CHAPEL HILL — Men and women who are gay or lesbian are more likely than their heterosexual counterparts to smoke, according to findings from a review study carried out by the University of North Carolina-Chapel Hill.

Joseph Lee
Joseph Lee

The findings, published in the August issue of the journal, Tobacco Control, show that as many as 37 percent of lesbians and 33 percent of gays smoke. That compares to national smoking rates of 18 percent for women and 24 percent for men in the 2006 National Health Interview Survey.

The authors reviewed findings from 42 studies of the prevalence of tobacco use among sexual minorities in the U.S. published between 1987 and May 2007. The findings suggest smoking is a significant health inequality for sexual minorities.

Recognizing and understanding the increased risk in a particular population can help policymakers, healthcare officials and others provide support for people more likely to start smoking or who may want to stop smoking, said Joseph Lee, lead author of the review and a social research specialist with the Tobacco Prevention and Evaluation Program in the UNC School of Medicine.

A number of small or geographically limited studies have suggested that sexual minorities have higher rates of tobacco use than the general population, said Lee, who conducted the review as a master’s student in collaboration with Cathy Melvin, Ph.D., at the UNC Gillings School of Global Public Health and UNC’s Sheps Center for Health Services Research and Gabriel Griffin, a medical student at the Duke University School of Medicine.

“The underlying causes of these disparities are not fully explained by this review,” Lee said. “Likely explanations include the success of tobacco industry’s targeted marketing to gays and lesbians, as well as time spent in smoky social venues and stress from discrimination.

“Tobacco is likely the number one cause of death among gays and lesbians,” Lee said, “but there is hope. Many gay and lesbian organizations are starting to reject addictive funding from the tobacco industry and the community is organizing itself to address this health inequality through the National LGBT Tobacco Control Network.”

In late February, Lee sent a letter to the Human Rights Campaign questioning its perfect scoring of Winston-Salem’s ReynoldsAmerican, Inc., owner of R.J. Reynolds Tobacco Company, in the organization’s 2009 HRC Corporate Equality Index. In a March 21 Q-Notes story, HRC said the Index scores are not meant to reflect anything other than a company’s treatment of LGBT employees.

Daryl Herrschaft, director of the HRC Foundation Workplace Project, told Q-Notes that the national organization is cognizant of the health-related ramifications of tobacco use. “HRC does not accept sponsorship dollars from tobacco companies because we recognize the harmful effects that tobacco has done, and in some ways its disproportionate effect on our community … We don’t want to play a role in advocating smoking to our membership and to people who come to our events.”

To learn more about the National LGBT Tobacco Control Network and the Tobacco Control journal, visit or

For more information on the study, call Ramona DuBose at the Gillings School at 919-966-7467 or email

Across the nation, initiatives have been established to counter the use of tobacco among the LGBT community. Among them are the Gay America Smoke Out. Visit to find out about the annual non-smoking challenge set in November of each year.

Lainey Millen was formerly QNotes' associate editor, special assignments writer, N.C. and U.S./World News Notes columnist and production director from 2001-2019 when she retired.