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Why LGBTQ More Likely to Smoke: How to Cope

July 20, 2021

Like alcohol and drugs, nicotine offers users an artificial and fleeting sense of calm during stressful moments, so it’s no surprise that those in the LGBTQ community are more likely to smoke than straight people.

“We know that people resort to negative coping skills — such as nicotine, other substances, alcohol, self-harm – to deal with stress and there are significant stresses with identifying as LGBTQ,” said Dr. Laura Saunders, clinical coordinator of The Right Track/LGBTQ Specialty Track at the Institute of Living, part of the Hartford HealthCare Behavioral Health Network.

Stresses can include:

  • Struggles to conceal their true identity from others.
  • Facing existing social stigmas.
  • Fearing rejection.
  • Fearing discrimination.

Statistics from the American Lung Association (ALA) show that one in seven heterosexual/straight people smoke cigarettes compared to one in five identifying as LGB. The number is higher in the transgender community, where 35 percent more smoke than straight people.

The results of a 2019 Centers for Disease Control and Prevention survey of high school students also revealed that twice as many LGB high school students start smoking as straight ones.

“High school is when one’s sexual identity is emerging, so these numbers reflect the stress LGBTQ teens are feeling and their need to cope,” Dr. Saunders said. “Nicotine is mood altering.”

Smoking can also seem like a way to fit in, she said.

“It may seem that everyone else is doing it and they want to feel connected,” Dr. Saunders said.

The problem is that smoking is unhealthy. The ALA reported that 480,000 people die each year from smoking-related diseases, making it the top cause of preventable disease and death globally.

Transgender individuals on estrogen hormone therapy must be even more careful because the combination of estrogen and nicotine increases the risk of blood clots, which can cause a stroke or heart attack.

While she is happy organizations like ALA are breaking down health behaviors by minority status, Dr. Saunders stressed that smokers, especially teens, need to be educated about the risks and shown healthier coping mechanisms, such as:

  • Exercise.
  • Meditating.
  • Art or crafts projects.
  • Playing with children or pets.

“There is also help in connecting socially with others, whether friends or in an organized support group,” Dr. Saunders said.

For more help coping with stress, click here. For help quitting smoking, go to smokefree.gov.