Deaths from smoking and from HIV/AIDS among gay and bisexual men in California, 2005–2050

Abstract

IntroductionDeaths from HIV/AIDS have long been of concern to the gay community, but less attention has focused on smoking-attributable deaths despite the relatively high smoking rates among gay and bisexual men. This study compared deaths from HIV/AIDS with smoking-attributable deaths among California gay and bisexual men from 2005 to 2050.MethodsSmoking-attributable fractions (SAFs) were estimated using smoking prevalence for gay and bisexual men from the 2011–2014 California Health Interview Surveys and published relative risks of death. Smoking-attributable deaths were calculated by multiplying the SAFs by deaths among gay and bisexual men. Deaths from HIV/AIDS among men who have sex with men was obtained from the California Department of Public Health. Future deaths from smoking and HIV/AIDS were projected using regression equations based on time trends.ResultsFrom 2005 to 2014, smoking caused over 6800 deaths among gay and bisexual men, while nearly 9500 died from HIV/AIDS. Mortality from both causes has been falling, but deaths from HIV/AIDS have been falling more rapidly. Projections suggest that in the mid-2040s, more gay/bisexual men will die from smoking than from HIV/AIDS.ConclusionSmoking will surpass HIV/AIDS as a cause of death among gay and bisexual men in California within a few decades. The lesbian, gay, bisexual and transgender (LGBT) community was highly effective in drawing attention and resources to the fight against HIV/AIDS, saving untold lives by hastening effective treatments. Lessons learnt in the fight against AIDS should be used to help fight the tobacco epidemic.

Perceived Importance of Health Concerns Among Lesbian, Gay, Bisexual, and Transgender Adults in a National, Probability-Based Phone Survey, 2017

“…Our findings suggest that health issues connected to immediate harms (e.g., HIV infection, health services access, violence) are more salient, and therefore perceived as more serious, to SGM adults as compared to health issues associated with more distal harms such as chronic disease. For example, smoking, which is a leading cause of death and disability for U.S. adults and for LGBT individuals (Max et al, 2020), was not generally perceived as a serious health risk to LGBT people.…”

“…For example, SGM populations smoke at much higher rates than other groups (Buchting et al, 2017; Wheldon et al, 2018). As such, tobacco use is a leading cause of death among SGM people given existing disparities (Max et al, 2020). Nonetheless, the disproportionate effect of tobacco use on the SGM community has received scant media attention and is not viewed as an important community issue by community members (Smith et al, 2008).…”

Inoculating Black/African American and LGBTQ Communities Against the Tobacco Industry: The Role of Community Connectedness and Tobacco Denormalization Beliefs

“…Tobacco industry marketing, particularly efforts targeted at Black/African American and LGBTQ youth, perpetuates tobacco-related health disparities (Max et al, 2020(Max et al, , 2022Mendez & Le, 2022). More recent strategies leverage the internet and social media to deliver tailored pro-tobacco content to these vulnerable populations (Cruz et al, 2019;Escobedo et al, 2020;Soneji et al, 2019).…”