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Are sexual minority adults differentially exposed to smoke-free laws and televised anti-tobacco media campaigns compared to the general US population? A descriptive analysis
  1. Andrea R Titus1,
  2. Kristi E Gamarel2,
  3. James F Thrasher3,4,
  4. Sherry L Emery5,
  5. Michael R Elliott6,
  6. Nancy L Fleischer1
  1. 1 Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
  2. 2 Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
  3. 3 Health Promotion, Education, and Behavior, University of South Carolina School of Public Health, Columbia, South Carolina, USA
  4. 4 National Institute of Public Health, Cuernavaca, Mexico
  5. 5 Public Health, NORC at the University of Chicago, Chicago, Illinois, USA
  6. 6 Biostatistics, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
  1. Correspondence to Andrea R Titus, Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI 48109, USA; titusa{at}


Background Sexual minority (SM) (gay, lesbian and bisexual) adults are at higher risk of smoking compared with heterosexual individuals, yet little is known about how the tobacco control policy landscape interacts with sexual orientation smoking disparities.

Methods We conducted a descriptive analysis to explore differential exposure to smoke-free laws and televised anti-tobacco media using two sources of national data from the United States: Census data on same-sex couple households/all households and data on SM adults/all adults from the National Health Interview Survey (NHIS). We combined this information with variables representing the proportion of individuals in each county covered by smoke-free laws (2013–2017), and average county-level exposure to televised anti-tobacco media campaigns (2013–2015). We compared average coverage levels for SM populations to average coverage levels for the broader US population.

Results Between 2013 and 2017, same-sex couple households/SM adults lived in counties with higher levels of smoke-free law coverage compared with all US households/adults for workplaces (Census: 71.3% vs 68.0%; NHIS: 70.7% vs 67.9%) and hospitality venues (Census: 82.3% vs 77.0%; NHIS: 80.5% vs 77.2%). There were no consistent differences in exposures to anti-tobacco media campaigns across datasets.

Conclusions SM adults may be more likely to live in areas with smoke-free laws, compared with the general population. Findings point to the need to examine other potential drivers of smoking in SM populations.

  • disparities
  • media
  • public policy

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  • Contributors NLF and ART conceived and supervised the study. ART completed the analysis and drafted and revised the article. KEG, JT, SLE, MRE and NLF provided feedback on the analysis and contributed to the writing. All authors approved the final version of the paper.

  • Funding Research reported in this publication was supported by the National Cancer Institute of the National Institutes of Health under Award Number R37CA214787. The content is solely the responsibility of the authors and does not necessarily represent the official views of NIH.

  • Disclaimer The findings and conclusions in this paper are those of the authors and do not necessarily represent the views of the Research Data Center, the National Center for Health Statistics or the Centers for Disease Control and Prevention.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.