Francisco O. Buchting, Ph.D.Francisco O. Buchting, Ph.D.Research AdministratorResearch Administrator

Epidemiology, Policy & Economic SciencesEpidemiology, Policy & Economic Sciences

Tobacco-Related DiseaseResearch Program

LGBT Communities and Tobacco:LGBT Communities and Tobacco:History, Knowledge Gaps, and ChallengesHistory, Knowledge Gaps, and Challenges

OverviewOverview Research and PolicyResearch and Policy In the beginning . . . In the beginning . . . Key milestones and Key milestones and

Knowledge gapsKnowledge gaps Working with LGBT (of Working with LGBT (of

color)color)

SemanticsSemantics

LGBT vs. GLBTLGBT vs. GLBT

Queer or Queer Youth Queer or Queer Youth

Research and PolicyResearch and Policy

Research and PolicyResearch and Policy Research findings are a cornerstone to Research findings are a cornerstone to

making or justifying policy – health, making or justifying policy – health, education, employment, housing, etc …education, employment, housing, etc …

LGBT communities are growing and LGBT communities are growing and increasingly becoming complex increasingly becoming complex Coming out – Queer YouthComing out – Queer Youth FamiliesFamilies Diversity – race/ethnicity, gender, religion, Diversity – race/ethnicity, gender, religion,

immigrationimmigration SESSES TechnologyTechnology

Research and PolicyResearch and Policy Making federal, state, and local Making federal, state, and local

policy for allocating resources policy for allocating resources targeted at specific targeted at specific communities/groups is a communities/groups is a combination of available resources, combination of available resources, politics, group mobilization, data, politics, group mobilization, data, etc.etc. Research data has been used to justify Research data has been used to justify

the increase or decrease in allocation the increase or decrease in allocation of dedicated or targeted resourcesof dedicated or targeted resources

Tobacco ControlTobacco Control A Comprehensive A Comprehensive

ApproachApproachResearch

Education & Intervention

Public Policy

LGBT Communities and LGBT Communities and TobaccoTobacco

“Running Down the Way Up” “Running Down the Way Up”

““In the beginning there was nothing. In the beginning there was nothing.

God said, 'Let there be light!' And there God said, 'Let there be light!' And there was light. was light.

There was still nothing, but you could There was still nothing, but you could see it a whole lot better.”see it a whole lot better.”

Ellen DeGeneres

In the Beginning . . .In the Beginning . . .

In the Beginning . . .In the Beginning . . . Community knowledge vs. scientific Community knowledge vs. scientific

knowledgeknowledge Research enterprise and the studying of Research enterprise and the studying of

LGBT communitiesLGBT communities Findings:Findings:

LGBs smoke at higher rates LGBs smoke at higher rates T rates - community knowledgeT rates - community knowledge Queer youth smoke at higher ratesQueer youth smoke at higher rates LGBTs of color – community knowledgeLGBTs of color – community knowledge

HEALTH DISPARITIESHEALTH DISPARITIES

Research Key Research Key MilestonesMilestones

Prevalence/epidemiologyPrevalence/epidemiology Queer youthQueer youth

Remafedi – (1987), N=29Remafedi – (1987), N=29 Faulkner (1998) & Garofalo (1998), Faulkner (1998) & Garofalo (1998),

MA Youth Risk Behavior SurveyMA Youth Risk Behavior Survey Paul (study ended 2004), qualitativePaul (study ended 2004), qualitative Youth Risk Behavior Surveillance, 2003; MMWR Youth Risk Behavior Surveillance, 2003; MMWR

2004, 53:SS22004, 53:SS2

Higher smoking ratesHigher smoking rates

Research Key Research Key MilestonesMilestones Prevalence/epidemiologyPrevalence/epidemiology

AdultsAdults Bradford (1994) publication, L & B women, Bradford (1994) publication, L & B women,

N=1925N=1925 Stall/Greenwood (1999), G & B men, N=2593Stall/Greenwood (1999), G & B men, N=2593 Skinner & Otis (1996) – L & G, N=1067Skinner & Otis (1996) – L & G, N=1067 CHIS (2003)CHIS (2003) Bye/Gruskin (2005) – TCS, TRDRP – Population Bye/Gruskin (2005) – TCS, TRDRP – Population

base statewide RDD study in CAbase statewide RDD study in CA

Higher smoking ratesHigher smoking rates Ryan et al (2001) – Lit reviewRyan et al (2001) – Lit review

Research Key Research Key MilestonesMilestones

CessationCessation Humfleet – NIDA (funded 2004),Humfleet – NIDA (funded 2004),

TRDRP (funded 2006) LGBT internet cessation TRDRP (funded 2006) LGBT internet cessation studystudy

Tobacco DocumentsTobacco Documents Malone – TRDRP, NCI, (2005 - Smith, Offen, Malone)Malone – TRDRP, NCI, (2005 - Smith, Offen, Malone)

Bar StudyBar Study Moore - TRDRP - LGBT Bars (2004, 2006)Moore - TRDRP - LGBT Bars (2004, 2006)

HIV/AIDS – Higher smoking ratesHIV/AIDS – Higher smoking rates www.gaydata.orgwww.gaydata.org

