Smoking experience among lesbian, bisexual and trans women

A study published in Tobacco Control focuses on the smoking experience of lesbian, bisexual and transgender women. While the results show that smoking is experienced by participants as a means of expressing their identity, and as a way of coping with an experience of marginalization and stigmatization, the authors highlight the need to develop an inclusive and adapted cessation policy for these populations.

The study is based on 42 semi-structured interviews with Australian women, smokers or former smokers. Most of the respondents identified as cisgender (30), while a minority claimed a trans (8) or non-binary (4) identity.[1].

Consumption closely linked to the “minority experience”

The LGBTQIA+ community is characterized by a higher than average prevalence of smoking. While this situation can largely be explained by the tobacco industry's targeting strategies, the authors of the study indicate that the phenomenon also finds cultural and psychological explanations, linked to the "minority experience". Indeed, the interviews conducted show that the situations of homophobia and transphobia experienced by some of the respondents can lead them to tobacco consumption, experienced as a way of dealing with negative emotions. While smoking is perceived by some as an aid likely to provide temporary comfort, other respondents see tobacco consumption as a form of self-harm, generally linked to periods of self-rejection and non-acceptance of their identity.

A means of gender expression and community belonging

The various interviews conducted by the researchers also show that smoking is experienced by the respondents as a means of gender expression, or as a form of rebellion against societal and sexual norms. In other words, smoking is for some cisgender women a way of exploring and affirming their gender identity, through the consumption of cigarettes perceived as "elegant", and associated with a feminine world. Conversely, transgender or lesbian people will tend more to adopt smoking as a means of expressing masculinity, and thus defying heterosexual norms. Finally, the study shows that smoking is experienced by the LGBTQIA+ community as a vector of socialization. More specifically, respondents emphasize that smoking allows them to escape a feeling of isolation, tobacco consumption being perceived as an "entry ticket" into a community, offering these people the possibility of living "marginal together".

The need for inclusive cessation policies

The cultural and identity construction of women or the LGBT community around smoking refers to an advertising and marketing strategy of the tobacco industry, seeking to make its products a symbol of freedom and emancipation. As a result, the strong anchoring of smoking in these symbolic universes translates into a high health cost for these populations. Although the study is based on a limited number of respondents, these results are consistent with the lessons of the scientific literature. For the authors, the results of this study highlight in particular the need to develop health messages that are more adapted to the experience and motivations of these audiences.

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[1] Grant R, Mooney-Somers J, McNair R, et al. Psychological, social and cultural influences on smoking among lesbian, bisexual and queer women, Tobacco Control Published Online First: 27 January 2025. doi: 10.1136/tc-2024-059039