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Reaching and Treating LGBT Smokers: The Internet and NRT

Institution: University of California, San Francisco
Investigator(s): Gary Humfleet, Ph.D.
Award Cycle: 2006 (Cycle 15) Grant #: 15RT-0165 Award: $509,201
Subject Area: Tobacco-Use Prevention and Cessation
Award Type: Research Project Awards

Initial Award Abstract
Cigarette smokers have changed over the years, and smoking is now concentrated in special populations. Data indicate that smoking rates are significantly higher among lesbian, gay, bisexual, and transgender (LGBT) populations compared to the general population. LGBT individuals also appear to be at increased risk for experiencing issues, e.g., poor mood, stress, alcohol/drug use, that have been associated with smoking treatment failure in other groups of smokers. Concerns regarding discrimination and stigmatization based on sexual orientation may also inhibit use of mainstream smoking treatment services by LGBTs, particularly those living outside large, urban areas. Technology, such as the Internet, can be an effective method to reach a large number of smokers and may be particularly effective in reaching hidden populations.

In the proposed project, we will adapt an Internet-based smoking treatment developed by our group to further examine the influence of technology-based smoking treatment in this unique group of smokers. Thus, the specific aims of the proposed project are to: 1) evaluate two technology-based smoking cessation treatment interventions, alone and in combination, that have been designed to address the unique needs of LGBT smokers and 2) examine factors that may influence smoking treatment success in this minimally studied group of smokers. 600 participants will be randomly assigned to one of four treatment conditions: a) a mail-based self-help smoking treatment (MSH); b) MSH plus Internet-based smoking treatment; c) MSH plus telephone counseling smoking treatment; and d) MSH plus Internet-based treatment plus telephone counseling treatment.

Before starting the program, all study participants will provide demographic information and answer questions on smoking, nicotine dependence, negative mood, stress and alcohol use. To determine if they are smoking or not, participants will be contacted at 3, 6, and 12 months after starting the program. This data will be used to compare the success rates of the four treatments. We will determine if poor mood, alcohol use and/or other factors influence success in quitting for LGBT smokers. We will also determine if LGBT smokers living in rural areas are more likely to visit and use the Internet-based program’s website more frequently than LGBT smokers living in urban areas.

The long-term goals of this line of work are to develop and evaluate innovative treatments for LGBT cigarette smokers and to understand what influences smoking and treatment success in this group. The study will also provide information on variables related to treatment success and failure, which can be used to further develop and improve strategies to treat nicotine dependence in this population.

The proposed project fits well with TRDRP's research priorities. The project evaluates an innovative treatment for nicotine dependence. The target population, LGBT smokers, is a diverse and understudied group of smokers who have been identified by TRDRP as a research priority. Also in line with TRDRP’s priorities, the project seeks to identify factors that may influence smoking treatment success in this group.