Lesbian, Gay, Bisexual, and Transgender Smokers: Correlations with External Health Control, Health Expectations, and Shame-Focused Coping Strategies

Abstract

Cigarette smoking is a major health concern in the lesbian, gay, bisexual, and transgender (LGBT) community. This study explored if LGBT smoking heaviness was predicted by the cognitive strategies of external health control, health expectations, avoidant shamefocused coping, and attack self shame-focused coping. Differences were assessed across LGBT identification and nicotine dependence status. Results indicated external health control significantly predicted heaviness of smoking over and above age and education. Shame-focused coping strategies correlated to heaviness of smoking, external health control, and health expectations. Transgender identity associated to earlier smoking initiation compared to lesbians and gay men. Implications for clinicians and researchers are presented.

LGBT friendly healthcare providers’ tobacco treatment practices and recommendations

“…While some correlates of smoking such as craving, lack of smoking bans, presence of other smokers, outside location, and seeing triggers have been identified in both the general and sexual minority population; other correlates are specific to LGBT populations such as being at a bar and the number of smokers present . Shame and external locus of health control have also been correlated with LGBT smoking . Behavior change techniques to promote smoking cessation should be built upon a foundation of affirmation and acceptance and employ motivational interviewing .…”

“…Shame and external locus of health control have also been correlated with LGBT smoking . Behavior change techniques to promote smoking cessation should be built upon a foundation of affirmation and acceptance and employ motivational interviewing . Individual triggers for smoking should be addressed and shame reduction and enhanced self‐esteem and self‐efficacy should be fostered …”

“…Tobacco‐related disparities for sexual and gender minorities are attributable to and impacted by multiple diverse, interrelated, and evolving factors such as the social determinants of health, tobacco industry influence, and the lack of comprehensive tobacco control policies . High rates of smoking by LGBT individuals have been linked, in part, to the stigma and discrimination associated with being a sexual or gender minority . Bränström and Pachankis’ research found that tobacco use cooccurred with psychological distress more often in LGB people than in their heterosexual counterparts.…”

“…9,13 High rates of smoking by LGBT individuals have been linked, in part, to the stigma and discrimination associated with being a sexual or gender minority. 11,[14][15][16][17] Bränström and Pachankis' 14 research found that tobacco use cooccurred with psychological distress more often in LGB people than in their heterosexual counterparts. In another study, LGB and queer/questioning college students who reported frequent experiences of microaggressions in the last year were significantly more likely to report recent tobacco use.…”

Perceived Sex Discrimination Amplifies the Effect of Antagonism on Cigarette Smoking

“…For example, African Americans who perceive racial/ethnic discrimination have greater odds of current smoking (Borrell, Artazcoz et al, 2010;Purnell et al, 2012). The prevalence of smoking also tends to be higher among other minority groups at high risk for discrimination (Greene & Britton, 2012;Lee, Griffin, & Melvin, 2009). Smoking is hypothesized to be one mechanism for coping with discrimination and the psychological distress (e.g., depressive symptoms, anger) that often accompanies such experiences (Purnell et al, 2012).…”