem and highlights how:

    Menthol perpetuates extreme health disparities

    Menthol cigarettes are a starter product for youth

    Predatory marketing by tobacco companies

    The focus on gay and transgender smokers

    Ban menthol cigarettes and most users would quit


    Recommendations

    Ban menthol

    Invest in cessation programs and prevention education

    Recognize lesbian, gay, bisexual, and transgender communities as a “priority population”

    Broaden advocacy coalitions

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  • FOLLETO INFORMATIVO SOBRE PERSONAS LGBT Y EL AIRE LIBRE DEL HUMO DE TABACO / LGBT PEOPLE ANDS MOKE-FREE AIR FACTSHEET

    Las comunidades LGBT están entre las poblaciones afectadas más gravemente por el uso de tabaco.

    Aún en exteriores, el humo de segunda mano tiene un efecto negativo en la salud.

    La Cirujana General de los Estados Unidos ha declarado: "ˇEl debate ha terminado!"

    El humo de segunda mano puede tener impacto adicional en las comunidades LGBT.

    ˇLas personas LGBT quieren aire libre del humo de tabaco!
    LGBTTOBACCO.ORG

    /

    LGBT communities are among the populations most severely impacted by tobacco use.

    Even outdoors, secondhand smoke has a negative health impact.

    The Surgeon General has declared: "The debate is over!"

    Secondhand smoke may have added impact in the LGBT communities.

    LGBT people want smoke free air!

    download file
  • Follow-up Report on the 2006 Oregon Pride Smoking Survey

    This report graphs statistics, highlights the important results, summarizes findings, and discusses possible reasons for disparities as found in the 2006 Portland Pride Survey conducted by Breathefree, Oregon LGBTQ Coalition Against Tobacco.

    download file
  • From adversary to target market: the ACT-UP boycott of Philip Morris

    Tob Control. 2003 Jun;12(2):203-7.
    Offen N, Smith EA, Malone RE.
    University of California, San Francisco, USA.

    Background: In 1990, the AIDS Coalition to Unleash Power (ACT-UP) sparked a year long boycott of Philip Morris’s Marlboro cigarettes and Miller beer. The boycott protested the company’s support of Senator Jesse Helms (R-North Carolina), a leading opponent of AIDS funding and civil rights for lesbian, gay, bisexual and transgender (LGBT) people. ACT-UP demanded that Philip Morris sever its ties with Helms and acknowledge its responsibility to the LGBT community and to people with AIDS.

    Objective: To assess the impact of the boycott on the LGBT community, the tobacco industry, and the tobacco control movement; and to determine what lessons tobacco control advocates can extract from this case.

    Data sources: Internal tobacco industry documents and newspaper archives.

    Methods: Search of tobacco industry documents websites using “boycott”, “ACT-UP”, “gay”, and other terms.

    Results: Philip Morris used the boycott to its own advantage. It exploited differences within the community and settled the boycott by pledging large donations to combat AIDS. Through corporate philanthropy, Philip Morris gained entrée to the LGBT market without appearing gay friendly. Many LGBT organisations, thirsty for recognition and funding from mainstream corporations, welcomed Philip Morris’s overtures without considering the health hazards of tobacco.

    Conclusions: Unless the goal of a boycott is to convince the tobacco industry to abandon tobacco altogether, such actions invite the industry to expand its marketing under the guise of philanthropy. Tobacco control advocates should be clear about goals and acceptable settlement terms before participating in a boycott of a tobacco company.

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  • Gay/Lesbian sexual orientation increases risk for cigarette smoking and heavy drinking among members of a large Northern California health plan

    BMC Public Health
    Authors: Elisabeth P Gruskin and Nancy Gordon
    Published: 03 October 2006
    BMC Public Health 2006, 6:241

    Background and significance: Tobacco and alcohol use and related morbidity and mortality are critical public health problems. Results of several, but not all, studies suggest that lesbians and gay men are at elevated risk for smoking tobacco and alcohol misuse.

    Methods: Data from random sample general health surveys of adult members of a large Northern California Health Plan conducted in 1999 and 2002 were analyzed using gender-based multivariate logistic regression models to assess whether lesbians (n = 210) and gay men (n = 331) aged 20–65 were more likely than similarly aged heterosexual women (n = 12,188) and men (n = 9342) to be smokers and heavy drinkers.

    Results: After adjusting for age, race/ethnicity, education, and survey year, lesbians were significantly more likely than heterosexual women to be heavy drinkers (OR 2.14, 95% CI 1.08, 4.23) and current smokers (OR 1.60, 95% CI 1.02, 2.51). Among men, gays were significantly more likely than heterosexuals to be current smokers (OR 2.40, 95% CI 1.75, 3.30), with borderline significant increased risk for heavy drinking (OR 1.54, 95% CI 0.96, 2.45).

    Conclusion: Lesbians and gay men may be at increased risk for morbidity and mortality due to higher levels of cigarette and alcohol use. More population-based research is needed to understand the nature of substance use in these communities so that appropriate interventions can be developed.

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  • Health status, behavior, and care utilization in the Geneva Gay Men's Health Survey

    Prev Med. 2007 Jan;44(1):70-5. Epub 2006 Sep 25.
    Health status, behavior, and care utilization in the Geneva Gay Men's Health Survey.
    Wang J, Häusermann M, Vounatsou P, Aggleton P, Weiss MG.
    SourceInstitute for Social and Preventive Medicine, University of Zurich, Switzerland. jwang@ifspm.unizh.ch





    BACKGROUND: Recent reviews and studies suggest distinctive health needs among gay men.

    METHODS: Swiss residents in the Geneva Gay Men's Health Survey (GGMHS, n=477) were matched with controls from the Swiss Health Survey (SHS, n=477) along sex, age, nationality, and region of residence and compared along standard indicators of health status, health behaviors, and health care utilization. Both health surveys were conducted in 2002 using probability sampling--i.e., time-space sampling (GGMHS) and household probability telephone sampling (SHS).

    RESULTS: Although gay men were significantly less likely to be overweight (adjusted odds ratio (AOR)=0.54), they reported significantly more and severe physical symptoms (AOR ranged from 1.72 to 9.21), short-term disability (AOR=2.56), risk factors for chronic disease--i.e., high cholesterol, high blood pressure, high glucose, and smoking (AOR ranged from 1.67 to 3.89), and greater health services utilization (AOR ranged from 1.62 to 4.28), even after adjustment for differences in socio-demographic characteristics and health behaviors.

    CONCLUSIONS: Evidence of greater morbidity among a community sample of gay men along standard health indicators underlines the relevance of sexual orientation as a socio-demographic indicator in public health in general and in the health inequalities discourse in particular.



