Abstract

Background: Tobacco industry documents have revealed marketing plans specifically to reach lesbian, gay and bisexual (LGB) populations. Research supports a causal linkage between receptivity and exposure to tobacco industry marketing and tobacco use uptake among adolescents. Pro-tobacco messages may diminish the effectiveness of tobacco control activities, and contribute to the high smoking prevalence among LGBs.

Objective: To compare receptivity and exposure to tobacco industry marketing between LGB and heterosexual populations.

Methods: Nearly 400 gay or bisexual men and more than 600 lesbian or bisexual women were identified in the 2003-06 Washington State Behavioral Risk Factor Surveillance System (BRFSS), a statewide, population-based telephone survey of adults. The BRFSS included questions measuring receptivity and exposure to tobacco industry marketing. Multiple logistic regression models stratified by gender were used to assess differences for lesbians, gays, and bisexuals separately, in comparison to their heterosexual counterparts.

Results As expected, smoking prevalence was higher among LGBs than among heterosexuals. After adjustment for demographic differences and smoking status, gay and bisexual men reported more exposure to tobacco industry marketing (free sample distribution) than straight men, but were equally receptive to it. Lesbian and bisexual women were both more receptive to and reported more exposure to tobacco industry marketing than straight women.

Conclusion: LGB communities, especially lesbian and bisexual women, appear to be effectively targeted by tobacco industry marketing activities. Strategies to limit tobacco industry marketing, and increase individuals’ resistance to marketing, may be critical to reducing smoking among LGBs.