The Network

for LGBT Tobacco Control

Tips for how to get health promotion messages into LGBT blogs

By Scout
Network for LGBT Health Equity
A project of The Fenway Institute, Boston, MA
Reporting from Netroots Nation LGBT Pre-Conference, Minneapolis, MN

It's a packed room of bloggers and LGBT orgs at the Netroots LGBT Pre-Conf

We all have to build new skills

Remember just last year when many state dept of health folk were blocked from Facebook, Twitter and other social media? Well, perhaps because the feds have set a standard of using social media for their routine promotion work, we all now realize that Facebook, LinkedIn, Twitter… all these are tools we will need to understand and use in order to ace health promotion work in this new era.

Well, despite the fact that you are reading this on a blog, don’t think we’re not as overwhelmed with all these new media as everyone else. We’re trying our hardest to learn how to use these new tools effectively. But boy it’s a lot.

Many of you know, lots of our LGBT print media has already gone out of business, some have switched to an all online format, some have just folded. This struggle is one of the reasons why the print media is really susceptible when folks like RJR Reynolds start pumping SNUS ads. Like happened in Minnesota, it’s often a real challenge to get the magazine or newspaper to refuse these ads in todays world. Face it, this is one of the main reasons why we have to struggle to raise awareness that we have health disparities like our crazy high smoking rate. It’s long past time for us to take some tips from major corporations and start being more savvy about how to get healthy messages integrated into LGBT media. But how do we do it with a fraction of their funding?

So, you know we’re at this Netroots LGBT Pre-Conf today… I’m listening avidly to all the many LGBT bloggers in the room. Let me share a bit of what I’ve learned about smart strategies for getting those healthy messages into LGBT online media.

First, what are the bigger LGBT blogs?

It’s a little hard to figure out exact readership, and some focus more on social versus serious messaging, but at least each of these LGBT blogs should be on our radar screens.

Tips for getting coverage in LGBT blogs

  1. Buy ads in them! Yes, the blogs are absolutely independent, but this is one way to start building a relationship which helps get your news noticed.
  2. Offer to write for a blog. One of the big ones, is actively seeking new contributors now, go on, sign up, one way to get health covered is to write the posts ourselves.
  3. Repost their stories on Twitter/FB, comment on the stories online, just start engaging with them.
  4. Make a short list of the editors of each of those blogs and send them press releases whenever you think somethink is news. Don’t worry if it’s not national, local is ok too. Pics help too.
  5. Give bloggers scoops or first rights to breaking news, this is one fast way to build a relationship.
  6. Write op-eds about health issues and submit them to blogs (customize them for each submission). See some of the op-eds we put up on the IOM report to see a sample of style.
  7. Did I mention buy ads on them? This seems to be a seriously underutilized strategy. Yet some of the blogs above get 40k views/day… that’s a lot of eyeballs we’d like to have reading our health messages, right?

Many of these strategies will work just as well for your local LGBT media as well. And many of them can be real smart strategies for health departments or hospitals to use as a way to demonstrate that your services are LGBT-friendly.

OK, now off I go to try to put some of these strategies into action!

June 15, 2011 Posted by | Action Alerts, APHA, Blogs en español, Break Free Alliance, CPPW, Creating Change, Creating Change 2010, Creating Change 2011, Minnesota, National Coalition for LGBT Health, NatNet, Presentations, Puerto Rico, Resources, Scholarship Opportunity, social media, Steering Committee, Tobacco Policy, two_spirit_wellness, Uncategorized, USSF, USSF_mlp, webinar | , , , | Leave a comment

LGBT Inclusion in Federal Leading Health Indicators

By Scout

Network for LGBT Health Equity

New Institute of Medicine Report on Healthy People 2020 Has LGBT Inclusion

So HHS asked the prestigious Institute of Medicine to come up with leading health indicators for Healthy People 2020 and their report just came out today. We’re poring over all 87 or so pages now but wanted to give you the heads up LGBT people figure prominently in the document.

First, the Institute of Medicine recommends 12 Leading Health Indicators, or measures of the overall nations health be used. These include things like “Proportion of the population with access to healthcare services” and of course our favorite “Proportion of the population using tobacco”.

Then they suggested 24 objectives from all of the many in Healthy People 2020 that are very related to the Leading Health Indicators. Now this is where it gets interesting to us, they noted that 12 of those objectives were particularly relevant to LGBT health disparities.