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  • Healthy People 2020 Bisexual People Fact Sheet

    Healthy People 2020 Bisexual People Fact Sheet

    http://www.healthypeople.gov/2020/default.aspx

    download file
  • Healthy People 2020 Gay Men's Fact Sheet

    Healthy People 2020 Gay Men's Fact Sheet

    http://www.healthypeople.gov/2020/default.aspx

    download file
  • Healthy People 2020 Lesbian Factsheet

    Healthy People 2020 Lesbian Factsheet

    http://www.healthypeople.gov/2020/default.aspx

    download file
  • Healthy People 2020 Transgender Fact Sheet

    Healthy People 2020 Transgender Fact Sheet

    http://www.healthypeople.gov/2020/default.aspx

    download file
  • Heightening Tobacco Prevention in Consideration of Sexual Minority and Gender Variant Youth

    Written By Susan Hollinshead, LCSW, MSSW, with input and review by National LGBT Tobacco Control Network's Panel of Experts. This document was created as a collaborative effort to discover the best practices when working with sexual minority and gender variant youth around tobacco cessation. This document discusses available research, difficulties in pursuing research in this area, the continuum of sexuality in regards to higher smoking rates, how tobacco has been marketed to youth, how youth might be more susceptible to smoking, violence and bullying, homelessness, LGBTs of color, and welcoming and inclusive successful tobacco cessation programming. This document includes action items and recommended strategies for work around smoking cessation and sexual minority and gender variant youth.

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  • Helping Smokers Quit: State Cessation Coverage 2010

    The American Lung Association

    What’s New in Helping Smokers Quit 2010
    *All data updated to October 2010 (unless otherwise noted)
    *2010 trends and changes to coverage policies
    *Information on how health care reform and other recent federal initiatives help smokers quit
    *Now featuring trends and state-by-state data on cessation quitlines

    The report discusses:
    *The benefits of helping smokers quit
    *Describes comprehensive cessation benefits
    *The role of the American Recovery and Reinvestment Act of 2009 (ARRA) and the Patient Protection and Affordable Care Act of 2010 (PPACA)
    *Next steps for states to take

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  • High Tobacco Use among Lesbian, Gay, and Bisexual Populations in West Virginian Bars and Community Festivals

    Joseph G. L. Lee, Adam O. Goldstein, Leah M. Ranney, Jeff Crist, and Anna McCullough

    International Journal of Environmental Research and Public Health. 2011; 8(7):2758-2769.



    Abstract: With no information on tobacco use for lesbian, gay, or bisexual (LGB) populations in West Virginia (WV), it is unclear if nationally-identified LGB tobacco disparities also exist in this State. To address this data gap, we conducted a community tobacco survey in bars and events associated with the WV Pride Parade and Festival. Trained community surveyors used electronic and paper survey instruments in bars (n = 6 ) in three WV cities and community events associated with the WV Pride Parade and Festival. We analyzed results from 386 completed surveys from self-identified LGB individuals. Tobacco use among LGB bar patrons and LGB attendees at Pride-affiliated events was elevated (45%), as was current cigarette use (41%). Users of cigars and chewing tobacco were frequently dual users of cigarettes, with 80% and 60% reporting dual use, respectively. A substantial disparity likely exists in tobacco use among LGB West Virginians. Targeted interventions addressing tobacco use among LGB West Virginians are warranted in these venues, and the addition of a demographic question on sexual orientation would improve data collection and monitoring of this disparity.

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  • How many people are lesbian, gay, bisexual, and transgender?

    by Gary J. Gates, Williams Distinguished Scholar

    The Williams Institute

    April 2011



    Executive Summary

    Increasing numbers of population-based surveys in the United States and across the world include questions that allow for an estimate of the size of the lesbian, gay, bisexual, and transgender (LGBT) population. This research brief discusses challenges associated with collecting better information about the LGBT community and reviews eleven recent US and international surveys that ask sexual orientation or gender identity questions. The brief concludes with estimates of the size of the LGBT population in the United States.

    Key findings from the research brief are as follows:

    *An estimated 3.5% of adults in the United States identify as lesbian, gay, or bisexual and an estimated 0.3% of adults are transgender.

    *This implies that there are approximately 9 million LGBT Americans, a figure roughly equivalent to the population of New Jersey.

    *Among adults who identify as LGB, bisexuals comprise a slight majority (1.8% compared to 1.7% who identify as lesbian or gay).

    *Women are substantially more likely than men to identify as bisexual. Bisexuals comprise more than half of the lesbian and bisexual population among women in eight of the nine surveys considered in the brief. Conversely, gay men comprise substantially more than half of gay and bisexual men in seven of the nine surveys.

    *Estimates of those who report any lifetime same-sex sexual behavior and any same-sex sexual attraction are substantially higher than estimates of those who identify as LGB. An estimated 19 million Americans (8.2%) report that they have engaged in same-sex sexual behavior and nearly 25.6 million Americans (11%) acknowledge at least some same-sex sexual attraction.

    *Understanding the size of the LGBT population is a critical first step to informing a host of public policy and research topics. The surveys highlighted in this report demonstrate the viability of sexual orientation and gender identity questions on large national population-based surveys. Adding these questions to more national, state, and local data sources is critical to developing research that enables a better understanding of the understudied LGBT community.

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  • How Secondhand Smoke Affects the Brain

    Secondhand smoke has a direct, measurable impact on the brain similar to what’s seen in the person doing the smoking, according to a new study. The finding highlights the importance of limiting exposure to secondhand smoke in cars and other enclosed spaces.

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  • Idaho Tobacco Prevention and Control Program

    LGBT Health Assessment Survey

    Final Survey Report 2004

    During the Spring of 2003, the Idaho Tobacco Prevention and Control Program (TPCP) contracted with United Vision for Idaho (UVI) to conduct a statewide survey of lesbian, gay, bisexual, and transgender individuals to assess the impact of tobacco use within this community. In addition to asking about tobacco-use related behaviors, the survey collected data on a wide range of health-related issues that are of concern to the LGBT community at large.

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  • Internalized Homophobia and Substance Use Among Lesbian, Gay, and Bisexual Persons

    Authors: Dean M. Amadio & Y. Barry Chung

    Journal of Gay and Lesbian Social Services, Vol. 17(1) 2004

    The purpose of the study was to determine the relationship between internalized homophobia and use of alcohol, marijuana, and cigarettes, as well as problems associated with alcohol and general substance use. Participants were 207 lesbian, gay, and bisexual persons recruited at a gay pride festival in Atlanta, GA. Significant negative correlations were found for females between internalized homophobia and lifetime use of alcohol, marijuana, and cigarettes, as well as monthly use of marijuana. No significant relationships were found for males. Research and practical implications are discussed.



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  • Is smoking tobacco an independent risk factor for HIV infection and progression to AIDS? A systemic review

    Furber AS, Maheswaran R, Newell JN, Carroll C.

    Sex Transm Infect. 2007 Feb;83(1):41-6. Epub 2006 Aug 21.


    OBJECTIVES: To systematically review the evidence of the relation between smoking tobacco and HIV seroconversion and progression to AIDS.

    METHODS: A systematic review was undertaken of studies to look at tobacco smoking as a risk factor for either HIV seroconversion or progression to AIDS.