Sell - Columbia U., Kellogg’s Foundation Sell - Columbia U., Kellogg’s Foundation

Knowledge GapKnowledge Gap

National LGBT Communities National LGBT Communities Tobacco Action Plan (2003)Tobacco Action Plan (2003)

www.ttac.org/lgbt/index.htmlwww.ttac.org/lgbt/index.html Report sections on LGBT research, Report sections on LGBT research,

cessation, policycessation, policy LGBT of Color Sampling LGBT of Color Sampling

Methodology Meeting (to be Methodology Meeting (to be published in 2007)published in 2007)

Knowledge GapKnowledge Gap

Social EpidemiologySocial Epidemiology Disease EpidemiologyDisease Epidemiology Cessation Research/Cessation Research/

NeuroscienceNeuroscience PreventionPrevention PolicyPolicy EconomicEconomic

Tobacco industry Tobacco industry documentsdocuments

Ethnographic/Ethnographic/

AnthropologyAnthropology International International

StudiesStudies Understudied areasUnderstudied areas OtherOther

Research AreasResearch Areas

Research Areas with Research Areas with Little or No ResearchLittle or No Research

LGBT and Tobacco Research AreasLGBT and Tobacco Research AreasWith Hardly Any Ongoing WorkWith Hardly Any Ongoing Work LGBTs of colorLGBTs of color TransgenderTransgender Impact of homophobia – Impact of homophobia –

individual and system levelsindividual and system levels Queer youthQueer youth Tobacco’s health burden on LGBT Tobacco’s health burden on LGBT

communities / health disparitiescommunities / health disparities SHS impact on LGBT communitiesSHS impact on LGBT communities Low SES LGBTsLow SES LGBTs

Tobacco Control in LGBT Tobacco Control in LGBT CommunitiesCommunities

HighlightsHighlights 1990 – Mautner Project, first Lesbian 1990 – Mautner Project, first Lesbian

smoking cessation groupsmoking cessation group 1991 – CLASH founded in SF1991 – CLASH founded in SF Last Drag – community cessation groups Last Drag – community cessation groups 1993 - Home for Little Wanderers’ TEGLY 1993 - Home for Little Wanderers’ TEGLY

(first queer youth cessation program)(first queer youth cessation program) 1994 – Increase TI activity in the LGBT 1994 – Increase TI activity in the LGBT

communities communities 1995 – PM launches “gay vague ad” in 1995 – PM launches “gay vague ad” in

gay publicationgay publication

Parliament ad in Details, Cosmopolitan,Madamoiselle, Penthouse, 1995

Parliament ad in Out magazine,1995

                                         

HighlightsHighlights 1998 - CLASH commissions guide on 1998 - CLASH commissions guide on

Ethical Funding for LGBT & HIV Ethical Funding for LGBT & HIV Community Based OrganizationCommunity Based Organization

2000 - “we the people of PM” ads2000 - “we the people of PM” ads 2002 – 12002 – 1stst LGBT Tobacco Control and LGBT Tobacco Control and

Research SummitResearch Summit 2003 American Legacy funds a number 2003 American Legacy funds a number

of LGBT projects of LGBT projects 2004 – four states add sexual orientation 2004 – four states add sexual orientation

question to Quitline intakequestion to Quitline intake 2006 – 12006 – 1stst smoke free Pride - Santa Cruz, smoke free Pride - Santa Cruz,

CACA

Key MilestonesKey Milestones MeetingsMeetings

““Alive With Pleasure!”, CLASH/CDC, 1996Alive With Pleasure!”, CLASH/CDC, 1996 American Legacy Foundation, DC, 2000American Legacy Foundation, DC, 2000 LGBT Tobacco Summit, SF/CA, 2002 LGBT Tobacco Summit, SF/CA, 2002

(Boston, 2003; Chicago, 2005; DC, 2006) (Boston, 2003; Chicago, 2005; DC, 2006) CDC – LGBT/ATS, GA, 2003CDC – LGBT/ATS, GA, 2003 LGBT National Action Plan, DC, 2003LGBT National Action Plan, DC, 2003 LGBT of Color Sampling Methodology LGBT of Color Sampling Methodology

Meeting, DC, 2006Meeting, DC, 2006 Next summit in Oct. 2007 before NCTOH Next summit in Oct. 2007 before NCTOH

Research ChallengesResearch Challenges

ChallengesChallenges The question or questionsThe question or questions

Depends on purposeDepends on purpose No agreement yetNo agreement yet www.gaydata.orgwww.gaydata.org

Tips on working with LGBT Tips on working with LGBT communities – (LGBT of Color communities – (LGBT of Color Sampling Methodology Meeting, Sampling Methodology Meeting, Ayala presentation and group Ayala presentation and group discussion)discussion)

ResourcesResources National LGBT Tobacco Control National LGBT Tobacco Control

NetworkNetwork LGBT Directory – by TRDRP, LGBT Directory – by TRDRP,

Network, CLASHNetwork, CLASH IndividualsIndividuals CBOCBO ProgramsPrograms

Resource AllocationResource Allocation

Research

Education & Intervention

Policy

Questions are never indiscreet,Questions are never indiscreet,answers sometimes are.answers sometimes are.

Oscar WildeOscar Wilde