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Smoking in the LGBTQ+ community: why rates are higher
LGBTQ+ people smoke at higher rates than straight and cisgender people. Here’s why, and how to quit in a way that works for you.
Earl Johns, MSN, PMHNP-BC
Board-certified psychiatric nurse practitioner and founder of Wellthy Psychiatry & Wellness
✓ Medically reviewed by Earl Johns, MSN, PMHNP-BC
Photos are illustrative and don’t show actual patients.
LGBTQ+ adults in the US smoke cigarettes at noticeably higher rates than straight and cisgender adults. That’s not a personal failing. It reflects stress, social history and decades of targeted marketing.
Minority stress
Discrimination, rejection and the constant work of staying safe add up. Many people learned to use cigarettes to manage that stress, often starting young.
Targeted marketing
Tobacco companies deliberately marketed to gay communities. In the 1990s, internal documents from one company described a plan to target gay men and unhoused people in San Francisco. Ads in LGBTQ+ media and sponsorship of community events followed for years.
Smoking and mental health
People with depression, anxiety and other mental health conditions are more likely to smoke and often find it harder to quit. They can still quit successfully, especially with medication and support.
Quitting works
Combining a quit medication with counseling roughly doubles the chance of success compared with willpower alone. Free support is available from 1-800-QUIT-NOW (1-800-784-8669), and Kick It California offers free coaching.
A gentle next step
Wellthy Psychiatry offers judgment-free, LGBTQ+ affirming care by telehealth across California. A free 15-minute phone consult is an easy way to see if we’re a good fit.
This article is for general education and isn’t medical advice. If you’re in crisis, call or text 988, the Suicide & Crisis Lifeline, or call 911.
About the author
Earl Johns, MSN, PMHNP-BC
Board-certified psychiatric nurse practitioner · UCSF-trained · Founder of Wellthy Psychiatry & Wellness
Earl provides LGBTQ+ and neurodivergent-affirming psychiatric care, blending medication management, therapy and whole-person approaches. His background includes inpatient psychiatry and community mental health at Glenn County Behavioral Health and Equity Health, a federally qualified health center. He sees clients in San Francisco and by telehealth across California.
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