The 12 Most Important Health Objectives for LGBT People

(The garble at the beginning refers to what HP2020 chapter they are in.)

  • AH 5L: Increase the educational achievement of lesbians, gay men, and bisexual and transgender adolescents and young adults.
  • AHS 1L: Increase the proportion of lesbians, gay men, and bisexual and transgender persons with health insurance.
  • AHS 5L: Increase the proportion of lesbians and transgender persons with a usual primary care provider.
  • HIV 17L: Increase the proportion of condom use among gay or bisexual males aged 15 and above who are sexually active with other men or women.
  • MHMD 4L.1: Reduce the proportion of gay, bisexual or questioning males and females aged 12 to 17 years who experience major depressive episodes (MDEs).
  • MHMD 4L.2: Reduce the proportion of lesbian, gay men, bisexual, and transgender persons aged 18 years and older who experience major depressive episodes (MDEs).
  • NWS 10L: Reduce the proportion of lesbian and bisexual female adolescents who are considered obese.
  • SA 13L: Reduce the proportion of lesbians’, gay males’, bisexuals’, and transgender persons’ past-month use of illicit drugs.
  • SA 14L: Reduce the proportion of lesbian, gay males, and bisexual persons engaging in binge drinking of alcoholic beverages.
  • TU 1L: Reduce tobacco use by lesbian, gay men, and transgender adults.

It’s great that they have identified priority objectives for LGBT people, but they even went further, they talked about data!

The Call for LGBT Inclusion in Health Surveys!

“A major difficulty in examining LGBT health relates to the availability of data for analysis. According to the Healthy People website,11 “Sexual orientation and gender identity questions are not asked on most national or state surveys, making it difficult to estimate the number of LGBT individuals and their health needs.” Therefore, the committee believes HHS should focus on improving and developing datasets that will facilitate analysis of disparities in LGBT health, thereby leading to action that can improve the quality of life and well-being of LGBT populations.” p. 43.

Hear hear, we agree heartily. And face it, if one more government policy doc comes out suggesting LGBT data inclusion, it’s going to be pretty hard to keep excluding us!

Read the whole report on the Institute of Medicine website.

March 16, 2011 Posted by | Uncategorized | , , , | 2 Comments

New Resource: Publication on Lessons Learned from Sexual Orientation Surveillance in New Mexico

by Joseph Lee
Network Steering Committee Member

Is sexual orientation too controversial to ask on state surveys?

No more so than race and weight according to researchers at the New Mexico Department of Health and the University of North Carolina at Chapel Hill (UNC).

In the first look at statewide data over time and in a rural state, Nicole VanKim and James Padilla from New Mexico’s Dept. of Health and Adam Goldstein and myself from UNC compared how often people refused to answer “sensitive” questions about their identity, income, and weight in state surveys from 2003-2008. Income was, by far, the most refused question. People refused to answer questions about sexual orientation at similar levels as race and weight in the state’s Behavioral Risk Factor Surveillance System (BRFSS) survey.

Previous studies looked only at women and healthcare professionals’ willingness to answer questions on sexual orientation or focused in the Pacific Northwest or New England. New Mexico’s results show that sexual orientation questions can easily be part of routine data collection in a rural border state. The authors note that the only reasons for not including sexual orientations are likely political and call on states and the CDC to add sexual orientation questions to document and track health inequalities.

The study is published in the December issue of the American Journal of Public Health.

November 11, 2010 Posted by | Uncategorized | , , , | 1 Comment

HHS Tobacco Strategic Plan Launch: Eyewitness Account & LGBT Inclusion Details

by Scout
Director of National LGBT Tobacco Control Network

1st ever HHS Tobacco Plan!

Reporting from George Washington University Auditorium Launch of the HHS Tobacco Strategic Plan

Houston We Have An Easy-to-Read Liftoff

As your intrepid guy about town, I zipped down to DC to attend the live launch of the first-ever HHS Tobacco Control Strategic Plan. If memories of Healthy People 2010 are leaving you waiting for the shorter movie version of the plan, let me tell you the first piece of important news – this plan is only 21 pages long! So, read away dear ones!

