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Health Disparities: Tobacco Media and LGBT Tobacco Use

Institution: University of California, San Diego
Investigator(s): Kristen Emory, Ph.D., M.A.
Award Cycle: 2014 (Cycle 23) Grant #: 23FT-0115 Award: $143,935
Subject Area: Disparities /Prevention/ Cessation/ Nicotine Dependence
Award Type: Postdoctoral Fellowship Awards

Initial Award Abstract

This national study explores the relationship between lesbian, gay, bisexual and transgender (LGBT) tobacco use and exposure to, searching for, sharing of, and acceptability of pro- and anti-tobacco messages on traditional and new media. The purpose of this project is fourfold: (a) to explore LGBT exposure to, searching for, sharing of, and preferences for pro- and anti-tobacco messages on new and traditional media, (b) provide reliable population-level estimates of LGBT tobacco use, (c) examine the relationship between LGBT interaction with tobacco messages and tobacco use behaviors, and (d) explore the role of social media in tobacco promotion and control.

Tobacco continues to be the leading cause of preventable death in the United States (US). LGBT populations appear to smoke at much higher rates (25-50%) compared to the US population (18.1%). However, these studies are restricted to the local level, and population-level estimates of LGBT tobacco use are not currently available. Little research assesses LGBT tobacco use beyond cigarette smoking. Of particular interest are novel products such as electronic (e) cigarettes, which are currently heavily marketed by the tobacco industry. The proposed fellowship will fill these significant gaps in the literature by providing national US estimates of LGBT smoking and other tobacco behaviors, with a particular focus on novel and heavily marketed tobacco products.

Tobacco advertising is strongly associated with tobacco use. Exposure to and appeal of tobacco industry (e.g. cigarette) advertising is associated with increased smoking, while tobacco control (anti-tobacco) messages are associated with decreased smoking. The tobacco industry has specifically targeted LGBT populations. LGBT have recently been recognized as an important target for tobacco control, resulting in both national and local campaigns targeting LGBT. However, there has been only limited assessment of these campaigns, and to our knowledge nothing has been done on a national level. Of particular importance is the role of new technologies in communication. Social media is a central part of the mass media and communication process in the US. Despite advertising restrictions put in place to reduce exposure to tobacco industry marketing, there is evidence that tobacco marketing is taking place on social media, which is largely unregulated. However, social media may also be a useful tool for tobacco control, providing a low cost solution to help counter tobacco industry advertising. Research is needed to understand if and how LGBT are currently exposed to, searching for and sharing tobacco-related messages on traditional and social media.

While there is strong evidence that LGBT are at increased risk for tobacco, population level estimates are necessary to confirm this association. This study will compare results in the LGBT population with those of the non-LGBT population, in an effort to provide a better understanding of the scope of the problem. Previous work indicate locations, such as California, with strong tobacco control programs show less tobacco use compared to other localities. However, this relationship has not been confirmed in LGBT populations. To address this gap, the proposed project will compare LGBT tobacco-related media exposure and tobacco use behaviors in California with that of the rest of the US.

This study includes: (a) secondary analysis of Dr. Sherry Emery’s national Tobacco in a Changing Media Environment (TCME) survey (CA154154-01 U01) and (b) analyses of tobacco-related social media content from Facebook and Twitter. We will employ descriptive and adjusted analyses, as well as qualitative content analysis of open-ended questions and social media data.

This study will fill important gaps in the available literature on LGBT tobacco-related health disparities. The findings will provide information that has the potential to inform policy makers, LGBT communities, and tobacco control professionals to help reduce tobacco-related health disparities among LGBT populations.