I just don’t get it.
The LGBT community is really good at getting stuff done. We know how to rally behind a cause and act with purpose. In my adult life, we responded to the deadly AIDS epidemic, cleared a path to military service and repealed laws that obstructed marriage equality.
That’s why I am puzzled to see the LGBT community stymied when it comes to battling nicotine addiction and the disproportionate abuse of tobacco products in our midst. Nearly 1 in 4 LGBT adults is a smoker — 23.9 percent for LGBT adults versus 16.6 percent for straight adults, according to a recent CDC report.
Have we not heard that smoking kills? For decades, the media have been broadcasting the dire consequences of tobacco addiction, which raises the user’s risk of lung cancer, heart disease and other ailments. In the U.S., smoking is responsible for 480,000 premature deaths each year, according to the Centers for Disease Control and Prevention. It is one of the leading preventable causes of death. Yet, somehow, the message isn’t getting across. While we are witnessing significant declines in smoking rates in the general population, one-quarter of the LGBT community continues to be hooked.
So, why can’t we quit? It’s hard to get answers, for the simple reason that most national and state tobacco use surveys don’t collect sexual orientation information and often include insufficient numbers of LGBT persons to yield representative results.
Surely LGBT individuals often suffer from stress caused by prejudice and stigma—conditions that are known risk factors for nicotine addiction. Studies show we struggle with societal and quality-of-life disparities that cause or exacerbate stress. These differences include higher rates of homelessness among LGBT youth and shocking rates of violence against transgender individuals, some of which a new CDC study describes in heart-wrenching detail.
These societal factors may illuminate causes of addiction, but they don’t explain the failure to mount a response.
Here’s my theory: While LGBT people are exposed to anti-smoking interventions such as tobacco price increases, smoke-free laws and campaigns in mass media, members of our community may not have equal access to smoking cessation programs and other forms of quitting assistance.
In addition, job-related discrimination and the lack of employment opportunities contribute to the challenges LGBT individuals face in accessing health services. Outright denial of care due to sexual orientation or gender identity have been identified as access barriers in a 2015 brief by the Kaiser Family Foundation.
Conditions can change. The pace of positive momentum for the LGBT community has been nothing short of breathtaking. We must not let the smoking habit take that breath away.
Companies like the one I work for can help through patient support programs, community outreach and other initiatives—some of which we have already begun.
At Pfizer, we understand social and cultural determinants of health care access. We work with healthcare providers, governments and local communities to support and expand access to reliable, affordable health care around the world, especially among communities where nicotine addiction rates are disproportionately high. Going forward, this will be especially important when working with social and sexual minorities, where smoking rates remain high and access to insurance and quality health care are often impaired.
It’s time the LGBT community recognizes that we are now stragglers in the global anti-smoking movement. Maybe we have relied too long on cultural explanations and justifications that enable the quiet killer in our midst. It’s time we exposed the villainy of addiction. Let’s commit to quit.
Sally Susman is executive vice president of corporate affairs at Pfizer.