The Launch Party

I get to DC and sure enough, it’s a gathering of the glitterati of the tobacco control world (which of course meant I didn’t know half the folk)… there’s the head of ALA, TFK, ACS, OSH*, BLDDT, CHRK, and ZLWY. (ok, maybe I made a few of those up). And there’s big TV cameras everywhere, like maybe there’s a new all-tobacco-all-the-time set of news channels? Arrayed in the front of the room are posters of all the new tobacco warning ads FDA just announced they are considering. Plus lo, I see the head of another tobacco disparity network, Jeannette Noltenius (the Latino network). We of course bond together, because we are nearly invincible as a team. With a nod to dear ally Rosie Hinson from HHS Assistant Secretary Koh’s office (she was the one who helped make sure there were enough LGBT references in the plan before launch) I sat down and hushed up ready for the show.

Many folk were obviously listening to the actual launch via webcast… so let me just hit a few points that stuck out for me in the launch comments.

HHS Secretary Sebelius explained how tobacco is a big focus for HHS and health care reform, she mentioned the 3 bigger initiatives they’ve taken till now.

The gathered media waiting for the launch party

Big 3 Govt Tobacco Initiatives Before This Plan

  1. Passing FDA oversight of nicotine, which will especially change the warning labels. (finally!)
  2. Investing about $250M in new tobaccoprograms (presumable through Communities Putting Prevention to Work (CPPW) and REACH awards, neither had much LGBT inclusion).
  3. Healthcare reform invests $15B (over years) in new prevention healthcare fund. (This money is expected to take the best practices from 2. and replicate them to other areas.)

Shocking Facts Rattled Off

  • Tobacco costs this country $193B a year in health care and lost productivity costs! ($96B in healthcare costs alone)
  • Tobacco estimated to take 1 billion lives worldwide this century.
  • 1,000 people each day become daily smokers.

    Assist. Secty. Koh rattling off shocking facts, but what is Secty. Sebelius doing?

  • 8 million people in US have chronic diseases stemming from tobacco.
  • Every 10% increase in cigarette costs decreases local smoking rates by 4%. (<- that’s why policy changes are SO hot right now)
  • US Tobacco industry spends $12.5 billion dollars a year in marketing, or $34M a day!

4 Pillars of New Tobacco Plan

  1. Change social norms (including big media campaign to counter last point above)
  2. Improve health (supporting states and communities to continue work like was launched with CPPW awards, or supporting quitlines).
  3. HHS leading by example (such as increasing cessation coverage through medicare and medicaid, both planned rollouts)
  4. Advancing knowledge (like more data collection on priority populations and more research on best practices)

The Goal

According to Assistant Secty Koh, “The goal is to make it as easy to quit a it is to buy a pack of cigarettes.” And of course… they also talked about the other goal of making sure young folk don’t start.

New FDA Tobacco Warnings

So Miguel, the videocam fits in your pocket but the mic needs its own suitcase?

Not sure if lesbians gained control of Congress while I wasn’t looking but in what seems to government by consensus, the FDA has rolled out 36 potential new warning labels for cigarette packages and are taking comments on them until Spring. Then they will pick 9 that will be required to cover the top 50% of front and back of each cigarette pack and top 20% of every tobacco industry advertisement by Sept 2011. Like the FDA Commissioner said… “this essentially makes each pack of cigarettes into a mini billboard for tobacco control.” It’s an interesting note that while the ads are sometimes graphic… it’s not necessarily because they feel adults need to learn the dangers (research has shown most adults know the dangers well), but because they feel it’ll be a deterrent to youth to see (or carry around) something so terribly yucky looking. Interesting. Linda Bailey from North American Quitline Consortium later asked, “why don’t any of the warnings include the national quitline 1-800-QUITNOW?” Good point Linda, maybe folk can suggest that in the comment period.

Open Comments and Other Bloggers

In the comment section Jeanette and I duly stood up and mentioned something about disparity populations. I believe I mostly thanked them then asked another question about elementary school programs (which showed how many were watching online because folk started to email me resources right after I spoke) and Jeannette asked about the importance of racial and ethnic minority community-based work. But then afterwards I hooked up with old buddy Miguel Gomez from Office on HIV/AIDS (who was sporting the biggest microphone I’ve ever seen attached to his flip camera). He runs and seems they are doing buckets of social media interviews and podcasting for, so when he finishes editing them up, I’ll be sure to link them here. And later, we’re hoping they teach us some tricks to get our Youtube channel really rolling. (until then thanks for reading the old school print version!) But I know you’re all waiting for the real news, so let me get right to…