    RESULTS: Six studies were identified with HIV seroconversion as an outcome measure. Five of these indicated that smoking tobacco was an independent risk factor after adjusting for important confounders with adjusted odds ratios ranging from 1.6 to 3.5. 10 studies were identified using progression to AIDS as an end point of which nine found no relation with tobacco smoking.

    CONCLUSIONS: Tobacco smoking may be an independent risk factor for HIV infection although residual confounding is another possible explanation. Smoking did not appear to be related to progression to AIDS although this finding may not be true in developing countries or with the longer life expectancies seen with highly active antiretroviral therapy.



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  • Is tobacco a gay issue? Interviews with leaders of the lesbian, gay, bisexual and transgender community.

    By Naphtali Offen, Elizabeth A. Smith & Ruth E. Malone at the
    School of Nursing, University of California San Francisco, USA

    This study examined the extent of tobacco industry funding of lesbian, gay, bisexual and transgender (LGBT) organisations and whether leaders of these organisations thought tobacco was a priority health issue for their community.

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  • LESBIAN, GAY, BISEXUAL, AND TRANSGENDER (LGBT) COMMUNITIES AND SMOKING

    Legacy for Health Factsheet on LGBT Smoking

    March 2011

    About:
    The prevalence of tobacco use among LGBT populations has not been adequately examined as national and most state surveys on tobacco lack questions about sexual orientation and gender identity. Further research is needed to understand the prevalence of tobacco use and the risk factors that influence LGBT smoking behavior, in particular in the transgender community.

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  • LGBT Companion Document to HP 2020

    The U.S. Department of Health and Human Services took an important step as they unveiled Healthy People 2020 (HP2020), the blueprint for national public health prevention and policy goals for the next decade. For the first time LGBT (lesbian, gay, bisexual and transgender) health is recognized and there is clear acknowledgement that LGBT individuals experience health disparities that affect their health status.

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  • LGBT/ HIV and Tobacco Survey Report
    (Tobacco Prevention & Cessation Program, Arkansas)

    Smoking is the leading cause of preventable illness and death in the country. It is the primary cause of two of the deadliest lung diseases: lung cancer (which causes more American deaths than any other cancer), and chronic obstructive pulmonary disease (COPD), the fourth leading cause of death in the nation. Since the smoking rate within the Lesbian, Gay, Bi-Sexual, and Transgender (LGBT) community is roughly double that of the general population, members of the LGBT community are at greater risk of contracting and suffering from other tobacco-related health threats such as heart attacks and strokes1. In order to better understand the root causes of the more prevalent use of tobacco in the LGBT community and find effective solutions to this deadly threat, the Arkansas Department of Health (ADH) Tobacco Prevention and Cessation Program (TPCP) developed an online survey to be completed by LGBT support organizations between October 19 and November 15, 2010.

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  • LGBTs of Color Sampling Methodology

    This report is the result of a collaborative effort that began in the Fall of 2006 with a meeting sponsored by the Tobacco Research Network on Disparities (TReND), California’s Tobacco Related Disease Research Program (TRDRP), the National Cancer Institute (NCI), and the American Legacy Foundation.

    The purpose of this meeting was to identify effective sampling methodologies and generate experience-based recommendations for conducting tobacco-related research on lesbians, gays, bisexuals and transgenders (LGBTs) of Color.

    The report provides a brief overview of the problem of tobacco use among LGBTs and minority racial and ethnic groups, highlights the discussions and lessons learned from some of the most advanced researchers in this challenging field, and lists key research recommendations to help eliminate tobacco-related health disparities.

    Please visit the link to download a PDF of this groundbreaking report

    view link
  • National Lesbian Health Care Survey: Implications for Mental Health Care

    J Consult Clin Psychol. 1994 Apr;62(2):228-42.

    Bradford J, Ryan C, Rothblum ED.
    Center for Public Service, Virginia Commonwealth University, Richmond 23284.

    Abstract
    This article presents demographic, lifestyle, and mental health information about 1,925 lesbians from all 50 states who participated as respondents in the National Lesbian Health Care Survey (1984-1985), the most comprehensive study on U.S. lesbians to date. Over half the sample had had thoughts about suicide at some time, and 18% had attempted suicide. Thirty-seven percent had been physically abused as a child or adult, 32% had been raped or sexually attacked, and 19% had been involved in incestuous relationships while growing up. Almost one third used tobacco on a daily basis, and about 30% drank alcohol more than once a week, 6% daily. About three fourths had received counseling at some time, and half had done so for reasons of sadness and depression. Lesbians in the survey also were socially connected and had a variety of social supports, mostly within the lesbian community. However, few had come out to all family members and coworkers. Level of openness about lesbianism was associated with less fear of exposure and with more choices about mental health counseling.

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  • National Transgender Discrimination Survey Report on Health and Health Care

    Findings of a Study by the National Center for Transgender Equality and the National Gay and Lesbian Task Force
    By Jaime M. Grant, Ph.D., Lisa A. Mottet, J.D., and Justin Tanis, D.Min.
    With Jody L. Herman, Ph.D., Jack Harrison, and Mara Keisling
    October 2010

    This survey examines Access to Care, HIV/STD prevelance, substance and alcohol use, suicidal ideation and topics surrounding gender transition.

    download file
  • Occasional smoking in college: Who, what, when and why?
    by Amy E. Browna, Matthew J. Carpentera, Erin L. Sutfin

    The majority of college students who smoke do so on an occasional basis and generally do not define themselves as smokers. This represents a considerable challenge for public health efforts to prevent escalation of use and to promote cessation. Strengthening such efforts will require further examination of the motivations behind occasional smoking within this vulnerable group.

    download file
  • Ohio's LGBT Focus Group Transcript
    July 2006

    The Institute for Local Government Administration and Rural Development (ILGARD), part of Ohio University’s Voinovich Center for Leadership and Public Affairs, gathered data through focus group discussions on the awareness, experience, and perspective of 13 population groups about tobacco use and prevention. The focus group transcripts for the Lesbian, Gay, Bisexual, and Transgender follows. This project was funded by the Ohio Department of Health and Centers for Disease Control and Prevention. Reports on the
    findings are available through the Ohio Department of Health.

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  • Patterns of cigarette smoking and alcohol use among lesbians and bisexual women enrolled in a large health maintenance organization

    Am J Public Health. 2001 June; 91(6): 976–979.
    E P Gruskin, S Hart, N Gordon, and L Ackerson


    OBJECTIVES: This study compared the prevalence of cigarette smoking and alcohol use among lesbians and bisexual women with that among heterosexual women. METHODS: Logistic regression models were created with data from an extensive member health survey at a large health maintenance organization. Sexual orientation was the primary predictor, and alcohol consumption and cigarette smoking were outcomes. RESULTS: Lesbians and bisexual women younger than 50 years were more likely than heterosexual women to smoke cigarettes and drink heavily. Lesbians and bisexual women aged 20 to 34 reported higher weekly alcohol consumption and less abstinence compared with heterosexual women and older lesbians and bisexual women. CONCLUSIONS: Lesbians and bisexual women aged 20 to 34 years are at risk for alcohol use and cigarette smoking.

