Objective: The purpose of this study is to explore the prevalence of Lesbian, Gay, Bisexual, and Transgender (LGBT) smoking prevalence and to identify possible associations between smoking behavior and depictions of smoking presented in visual media programming commonly viewed by these groups.

Background: Recent studies have shown there is a higher prevalence of smoking in LGBT communities (Tang et al., 2004). Approximately 17.8% of adults age 18 or older in the U.S. smoke cigarettes; while, 26.6% - 36.0% of LGBT persons smoke. The Big Tobacco industry has been known to intentionally target sub-groups of the general population, particularly minorities such as African Americans, youth, and the LGBT Community (Washington, 2002).

Methods: This thesis was implemented in two ways, a survey and media review analysis. The survey used gatekeepers to initiate a snowball technique to distribute the survey. The survey collected demographic information on sexual preference, behavioral habits, and knowledge of harms of smoking. The media analysis involved three research assistants who viewed eight movies and 24 TV shows produced in the last 5 years, tallying incidence and evidence of tobacco use.

Results: A total of 78 surveys were completed and 63 met the qualifications, over 18 years of age and was a part of the LGBT community either through self-identification, sexual attraction, or sexual behavior. Of the qualified survey participants, 30.8% were lesbian or gay, 30.8% were bisexual, 21.2% were pansexual, and 15.4% were heterosexual. Approximately 20.6% of participants were current tobacco users and 68.3% of participants had ever used tobacco. Overall LGBT media demonstrated marginally significant higher averages of tobacco incidence than mainstream media (6.98 n = 45 and 2.40 n = 45 respectively; T-Test p = 0.074). There is little difference between tobacco incidence in movies versus TV shows (4.70 n = 23 and 4.69 n = 67 respectively). LGBT TV shows revealed a significantly higher average tobacco incidence than mainstream TV shows (8.71 n = 34 and 0.55 n = 33; Mann-Whitney = 0.003). However, surprisingly, the average tobacco incidence in LGBT movies was significantly lower than mainstream movies (1.64 n = 11 and 7.50 n= 12; Mann-Whitney = 0.011).

Conclusion: There is a higher rate of tobacco use in the LGBT community. The exact cause for the higher rates are unknown; however, (1) higher stress may induce more tobacco use, and (2) tobacco use in LGBT films could contribute to the increased rates. I uncovered evidence of higher tobacco use in LGBT TV shows, but the opposite in movies. However, I did observe a general trend of higher tobacco use overall in LGBT media. This is further evidence that tobacco companies may target sub-populations, such as the LGBT community. Education on this type of advertising is likely an effective way to counter the subtle targeting and raise awareness of tobacco use in sexual and gender minority populations. Healthy stress management education may also benefit this population.

Date of publication

Fall 12-14-2016

Document Type




Persistent identifier


Committee members

William Sorensen, Ph.D., Cheryl Cooper, Ph.D., Tasha Dubriwny, Ph.D.


Masters of Science in Health Sciences