LGBT Inclusion in Tobacco Plan

  • P. 12 CHALLENGES: THE BURDEN OF TOBACCO USE AND BARRIERS TO PROGRESS. “Members of certain racial/ethnic minority groups, individuals of low socio-economic status (SES),pregnant women, and other groups carry a disproportionate burden of risk for tobacco use and tobacco-related illness and death… [last sentence of para] Available evidence also reports very high smoking rates among lesbian, gay, bisexual and transgender populations;however these populations remain underrepresented in current surveillance systems used to monitor tobacco use.”
  • p. 23 STRATEGIC ACTIONS: 4. Advance Knowledge. [bullet 3] “Expand research and surveillance related to high-risk populations (e.g. American Indians/Alaskan Natives and other minority racial/ethnic groups; lesibn, gay, bisexual, and transgender populations; individuals with mental disorders; those of low socio-economic status) to identify effective approaches to prevention and cessation.”
  • P. 24 STRATEGIC ACTIONS: 4. Advance Knowledge. [bullet 4] Expand research andsurveillance that promote the effectiveness of both population- and individual-based cessation interventions and tobacco dependence treatments. [Descriptive subtext] … “In addition there is a need for more evidence of effective cessation interventions for populations such as youth; young adults; pregnant women; low-income smokers; racial/ethnic minorities; lesbian, gay, bisexual and transgender smokers; light or intermittent smokers; and those with comorbidities (particularly mental health and substance abuse disorders).”

That’s all I’ve got for now folk, hope you enjoyed the eyewitness account of the launch!



* ALA = American Lung Association
TFK = Campaign for Tobacco Free Kids
OSH = CDC Office on Smoking and Health
ACS = American Cancer Society

November 11, 2010 Posted by | Uncategorized | , , , , , , | Leave a comment

Eldin the Cabbie: Wellness Policy Savant

by Scout

Stay tuned, Institute over but more posts to come

It’s been a busy week with posting to the blog, but stay tuned, it’s not done. We still have a few more posts to finalize about lessons from the Tobacco & Diabetes Training Institute 2010, and today our team splits forces to head into 2 more meetings, I’ll be up in DC meeting with Secretary Sebelius and members of the new HHS Task Force on LGBT Health, while Gustavo and Emilia stay in Atlanta to attend the all-day tobacco disparity network planning day. So stay tuned for blogs on all.

Eldin the amazing

How did it start? I jumped into the cab to race to the airport and I think my cabbie warned me about his New York style driving but next thing you know he’s launching on a world class high volume rant about how we’re messing up health in this country. Crazy part was, he’s like a policy savant, nailing every single problem us fancy wellness folk are trying to prioritize.

Eldin on city planning for health

“Now New York has it right, in NY you can walk everywhere. Now look at Atlanta downtown, go down after dark, do you see anything? No! And it’s dangerous. They need to build more stores in those big buildings, so people can have something to walk to at night.” Right on Eldin. “And look at it here.” We’re zipping through Atlanta sprawl-lands. “Those people can’t go anywhere without their car. They can’t even walk anywhere at all. Now in New York, you can walk for hours. And do you wanna know how many different juristictions we just went through? Four. All of those places have to agree to do anything new.”

Eldin on exercise

“And what about bicycles? We’re driving through a park right now, you see any people biking or even walking? You used to use your bicycle to go places, but now you have to put it in your car before you can get anywhere safe to bike, and then we don’t, we just don’t even use our parks. Now think if you were in New York City now, how many joggers would you see in Central Park?” I admit, plenty. “Yah, we don’t even use our parks here, it’s such a shame.”

Eldin on diet

“And look around you, have we passed any grocery stores at all?” No sir. “You see, where are you supposed to even get vegetables. Yet you wanna know what’s one block that way? Lines of fast food restaurants all the way into Atlanta. What is that stuff? It’s all fried. There’s no vegetables in it. People don’t even know to eat them any more. That’s why we’re all fat. Now back in Haiti when I was a boy, whenever my mama was pregnant, my grandma would be cooking spinach and greens for months because that made your blood strong. But here, where do you even find them?”

Eldin on tobacco

I tell Eldin one of the tidbits I learned at the training, that part of the aid we sent to Haita after the quake included cigarettes.  He’s incensed, “Like they can eat that? I mean people are going to do what they’re going to do, but we’re growing enough tobacco there already. We used to grow lots of our own food, now other countries keep teaching us how to get rid of our farms and buy things from companies instead. But none of it is healthier!”