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  • Perceived risk for cancer in an urban sexual minority

    Burkhalter JE, Hay JL, Coups E, Warren B, Li Y, Ostroff JS. Perceived risk for cancer in an urban sexual minority. J Behav Med. 2010 Sep 25.


    Abstract
    Lesbians, gay men, and bisexuals are a sexual minority experiencing elevated cancer risk factors and health disaparites, e.g., elevated tobacco use, disproportionate rates of infection with human immunodeficiency virus. Little attention has been paid to cancer prevention, education, and control in sexual minorities. This study describes cancer risk perceptions and their correlates so as to generate testable hypotheses and provide a foundation for targeting cancer prevention and risk reduction efforts in this high risk population. A cross-sectional survey of affiliates of a large urban community center serving sexual minority persons yielded a study sample of 247 anonymous persons. The survey assessed demographics, absolute perceived cancer risk, cancer risk behaviors, desired lifestyle changes to reduce cancer risk, and psychosocial variables including stress, depression, and stigma. Univariate and multivariate nonparametric statistics were used for analyses. The sample was primarily white non-Hispanic, middle-aged, and > 80% had at least a high school education. Mean values for absolute perceived cancer risk (range 0-100% risk), were 43.0 (SD = 25.4) for females, and for males, 49.3 (SD = 24.3). For females, although the multivariate regression model for absolute perceived cancer risk was statistically significant (P < .05), no single model variable was significant. For men, the multivariate regression model was significant (P < .001), with endorsement of "don't smoke/quit smoking" to reduce personal cancer risk (P < .001), and greater number of sexual partners (P = .054), positively associated with absolute perceived risk for cancer. This study provides novel data on cancer risk perceptions in sexual minorities, identifying correlates of absolute perceived cancer risk for each gender and several potential foci for cancer prevention interventions with this at-risk group.


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  • Prevalence and Correlates of Tobacco Use Among a Sample of MSM in Shanghai, China

    Berg CJ, Nehl EJ, Wong FY, He N, Huang ZJ, Ahluwalia JS, Zheng T

    Men who have sex with men (MSM) have higher smoking rates than the general population in the United States, but less is known about smoking among MSM in developing countries. Thus, we examined the prevalence and correlates of smoking among MSM in China.

    Smoking prevalence was 65.9% in this sample. Recent smoking (i.e., in the past 3 months) was significantly associated with lower education, greater alcohol use, and higher LGBIS scores, after controlling for important sociodemographics. Among smokers, smoking ˇÝ10 cigarettes per day (CPD), in comparison with <10 CPD, was related to older age and lower LGBIS scores and marginally related to heavy alcohol use. Heavier alcohol consumption, lower education, and older age were also associated with smoking.

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  • Promoting Health for Transgender Women: Transgender Resources and Neighborhood Space (TRANS) Program in San Francisco

    Am J Public Health. 2005 March; 95(3): 382–384.
    doi: 10.2105/AJPH.2004.040501
    Copyright American Journal of Public Health 2005

    Tooru Nemoto, PhD, Don Operario, PhD, JoAnne Keatley, MSW, Hongmai Nguyen, BS, and Eiko Sugano, MPH

    Transgender women are at high risk for HIV, substance abuse, and mental health problems. We describe a health promotion intervention program tailored to transgender women in San Francisco. The program creates a safe space for providing transgender-sensitive education about HIV risk reduction, substance abuse prevention, and general health promotion. Transgender health educators conduct workshops and make referrals to appropriate substance abuse treatment programs and other services in the community. Evaluation findings indicate that this community-tailored intervention may be an effective way to reach transgender women and reduce sexual risk behaviors, depression, and perceived barriers to substance abuse treatment.

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  • Racial and Ethnic Differences in Current Use of Cigarettes, Cigars, and Hookahs Among Lesbian, Gay, and Bisexual Young Adults

    John R. Blosnich, M.P.H., Traci Jarrett, M.P.H., & Kimberly Horn, Ed.D.

    Introduction:
    Research demonstrates that lesbians, gays, and bisexuals (i.e., LGBs or sexual minorities) smoke more than their heterosexual peers, but relatively less is known about the heterogeneity within LGB populations, namely racial/ethnic differences. Moreover, smoking research on sexual minorities has focused mainly on cigarette smoking, with little attention to other forms of smoking, such as hookahs/water pipes.

    Methods: Using a large national sample of college students, we examined differences by race and sexual orientation in prevalence of smoking cigarettes, cigars/cigarillos/clove cigarettes, and hookahs.

    Results: All LGB racial groups had higher cigarette smoking prevalence than their heterosexual racial group counterparts. Significantly more White and Hispanic LGBs smoked hookahs when compared, respectively, with White and Hispanic heterosexuals.

    Conclusions: Given the higher prevalence of multiple forms of smoking among sexual minorities, the heterogeneity within sexual minority populations and the nuances of multiple identities (i.e., racial, ethnic, and sexual minority), targeted—if not tailored—prevention and cessation efforts are needed to address smoking disparities in these diverse communities. Prevention, intervention, and epidemiological research on smoking behaviors among college attending young adults should take into account other forms of smoking, such as hookah use.


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  • Rates and reasons: disparities in low intentions to use a state smoking cessation quitline.

    Burns EK, Deaton EA, Levinson AH.
    SourceColorado School of Public Health, Aurora, Colorado,

    Abstract
    PURPOSE: Little is known about population-level rates and reasons for low intentions to call the quitline, a widely available evidence-based smoking cessation treatment.

    DESIGN: This study is a secondary analysis of the 2008 Colorado Adult Tobacco Attitudes and Behavior Survey.

    SETTING: This is a population-based telephone survey of adults in Colorado.

    SUBJECTS: Study respondents (N = 1662) included current adult smokers who had heard of the Colorado QuitLine (QL) and did not report that they never intend to quit.

    MEASURES: Outcome measures included intent to call the QL, self-reported reasons for not intending to call the QL, and knowledge of QL services.

    ANALYSIS: Descriptive and multivariate logistic regression analyses were used for each outcome variable. All analyses were weighted for complex survey design to represent the population of Colorado.

    RESULTS: Overall 45.6% of smokers intend never to call the QL. In multivariate analysis, Latinos (odds ratio [OR] = 2.5; 95% confidence intervals [CI], 1.4, 4.7), gay/lesbian/bisexuals (OR = 5.2; 95% CI, 2.4, 11.4), and those with no insurance compared with Medicaid (OR = 3.8; 95% CI, 1.1, 13.0) were most likely to intend never to call the QL. Perceiving no need for assistance (34.8%) was the most common reason for not calling.

    CONCLUSIONS: A majority of smokers have no or weak intentions of ever calling the QL, with variation by subgroup. Reasons for not intending to call can inform targeted media campaigns to increase QL reach.



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  • REPORT ON TOBACCO CONSUMPTION AMONG THE HISPANIC/LATINO LGBT POPULATION

    The National Lesbian, Gay, Bisexual, Transgender (LGBT) Tobacco Control Network and the National Latino Tobacco Control Network (NLTCN) recognize that the burden of tobacco addiction has taken its toll on the LGBT and Hispanic/Latino communities. The purpose of this report is to shed light on the prevalence of tobacco use among Hispanic/Latino LGBTs, patterns, health effects and recommendations for action.

