LGBTQ+ People Encounter Barriers to Quitting Successfully

LGBT person at a doctors office

Most people who smoke want to quit, and more than half of them try to do so each year.3 Proven treatments, such as FDA-approved medicines and behavioral counseling, make it more likely that people will quit smoking successfully, but LGBTQ+ people who smoke run into barriers when trying to find and use these treatments:

LGBT person at a doctors office
  • In a national study in 2009-2010, a lower percentage of gay, bisexual, and transgender men (66.7%) were aware of tobacco quitlines than their non GBT counterparts (83.9%), though quitline use was similar.41
  • In a study of smoking adults in one state, lesbian, gay, and bisexual adults who were aware of their state quitline were less likely to report an intention to call the quitline than their heterosexual counterparts.42
  • In 2015, fewer gay, lesbian, and bisexual adults who smoked reported using counseling and/or FDA-approved medication to help them quit than straight adults who smoked (14.5% vs 31.7%).43
    • Guy couple at a table drinking coffee
  • LGBTQ+ people often fear or experience discrimination or disrespect from medical professionals.44 People who are afraid of discrimination from doctors and other health workers are less likely to seek medical care, including preventive screenings. The 2015 U.S. Transgender Survey found that nearly 1 in 4 transgender people (23%) reported avoiding looking for health care they needed in the past year because they were afraid of discrimination or mistreatment on the basis of gender identity.44
  • LGBTQ+ people may rank tobacco use as a lower health priority than other issues that affect the LGBTQ+ community (e.g. HIV/AIDS, hate crimes, suicide).45

Connecting every person who wants to quit with treatment proven to help them quit for good is important for improving people’s health.

Some strategies that states and communities can use are:
clipboard with no smoking symbol

Provide barrier-free, widely promoted coverage for all evidence-based cessation treatments by all types of health insurance.
For example, as of 2018, only 15 state Medicaid programs fully covered tobacco cessation (quitting) services for all enrollees of traditional Medicaid.46

no smoking symbol on drawing of head

Increase access to culturally tailored cessation services.
When it comes to health issues, one size does not fit all. Different people and communities have varying needs and make decisions in different ways. For example, some LGBTQ+ people may think of smoking as a way of rebelling against traditional gender roles.47 Tailored cessation resources and improved access to these resources could be helpful, including acknowledgment that some experiences and stressors associated with smoking may be unique for LGBTQ+ people.48

computer monitor with no smoking symbol

Share health messages that feature LGBTQ+ people and their experiences.
Mass media campaigns are proven to increase smoking cessation, prevent tobacco use initiation, and reduce the prevalence of tobacco use.7,49 However, anti-smoking messages rarely appear in media designed for LGBTQ+ people.48 Anti-commercial tobacco* messaging and mass media campaigns can feature testimonials from LGBTQ+ people.48 CDC’s Tips From Former Smokers® (Tips®) is one example of a campaign that has done this. Educational and outreach campaigns should consistently include and reach out to LGBTQ+ people.44

The term “LGBTQ+” is used on this page to refer to people who are lesbian, gay, bisexual, or transgender, with the plus sign indicating inclusion of people who are queer, questioning, intersex, asexual, or who hold other gender/sex/romantic identities not specifically identified. Many studies cited on this page only looked at certain groups within the greater LGBTQ+ community. When single terms like “gay” or “lesbian,” or acronyms like “LGB” are used on this page, this corresponds with how terms are used in the cited studies. More studies are needed to understand the ways that commercial tobacco and exposure affects other groups in the LGBTQ+ community.
*“Commercial tobacco” means harmful products that are made and sold by tobacco companies. It does not include “traditional tobacco” used by Indigenous groups for religious or ceremonial purposes.
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