“This country is messed up!”

“And it’s going to take a long time to fix!” Eldin finishes with a flourish. He’s gotten all worked up and I sigh thinking, yup, it’s going to take a lot of time to make it simpler for people stuck in the car wilds of Atlanta sprawl to have easy access to routine exercise. Back in my doctoral program I remember wondering why the World Health Organization had Transportation as one of their top 10 social determinants of health, now that link is becoming crystal clear. (I’m not even counting how naïve me thought their listing of Food as another major determinant of health was mostly about famine, not feasting. Ha!)

New health care reform prevention council

But change is afoot from top to bottom here. The passing of health care reform, also known as ACA or Affordable Care Act is setting some big pieces in motion to focus on wellness and prevention nationally. A large step is the creation of a new Prevention Council filled with cabinet members from all over government. And no, it’s not just filled with people from Health and Human Services, but with the head of the EPA, Dept of Transportation, Dept of Agriculture, etc. Folk realize we need changes at all these levels to clear the path to make it easy to be healthy in our country. Nicely, in the first report of this council, they are also naming sexual orientation (crossing fingers for gender identity soon) as a disparity population! So, I’m looking forward to this new top level coordination to change systems and the from-the-getgo inclusion of LGBTs. I know they’re putting together an attached community advisory council, I sure hope we have LGBT health experts on it. And I think we should have Eldin too!

October 7, 2010 Posted by | Uncategorized | , , , , , | 1 Comment

Institute 2010: Tobacco Policy & Health Systems Change

by Scout

While some of this workshop was deep talk from state viewpoint about changing systems, they did do a great review of best strategies for how to get a health care agency to integrate routine cessation interventions. Considering I bet every community has a few LGBT friendly docs with large natural LGBT patient populations, focusing on getting these community-friendly offices to change can probably have a big impact on LGBT smoking status community-wide.

Background: Multi-state Collaborative for Health Systems Change

Who is this? It’s a group of 20 states that have partnered with national groups to pioneer better integration of cessation services into routine health care. See lots of great case studies and tools about this on their website.

How do we integrate better cessation into health care systems? Most current leading edge work is still focused on the basics: getting medical providers to do the AAR, or Ask, Advise, Refer model from the Public Health Guidelines. Referrals these days are often through fax forms to quitline, which allow nice followup contact between quitline & doc.

Entree: Best tips and tricks for getting health care providers to integrate cessation?

Note: This is a real time of change for providers, healthcare reform is going to usher in conversion to electronic health records for all soon, so it’s a great time to address tobacco use well. See some bullets on this at end.

  • Assess current tobacco intervention process (multi state collab has assessment tools on their website)
  • ID clinical and administrative champion (make sure clinical champion is high enough up ladder)
  • See if they have electronic health records for at least 2 yrs (so they’ve worked out bugs) (you can change systems without this but much harder to track change)
  • The newer AAR (Ask, Assist, Refer) intervention is good & takes less time than the old intervention (aka “5As” from the old guidelines).
  • Try to advocate for smoking assessment to be part of vital signs (taken at each visit) versus other medical info (not looked at too often). And it should be required vital sign, not optional.
  • Might not be doc taking vital signs, could be nurses, make sure you have champion there!
  • American Acad of Family Physicians and Amer Acad of Pediatrics have full Ask and Act toolkit for providers to integrate this work into their routine. Lots of templates and resources there, esp for elec health record integration.
  • Have info technology (IT) person at table from start, esp to plan to routinely circulate performance info reports (# smokers identified, # brief interventions, # referrals, by provider). Docs are competitive & like to do well!
  • Train staff, test changes (revise if needed), implement the feedback reports (see sample reports on web)
  • There is new money under healthcare reform to assist many medical practices to convert to electronic health records, I hear $44k per doc.
  • Eventually, healthcare reform changes means docs will get lower medicare and medicaid payments if they don’t have electronic health records that collect key info, like tobacco use.
  • See Federal Health IT website for details on how new electronic records need to meet “meaningful use” guidelines and for local tech support for conversions.

Bonus Tidbit: Best Tobacco Healthcare Reform Briefing Sheet

University of Wisconsin has boiled down the several thousand page Affordable Healthcare Act to 7 pages of what changes for tobacco and when those changes roll out. These folk say it’s the best summary they’ve seen, download it here.