    Two national networks (LGBT and NLTCN) collaborated to produce this part of a report series which is intended as a useful resource for agencies, advocates and researchers
    working on tobacco control initiatives among LGBT and Hispanic/Latino communities.

    With this report we intend to educate and inform researchers, policy advocates and community organizers of the importance
    of addressing Latino Lesbian, Gay, Bisexual and Transgender (LGBT) tobacco disparities. Few studies have focused on the tobacco prevalence, cessation needs, or protective factors that keep Latino LGBT individuals from initiating or continuing smoking. However, given the size of these minority groups, and the health disparities of each, the Latino LGBT is at significant risk due to their double disparity. Due to the known
    disparities and uncertain data on LGBT and Latino LGBT communities, we offer recommendations for researchers, policy makers and community organizations to be more inclusive of Latino LGBT communities.

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  • RESEARCH - Gay/Lesbian Sexual Orientation May Increase Risk for Cigarette Smoking.

    An article in the October 2006 issue of BMC Public Health shows lesbians and gay men may be at increased risk for morbidity and mortality due to higher levels of cigarette and alcohol use.

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  • RESEARCH - Smith EA, Offen N, Malone RE. 2006. Pictures worth a thousand words: noncommercial tobacco content in the lesbian, gay, and bisexual press. J Health Commun. Oct-Nov;11(7):635-49.

    Smoking prevalence in the lesbian, gay, and bisexual (LGB) community is higher than in the mainstream population. The reason is undetermined; however, normalization of tobacco use in the media has been shown to affect smoking rates. To explore whether this might be a factor in the LGB community, we examined noncommercial imagery and text relating to tobacco and smoking in LGB magazines and newspapers. Tobacco-related images were frequent and overwhelmingly positive or neutral about tobacco use. Images frequently associated smoking with celebrities. Text items unrelated to tobacco were often illustrated with smoking imagery. Text items about tobacco were likely to be critical of tobacco use; however, there were three times as many images as text items. The number of image items was not accounted for by the number of text items: nearly three quarters of all tobacco-related images (73.8%) were unassociated with relevant text. Tobacco imagery is pervasive in LGB publications. The predominant message about tobacco use in the LGB press is positive or neutral; tobacco is often glamorized. Noncommercial print images of smoking may normalize it, as movie product placement does. Media advocacy approaches could counter normalization of smoking in LGB-specific media.

    PMID: 17074732 [PubMed - in process]

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  • Romantic attraction and adolescent smoking trajectories

    Addict Behav. 2011 Dec;36(12):1275-81. Epub 2011 Aug 5.
    Romantic attraction and adolescent smoking trajectories.
    Pollard MS, Tucker JS, Green HD, P Kennedy D, Go MH.

    Abstract
    Research on sexual orientation and substance use has established that lesbian, gay, and bisexual (LGB) individuals are more likely to smoke than heterosexuals. This analysis furthers the examination of smoking behaviors across sexual orientation groups by describing how same- and opposite-sex romantic attraction, and changes in romantic attraction, are associated with distinct six-year developmental trajectories of smoking. The National Longitudinal Study of Adolescent Health dataset is used to test our hypotheses. Multinomial logistic regressions predicting smoking trajectory membership as a function of romantic attraction were separately estimated for men and women. Romantic attraction effects were found only for women. The change from self-reported heterosexual attraction to lesbian or bisexual attraction was more predictive of higher smoking trajectories than was a consistent lesbian or bisexual attraction, with potentially important differences between the smoking patterns of these two groups.

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  • Sexual Identity, Sex of Sexual Contacts, and Health-Risk Behaviors Among Students in Grades 9-12 -- Youth Risk Behavior Surveillance, Selected Sites, United States, 2001-2009 (CDC Morbidity and Mortality Weekly Report (MMWR), June 6th, 2011)

    Laura Kann, PhD
    Emily O'Malley Olsen, MSPH
    Tim McManus, MS
    Steve Kinchen
    David Chyen, MS
    William A. Harris, MM
    Howell Wechsler, EdD

    Division of Adolescent and School Health, National Center for Chronic Disease Prevention and Health Promotion, CDC

    Problem: Sexual minority youths are youths who identify themselves as gay or lesbian, bisexual, or unsure of their sexual identity or youths who have only had sexual contact with persons of the same sex or with both sexes. Population-based data on the healthrisk behaviors practiced by sexual minority youths are needed at the state and local levels to most effectively monitor and ensure the effectiveness of public health interventions designed to address the needs of this population.

    Reporting Period Covered: January 2001-June 2009

    Description of the System: The Youth Risk Behavior Surveillance System (YRBSS) monitors priority health-risk behaviors (behaviors that contribute to unintentional injuries, behaviors that contribute to violence, behaviors related to attempted suicide, tobacco use, alcohol use, other drug use, sexual behaviors, dietary behaviors, physical activity and sedentary behaviors, and weight management) and the prevalence of obesity and asthma among youths and young adults. YRBSS includes state and local schoolbased Youth Risk Behavior Surveys (YRBSs) conducted by state and local education and health agencies. This report summarizes results from YRBSs conducted during 2001–2009 in seven states and six large urban school districts that included questions on sexual identity (i.e., heterosexual, gay or lesbian, bisexual, or unsure), sex of sexual contacts (i.e., same sex only, opposite sex only, or both sexes), or both of these variables. The surveys were conducted among large population-based samples of public school students in grades 9-12.

    Interpretation: Sexual minority students, particularly gay, lesbian, and bisexual students and students who had sexual contact with both sexes, are more likely to engage in health-risk behaviors than other students.

    Public Health Action: Effective state and local public health and school health policies and practices should be developed to help reduce the prevalence of health-risk behaviors and improve health outcomes among sexual minority youths. In addition, more state and local surveys designed to monitor health-risk behaviors and selected health outcomes among population-based samples of students in grades 9-12 should include questions on sexual identity and sex of sexual contacts.

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  • Sexual Orientation and Mental and Physical Health Status: Findings From a Dutch Population Survey

    Am J Public Health. 2006 June; 96(6): 1119–1125.
    doi: 10.2105/AJPH.2004.058891
    Copyright American Journal of Public Health 2006

    Objectives. We sought to determine whether sexual orientation is related to mental and physical health and health behaviors in the general population.

    Methods.
    Data was derived from a health interview survey that was part of the second Dutch National Survey of General Practice, carried out in 2001 among an all-age random sample of the population. Of the 19685 persons invited to participate, 65% took part in the survey. Sexual orientation was assessed in persons aged 18 years and older and reported by 98.2% of 9684 participants. The respondents’ characteristics are comparable with those of the Dutch general population.

    Results.
    Gay/lesbian participants reported more acute mental health symptoms than heterosexual people and their general mental health also was poorer. Gay/lesbian people more frequently reported acute physical symptoms and chronic conditions than heterosexual people. Differences in smoking, alcohol use, and drug use were less prominent.

    Conclusions.
    We found that sexual orientation was associated with mental as well as physical health. The causal processes responsible for these differences by sexual orientation need further exploration.

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  • Sexual orientation and tobacco use in a cohort study of US adolescent girls and boys

    Arch Pediatr Adolesc Med. 2004 Apr;158(4):317-22.
    Austin SB, Ziyadeh N, Fisher LB, Kahn JA, Colditz GA, Frazier AL.
    Division of Adolescent and Young Adult Medicine, Children's Hospital, Channing Laboratory, Boston, Massachusetts 02115, USA. bryn.austin@tch.harvard.edu



    OBJECTIVE: To examine sexual-orientation group disparities in tobacco use in adolescent girls and boys.

    DESIGN: Survey data from 10685 adolescent girls and boys participating in 1999 in the Growing Up Today Study were examined cross-sectionally.

    SETTING: Community-based population of adolescents living throughout the United States. Main Outcome Measure Prevalence of tobacco use.

    RESULTS: Ninety-two percent of the participants described themselves as heterosexual (n = 9296), 5% as mostly heterosexual (n = 511), 1% as lesbian/gay/bisexual (n = 103), and 2% as unsure (n = 226). Ages ranged from 12 to 17 years. Compared with heterosexuals, mostly heterosexual girls were 2.5 (95% confidence interval, 1.8-3.5), lesbian/bisexual girls were 9.7 (95% confidence interval, 5.1-18.4), and mostly heterosexual boys were 2.5 (95% confidence interval, 1.4-4.6) times more likely to smoke at least weekly. In contrast, gay/bisexual boys were not more likely to smoke. Findings persisted even when controlling for multiple sociodemographic and psychosocial covariates.

    CONCLUSION: Our findings indicate that mostly heterosexual adolescents of both sexes and lesbian/bisexual girls are at heightened risk for tobacco use.



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  • Sexual Orientation on 2009 YRBS

    James F. Bogden of Healthy Lesbian, Gay, and Bisexual Students Project reviewed jurisdictions that asked high school students about same-sex attraction, same-sex sexual behavior, or sexual identity. Here is a map of the limited number states.



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  • SMOKE-FREE LAWS: REBUTTALS TO SEVEN COMMON CLAIMS BY THE OPPOSITION

    Contents: Opposition Claims, Rebuttals, and Suggested Talking Points
    1) Economic Loss
    2) Not the Government’s Role
    3) Requires Approval by Planning Commission vs. Local Government
    4) Employees Can Decide Where to Work
    5) Smoking Tobacco is Legal
    6) Smoking Laws Divert Attention from More Critical Issues
    7) The Dangers of Secondhand Smoke are Based on Junk Science

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  • SmokeLess LGBT DC Fact Sheet on Smoking and Tobacco

    Tobacco causes 30,000 LGBT deaths in the United States each year. That’s far more than are caused by suicide, far more than hate crimes. Mautner Project invites you to join a renewed coalition, SmokeLess LGBT DC.

    The goal of SmokeLess LGBT DC is to build support in our community and among our allies for improved public policies in the District to help people stop smoking, and to help our young people never start.

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  • Smoking among Lesbians, Gays, and Bisexuals

    Smoking Among Lesbians, Gays, and Bisexuals: A review of literature - American Journal of Preventative Medicine, 2001

    This review attempts to collect estimates of smoking prevalence among lesbian, gay, and bisexual people from the published literature and to compare with general population estimates. The reseach suggests that smoking rates are higher among adolescent and adult lesbians, gays, and bisexuals than in the general population and that steps should be taken to ensure representation of lesbians, gays, and bisexuals in tobacco-use surveillance and to collect data in order to understand the apparent high smoking rates in these groups.

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  • Smoking Cessation Among Women with and at Risk for HIV: Are They Quitting?

    HIV-infected and at-risk women in this cohort have lower smoking cessation rates than the general population. Given the high prevalence of smoking, the high risk of adverse health events from smoking, and low rates of cessation, it is imperative that we increase efforts and overcome barriers to help these women quit smoking.

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  • SOMOS: evaluation of an HIV prevention intervention for Latino gay men

    The Latino Commission on AIDS is proud of the SOMOS home-grown intervention. Unlike other HIV prevention interventions, SOMOS was designed specifically to arm Latino gay men with the tools to understand and combat homophobia. Participants went through work groups focused on culture, stigma, masculinity, identity and community. After the sessions, the participants produced a public event – an ad in a newspaper, a theater event, or a presentation at a community forum – rooted in their awareness and experience. After ten cycles, the 113 participants reported increased social connectedness, increased knowledge about HIV and STDs, and less HIV risk behaviors.



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  • Surgeon General 2010 Clinician Booklet: What to Tell Your Patients About Smoking

    Surgeon General 2010 Clinician Booklet: What to Tell Your Patients About Smoking

    This one-page fact sheet summarizes the findings from How Tobacco Smoke Causes Disease: The Biology and Behavioral Basis for Smoking-Attributable Disease: A Report of the Surgeon General. This fact sheet features smoking-attributable chronic disease information as well as “how to quit” information from the Clinical Practice Guidelines (published by the U.S. Agency for Healthcare Research and Quality). The fact sheet provides simple talking points and key information to help medical providers talk to their patients about quitting tobacco use.


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  • Surgeon General 2010 Full Report: How Tobacco Smoke Causes Disease

    The Biology and Behavioral Basis for Smoking-Attributable Disease

    U.S. Department of Health and Human Services

    A Report of the Surgeon General

    Thursday, December 9, 2010, U.S. Surgeon General Regina M. Benjamin, MD, MBA, released a comprehensive scientific report that details new findings on how tobacco smoke damages the human body and leads to disease and death.

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  • Targeting smoking cessation to high prevalence communities: outcomes from a pilot intervention for gay men

    Targeting smoking cessation to high prevalence communities: outcomes from a pilot intervention for gay men
    Richard Harding, James Bensley and Nick Corrigan
    BMC Public Health 2004, 4:43doi:10.1186/1471-2458-4-43



    Background
    Cigarette smoking prevalence among gay men is twice that of population levels. A pilot community-level intervention was developed and evaluated aiming to meet UK Government cessation and cancer prevention targets.

    Methods
    Four 7-week withdrawal-oriented treatment groups combined nicotine replacement therapy with peer support. Self-report and carbon monoxide register data were collected at baseline and 7 weeks. N = 98 gay men were recruited through community newspapers and organisations in London UK.

    Results
    At 7 weeks, n = 44 (76%) were confirmed as quit using standard UK Government National Health Service monitoring forms. In multivariate analysis the single significant baseline variable associated with cessation was previous number of attempts at quitting (OR 1.48, p = 0.04).

    Conclusions
    This tailored community-level intervention successfully recruited a high-prevalence group, and the outcome data compares very favourably to national monitoring data (which reports an average of 53% success). Implications for national targeted services are considered.