October 5, 2010 Posted by | Uncategorized | , , , | 1 Comment

The Tobacco & Diabetes Training Institute Reports

by Scout, Network Director

This week the whole Network staff team and reps from each state are all down in Atlanta, attending The Institute 2010, a training event for people in tobacco and diabetes. We’ve been to one of these a few years ago, but this is the first time it’s combined with diabetes folk too, so this time it’s a joint production of the Tobacco Technical Assistance Consortium (TTAC) and the Diabetes Training and Technical Assistance Center (DTTAC).

So, since we’re all about linking people and information, watch this week as we keep posting info about what we’ve learned in our courses down here.

Just to start us off, we had an introduction by Dr. Ursula Bauer, the head of CDC’s Chronic Disease Center. As we know from some prior meetings, Dr. Friedan, the new head of CDC, is really taking a strong hand in shaping CDC direction now. Dr. Bauer reviewed the 6 “winnable battles” Dr. Friedan has identified as agency priorities:

  1. tobacco use
  2. nutrition/physical activity
  3. teen pregnancy
  4. iatragenic infections (caused by healthcare)
  5. motorvehicle injury
  6. HIV

Dr. Bauer says, chronic diseases account for nearly 3/4 of the $2 trillion dollars we spend on health care every year. Plus we know nearly every chronic disease is influenced by the 3 pillars of what’s now known informally as “wellness”, that’s tobacco, physical activity, and nutrition. So, right now there’s an increasing emphasis on changing these upstream factors to save some of that cash downstream. That’s right, run that balance sheet and show everyone how doing tobacco control work offers a great return on the healthcare dollar.

As I know we’ve reported before, Dr. Bauer continued to echo the new big emphasis on environmental policy change as a smart strategy for changing the arena. As she aptly noted, an investment in policy change lasts long after the original money is gone. Some of the ones she brought up as smart continue to echo some of the strategies we saw before at the big wellness conference, namely: banning transfats, taxing sugar sweetened beverages, increasing tobacco taxes, bolstering clean air laws, building better walking/biking options. She talked a lot about building structures that support health. As Dr. Bauer says, “Right now our communities are designed for disease. It’s unreasonable to expect people will change behaviors when so many social and cultural factors conspire against them.” (I believe part of that was a quote of B. Smedley).

I know I’m not alone in loving this larger persepective on structures to support health. Every time I’m at a conference on health, I struggle as a vegetarian to even get reasonable food to eat. And last time I was down here at the CDC wellness conference, I was biking on some of the overcongested streets to the local health store and a driver leaned out their window and yelled, “See you in the emergency room!”. Which, considering the 18″ rut that was my bike lane, I thought wasn’t terribly far fetched. So, again, loving this bigger perspective on real health and I for one can’t wait until we all do enough work to see more of those ground level changes. Just even 12 more inches of them!

Watch for more reports from the team about other things we learn at the Institute in the next few days.

Director, Network for LGBT Tobacco Control

Bookmark and Share

October 5, 2010 Posted by | Uncategorized | , , , | Leave a comment

Deconstructing a Disparity: Association of Violence and Discrimination with Smoking Among Sexual Minority Youth Adults

This afternoon, I attended some intriguing presentations from the Population Center’s Summer Institute graduates. Among them, John Blosnich, PhD candidate of Public Health Sciences at West Virginia University stuck out as a researcher looking into violence and discrimination within the context of LGB youth smoking rates. In his presentation, titled:  “Deconstructing a Disparity: Association of Violence and Discrimination with Smoking Among Sexual Minority Youth Adults,” John discusses the hypothesis that minority stress (including homophobia, alcohol abuse, depression, disclosure and bullying) may impact smoking rates among LGB youth–specifically, with regarding minority stress, how sexual minorities use tobacco as a strategy to deal with stress.

Using the National College Health Assessment Survey Fall 2008/Spring 2009 data, John identified the variables victimization, discrimination and tobacco use in comparing gay, lesbians and bisexuals with heterosexuals. As expected, GLB youth experienced not only higher rates of smoking but also higher rates of sexual assault, discrimination, physical assault and threats. However, despite higher rates of all of these factors, higher rates of discrimination and assault did not translate into higher smoking rates. In other words, discrimination and other minority related negative experiences did not affect smoking rates in this sample.