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  • THE ECONOMIC IMPACT OF A SMOKE-FREE BYLAW
    ON RESTAURANT AND BAR SALES IN OTTAWA, CANADA

    The purpose of our study was to determine the impact of this smoke-free bylaw on the taxable sales
    of restaurants and bars in the city of Ottawa

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  • The Health of Lesbian, Gay, Bisexual, and Transgender (LGBT) People: Institute of Medicine (IOM) Summary

    Free Summary

    ISBN: 978-0-309-21061-4, 340 pages, 6 x 9, hardback (2011)

    This summary plus thousands more available at www.nap.edu.

    The Health of Lesbian, Gay, Bisexual, and Transgender (LGBT) People: Building a Foundation for Better Understanding Committee on Lesbian, Gay, Bisexual, and Transgender Health Issues and Research Gaps and Opportunities; Board on the Health of Select Populations; Institute of Medicine

    This report discusses:

    CONTEXT FOR UNDERSTANDING LGBT HEALTH

    CHALLENGES TO CONDUCTING RESEARCH ON LGBT POPULATIONS

    HEALTH STATUS OVER THE LIFE COURSE

    And Provides recommendations

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  • The health of people classified as lesbian, gay and bisexual attending family practitioners in London: a controlled study

    BMC Public Health. 2006; 6: 127.
    Michael King and Irwin Nazareth

    Background
    The morbidity of gay, lesbian or bisexual people attending family practice has not been previously assessed. We compared health measures of family practice attendees classified as lesbian, gay and bisexual.

    Methods
    We conducted a cross-sectional, controlled study conducted in 13 London family practices and compared the responses of 26 lesbian and 85 bisexual classified women, with that of 934 heterosexual classified women and 38 gay and 23 bisexual classified men with that of 373 heterosexual classified men. Our outcomes of interest were: General health questionnaire; CAGE questionnaire; short form12; smoking status; sexual experiences during childhood; number of sexual partners and sexual function and satisfaction.

    Results
    In comparison to people classified as heterosexuals: men classified as gay reported higher levels of psychological symptoms (OR 2.48, CI 1.05–5.90); women classified as bisexual were more likely to misuse alcohol (OR 2.73, 1.70–4.40); women classified as bisexual (OR 2.53, 1.60–4.00) and lesbian (OR 3.13, 1.41–6.97) and men classified as bisexual (OR 2.48, 1,04, 5.86) were more likely to be smokers and women classified as bisexual (OR 3.27, 1.97–5.43) and men classified as gay (OR 4.86, 2.28–10.34) were much more likely to report childhood sexual experiences in childhood. Psychological distress was associated with reporting sexual experiences in childhood in men classified as gay and bisexual and women classified as heterosexual. Men classified as bisexual (OR 5.00, 1.73–14.51) and women classified as bisexual (OR 2.88, 1.24- 6.56) were more likely than heterosexuals to report more than one sexual partner in the preceding four weeks. Lesbian, gay and bisexual classified people encountered no more sexual function problems than heterosexuals but men classified as bisexual (OR 2.74, 1.12–6.70) were more dissatisfied with their sex lives.

    Conclusion
    Bisexual and lesbian classified people attending London general practices were more likely to be smokers and gay classified men were at increased risk of psychological distress in comparison to heterosexual classified people. Increased awareness of the sexuality of people seen in primary care can provide opportunities for health promotion.

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  • The Outing of Philip Morris: Advertising Tobacco to Gay Men

    This case study describes the events surroundingthe first time a major tobacco company advertised in gay media and concludes that the tobacco industry relationship with the gay community is relatively undeveloped, leaving opportunity for early intervention (2003).

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  • The Toronto Rainbow Tobacco Survey:
    A Report on Tobacco Use in Toronto's LGBTTQ Communities

    The Toronto Rainbow Tobacco Survey (TRTS) gathered data from over 3,000 members of Toronto's LGBTTQ communities from April to July 2006, through outreach at LGBTTQ community events and through an online survey. Results were similar to other findings, with the LGBT population smoking at much higher rates. Recommendations include targeting tobacco control efforts at the LGBTTQ population, expanding treatment resources to address the most at-risk communities and conducting further research on the determinants of tobacco use among LGBTTQ communities.

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  • The Trouble With "MSM" and "WSW": Erasure of the Sexual-Minority Person in Public Health Discourse

    Am J Public Health. 2005 July; 95(7): 1144–1149.
    doi: 10.2105/AJPH.2004.046714
    Copyright © American Journal of Public Health 2005

    Rebecca M. Young, PhD and Ilan H. Meyer, PhD

    Men who have sex with men (MSM) and women who have sex with women (WSW) are purportedly neutral terms commonly used in public health discourse. However, they are problematic because they obscure social dimensions of sexuality; undermine the self-labeling of lesbian, gay, and bisexual people; and do not sufficiently describe variations in sexual behavior.MSM and WSW often imply a lack of lesbian or gay identity and an absence of community, networks, and relationships in which same-gender pairings mean more than merely sexual behavior. Overuse of the terms MSM and WSW adds to a history of scientific labeling of sexual minorities that reflects, and inadvertently advances, heterosexist notions.Public health professionals should adopt more nuanced and culturally relevant language in discussing members of sexual-minority groups.

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  • Tobacco Control in Low SES Populations

    A document of Legacy: For Longer Healthier Lives

    September 2010



    The report addresses tobacco use and prevention and cessation resources in low-SES populations. It explores promising evidence-based practices that address tobacco-related disparities. It also features five LEGACY-funded case studies that demonstrate how organizations are addressing these issues: 1) Culturally Tailored Tobacco Cessation and Prevention for Asian America Men (International Community Health Services, Seattle, Washington); 2) Youth Social Media Campaign to Reduce Cultural Tolerance for Tobacco in Rural Maine (CUT the Habit Project, Franklin County); 3) Adapting the 5As Model for Pregnant Smokers in Rural Tribal Communities (Inter-Tribal Council of Michigan, Keweenaw Bay Area); 4) Putting the Spotlight on Commercial Tobacco Use (Indian Health Service Change Tobacco project); and 5) Tobacco Cessation for the Low Income Population (Newark Beth Israel Medical Center, STRIDE-Strategies to Reduce Tobacco Related Illness in the Emergency Department, New Jersey).


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  • Tobacco Control Needs in Colorado

    Tobacco Control Needs of the LGBT Community in Colorado - A Priority Population Statewide Needs Assesment conducted for Colorado STEPP in July 2002. This qualitative data was gathered in order to better understand the needs of the LGBT community in terms of reducing initiation of tobacco use by youth, promoting cessation among both youth and adults, reducing exposure to tobacco smoke and to inform the development of cessation programs.

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  • Tobacco Use Among Missouri LGBTQ 2009

    The Check-Out Project: An Examination of Smoking and Tobacco Attitudes in the LGBTQ Community in Missouri

    This report identifies significant tobacco-related disparities in Missouri's LGBTQ community and provides a broad description of the LGBTQ community with regards to tobacco issues.

    There is a higher rate of smoking and a lower rate of successful cessation. There is a lower level of knowledge of the harmful effects of smoking and exposure to secondhand smoke, and a general lack of awareness of evidence-based cessation treatment options.

    Unfortunately, there is also a significant lack of awareness of the disparities identified in this assessment. The LGBTQ community of Missouri is unaware of these disparities and the health impact of tobacco use.

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  • Tobacco use and cessation among a household-based sample of US urban men who have sex with men

    Am J Public Health. 2005 Jan;95(1):145-51.
    Greenwood GL, Paul JP, Pollack LM, Binson D, Catania JA, Chang J, Humfleet G, Stall R.
    SourceCenter for AIDS Prevention Studies, University of California-San Francisco, 74 New Montgomery St, Suite 600, San Francisco, CA 94105, USA. ggreenwood@psg.ucsf.edu

    Abstract
    OBJECTIVES: We examined tobacco use and cessation among a probability sample of urban men who have sex with men (MSM) living in 4 large US cities.

    METHODS: Of the 2402 men who were eligible for follow-up from a previously recruited probability sample, 1780 (74%) completed tobacco surveys between January and December 1999.

    RESULTS: Current smoking rates were higher for urban MSM (31.4%; 95% confidence interval [CI]=28.6%, 34.3%) than for men in the general population (24.7%; 95% CI=21.2%, 28.2%). Among MSM, 27% were former smokers. A complex set of sociodemographic, tobacco-related, and other factors were associated with cessation.

    CONCLUSIONS: Results support earlier reports that smoking rates are higher for MSM compared with men in the general population. Findings related to cessation underscore the need to target tobacco control efforts for MSM.



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  • Tobacco Use and Interventions among Arizona Lesbian, Gay, Bisexual, and Transgender People

    This study focuses on tobacco use and intervention strategies through surveys, interviews, and focus groups. It was funded by the Arizona Department of Health Services and sponsored by southern Arizona's LGBT community center, Wingspan.

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  • Tobacco Use and Readiness to Quit in Low Income HIV Infected Persons

    Jack E. Burkhalter, Carolyn M. Springer, Rosy Chhabra, Jamie S. Ostroff, Bruce D. Rapkin

    Nicotine & Tobacco Research, Vol. 7, Number 4 (August 2005)

    This article examines the impact of sociodemographic factors on smoking cessation such as HIV impact, age, income, drug use, etc.



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  • Variations in Amenable Mortality--Trends in 16 High-Income Nations

    Background: There has been growing interest in the comparison of health system performance within and between countries, using a range of different indicators. This study examines trends in amenable mortality, as one measure of health system performance, in sixteen high-income countries.

    Methods: Amenable mortality was defined as premature death from causes that should not occur in the presence of timely and effective health care. We analysed age-standardised rates of amenable mortality under age 75 in 16 countries for 1997/1998 and 2006/2007.

    Results: Amenable mortality remains an important contributor to premature mortality in 16 high-income countries, accounting for 24% of deaths under age 75. Between 1997/1998 and 2006/2007, amenable mortality fell by between 20.5% in the US and 42.1% in Ireland (average decline: 31%). In 2007, amenable mortality in the US was almost twice that in France, which had the lowest levels.

    Conclusions: Amenable mortality continues to fall across high-income nations although the USA is lagging increasingly behind other high income countries. Despite its many limitations, amenable mortality remains a useful indicator to monitor progress of nations.

    September 23, 2011
    Authors: Ellen Nolte, Ph.D., and Martin McKee, M.D., D.Sc.
    Journal: Health Policy, published online Sept. 12, 2011
    Contact: Ellen Nolte, Ph.D., RAND Europe, enolte@rand.org
    Summary Writers: Deborah Lorber
    Access to full article: View Article

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  • Voices of the Population Disproportionately Affected by Tobacco Use On: Tobacco Use, Tobacco Control, and the Effects of Tobacco

    Voinovich Center for Leadership and Public Affairs Report sponsored by the Ohio Department of Health

    Qualitative Data Gathering Through Focus Groups on Population Disproportionately Affected by Tobacco Use from 2005-2006. This document includes the studie's methodology, findings, the Focus Group script, the Informed Consent form, and recruitment material.

    Populations including Lesbian, Gay, Bisexual, Transgender as well as African-American, Deaf and hard of hearing, Persons in poverty, Amish, Hispanic/Latino, Refugee/Immigrant, Appalachian Veterans/Current military, Asian, Mentally/physically challenged, Chemically dependent, Native American

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  • West Virginia Lesbian, Gay, and Bisexual Tobacco Survey

    Final Report: August 11, 2010 

    Prepared for: West Virginia Covenant House  

    Prepared by: UNC School of Medicine Tobacco Prevention and Evaluation Program

    This report provides an independent assessment of evidence for a LGB tobacco disparity in WV. This is one of the first and most comprehensive studies of LGB tobacco use in Appalachia.  To identify rates of tobacco use for LGB West Virginians, the UNC Tobacco Prevention and Evaluation Program conducted two pilot surveys of tobacco use in LGB populations at bars and community events.

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  • What makes an ad a cigarette ad? Commercial tobacco imagery in the lesbian, gay, and bisexual press

    J Epidemiol Community Health. 2005 December; 59(12): 1086–1091.
    doi: 10.1136/jech.2005.038760

    E. Smith, N. Offen, and R. Malone

    Objectives: To determine the extent of commercial tobacco imagery in the lesbian, gay, and bisexual (LGB) press.

    Methods: Content analysis of all advertising containing tobacco related text or imagery in 20 LGB community periodicals, published between January 1990 and December 2000.

    Results: 3428 ads were found: 689 tobacco product ads, 1607 ads for cessation products or services, 99 ads with a political message about tobacco, and 1033 non-tobacco ads that showed tobacco (NAST). Although cessation ads were numerically dominant, tobacco product ads and NAST occupied more space and were more likely to use images. NAST almost never had an anti-tobacco message. Formal sponsorship between tobacco and other companies was very rare. Lesbian periodicals had proportionally more NAST and fewer cessation ads.

    Conclusions: Cigarette ads were outnumbered by NAST. Although these ads do not usually show brands, and are unlikely to be the result of formal sponsorship agreements, they may be "selling" smoking. Tobacco control advocates should persuade editors to refuse tobacco product ads and those with gratuitous tobacco imagery.

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  • WPATH Standards of Care for the Health of Transsexual, Transgender, and Gender Nonconforming People

    The overall goal of the SOC is to provide clinical guidance for health professionals to assist transsexual, transgender, and gender nonconforming people with safe and effective pathways to achieving lasting personal comfort with their gendered selves, in order to maximize their overall health, psychological well-being, and self-fulfillment. This assistance may include primary care, gynecologic and urologic care, reproductive options, voice and communication therapy, mental health services (e.g., assessment, counseling, psychotherapy), and hormonal and surgical treatments. While this is primarily a document for health professionals, the SOC may also be used by individuals, their families, and social institutions to understand how they can assist with promoting optimal health for members of this diverse population.

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