As a result of these findings, John plans to look at resiliency as a factor in why LGBT people who experience discrimination don’t smoke. In addition, he plans to look more closely at gender and race within this context. We are very excited to follow the progress of John’s research project to see what his research yields. Stay tuned for some information, and for more information or to discuss the project, please email him.

by Emilia Dunham

Program Associate with the Network for LGBT Tobacco Control

Bookmark and Share

August 20, 2010 Posted by | Uncategorized | , , , , , | Leave a comment

New Fed Regulations Media Tools to Educate on “Mild” Tobacco

(From our Friends at the CDC)

CDC’s Office on Smoking and Health (OSH) and the Food and Drug Administration (FDA) are working to educate consumers, public health partners, and the general public about new tobacco regulations that took effect July 22, 2010. These regulations prohibit the tobacco industry from distributing or introducing into the U.S. market any tobacco products for which the labeling or advertising contains the descriptors “light,” “low,” “mild,” or any similar descriptor, irrespective of the date of manufacture. However, consumers may continue to see some products with these descriptors for sale in stores after July 22 because retailers are permitted to sell off their inventory.

OSH has developed several Web-based and social media materials to get the word out about these latest FDA tobacco regulations. Following are suggestions communicated to states and partners on how they can further support this communication effort.

  • Post the new “Light/Low/Mild: No such thing” graphical button on your Web site. When clicked, this button will take visitors to newconsumer-focused information entitled “No More “Light,” “Low,” or “Mild” Cigarettes.” This information provides a summary of the July 22 regulations, the public health impact, and links to key resources, including a new, expanded feature article by the same title posted on CDC’s Web site.
  • Encourage others to send Health-e-Cards emphasizing the value of being tobacco-free. See the new animated Health-e-Card that reiterates there’s no such thing as a safe cigarette.
Put Out the Myth on Light, Low, Mild. Flash Player 9 or above is required.
  • Inform others of anew widget located on FDA’s Tobacco Products Web site. A widget is an application that enables users to embed content from another Web site onto their Web site. As content gets updated on the source site, it’s automatically updated on the user’s site. This particular widget enables readers to embed regulation information from FDA’s Tobacco Products Web site, health information from OSH’s Smoking & Tobacco Web site, and quit information from NCI’s Web site.
  • Follow CDCTobaccoFree on Twitter and retweeting new messages related to the July 22 FDA tobacco regulations.
  • Become a fan of CDC’s Facebook page and posting new“Light/Low/Mild: No such thing” status updates on your Facebook profiles.
  • Tell others about our new posting on CDC’s Everyday Health Widget (coming soon).
  • View OSH’s new entry on CDC’s MySpace page.
  • Follow OSH on GovLoop. GovLoop is a social networking site for the government community. It currently serves about 30,000 members, including local, state, and federal government employees and contractors. Academics and students interested in government are also welcome to join.
  • Subscribe to CDC’s Smoking and Tobacco Use main feed to receive updates of new and recently changed content from CDC’s Smoking & Tobacco Use Web site on your browser or desktop.
  • Continue to access CDC’s Smoking & Tobacco Use Web site for helpful resources and the latest information.
Tobacco Control State Highlights 2010 Widget. Flash Player 9 is required.

We hope you find this information to be helpful as you plan your communication campaigns. If you have any questions, please contact Patti Seikus ( in OSH’s Health Communications Branch.

July 27, 2010 Posted by | social media, Tobacco Policy | , , , | Leave a comment

HIV and Tobacco Webinar: Lessons Learned

Yesterday the Network co-hosted a great webinar with the National Youth Advocacy Coalition, examining the relationship between HIV and tobacco.  With over 50 participants, the information disseminated and discussions articulated was a fascinating opening dialogue.

Some really interesting facts I learned:

  • Smokers are contracting HIV faster than the general population: About two-to-three times faster actually, with 50-70% of HIV-positive individuals using tobacco.  HIV-positive men-who-have-sex-with men (MSM’s) are two times more likely to smoke than HIV-negative MSM’s.  This can be contributed to oral ulcerations caused by tobacco use, more minority-related stress, and the higher incidence of risky behaviors with smokers generally.
  • Smokers are developing AIDS faster than HIV-positive individuals overall:  With anti-retrovirals (ART’s) today, HIV is considered to be a chronic illness rather than a death sentence. But if you use tobacco, that notion decreases. Smoking can interfere with the processing of  anti-retrovirals (ART).  The liver processes the 4,000 chemicals ingested from cigarette smoke as well as the ART medications…and the liver always chooses the tobacco first. Tobacco also reduces immune function, increasing the susceptibility to opportunistic infections (OI’s).  One of the OI’s, Mycobacterium Avium Complex or MAC, is actually found IN the cigarette paper, active even when it burns down to the filter.
  • HIV-positive smokers are dying from tobacco-related illnesses rather than AIDSl: Consequences of smoking such as cardio-vascular disease and liver issues can kill you before AIDS can, influencing 53% of all AIDS moralities.  Studies have shown that quitting smoking does more to reduce cardiovascular attack risk in HIV-positive patients than ANYTHING else, including changes in ART regimens.  You can also be on less ART ‘s because your liver will have to digest less chemicals.  Less tobacco and less medications means you will be saving your body and a combined total of $5500 a year to be a smoker on ART’s.
  • HIV-positive smokers have a harder time quitting than tobacco users overall: Not only do HIV-positive people face increased tobacco use and effects, but their ability to quit is compromised as well. HIV-positive individuals have higher relapse rates and lower quit attempts…even though they need to quit and want to quit! Providers frequently have the perception that people living with HIV have enough on their plate as is, so why try and get them to quit if the self-medicating helps them with the stress of the disease. In turn, the provider feels uncomfortable addressing the issue. However, if patients don’t know the negative impacts of tobacco, how can they make educated decisions about whether or not they want to quit?

Helping to Quit: Lessons Learned

Barbara E. Warren, Psy.D.

Danielle Grospitch, CTTS

Danielle Grospitch, a certified tobacco treatment specialist and HIV educator, gave some great insight on how to aide HIV-positive smokers in quitting. There seems to be a success in numbers when it comes to cessation in positive communities rather than individual support.  Be careful if you use nicotine replacement therapy (NRT) in treatment. While it is covered by Medicaid in most states, cessation medications like Zyban can interact with protease inhibitors. For longer-term success, behavioral modification techniques such as cognitive behavioral therapy are more effective than NRT.

An example of a program that has all the above components is the first east-coast LGBT/HIV-positive support group to address tobacco cessation overall.  Apart of the LGBT center of New York City for 22 years, presenter and psychologist Barbara Warren helped to find all mental health and social services for the center, including the LGBT Smokefree project. The most interesting component of the case study I found was supporting the ambivalence of cessation. If your client is not ready to quit, that’s okay. Videos like the one below featuring “Mercedes Maybe”  allows individuals to explore their ambivalence about quitting, aiding them to quit when they feel its right and increasing their ability to quit successfully.

Videos are also great ways to get youth and young adults to think about quitting as well.

While incentives were found to be helpful to recruit and maintain people in the group, extrinsic motivations were replaced with intrinsic motivation by the end. 50% of the individuals who graduated from the program wanted to donate their final incentive back to the center because they were so grateful for being able to quit. Barbara found that the most important attribute for a group facilitator is  to be an ex-smoker, proclaiming that status allowed her to connect with the group members even though she was not HIV-positive or LGBT-identified.

Suggestions on what you can do to help:

  • Ask, Advise, Refer: Providers need to be asking and advising HIV-positive smokers, and feel comfortable doing so. Three simple steps will send the person in the right direction: ask if they use tobacco, advise them to quit, and refer them to the appropriate program.
  • Collaborate:  Collaborating with other local tobacco efforts can decrease costs and resources. If you are interested in funding opportunities, make sure to sign-up for our discussion listserv on our homepage,, to learn about new tobacco RFP’s in your state.
  • Accessibility: If you are going to start a peer-led support group, providing the meeting at an easily accessible location by public transportation and in a comfortable environment like an LGBT center is helpful.
  • Following the leader: Howard Brown Health Center and the University of Chicago have just finished four focus groups examining smoking cessation in HIV-positive, African-American MSM’s. The major theme that emerged was that being an ex-smoker was the most deterimental factor for the group make-up. (Click here to request more information on the Chicago Study…) If you cannot have an ex-smoker facilitating, videos sharing success stories of HIV-positive individuals quitting can be used for motivation, like “Ready Rico.”
  • Address the whole individual: In cessation, examine the physical, mental, and emotional factors that influence a person’s tobacco use and ability to quit. Having information on nutrition is also pertinent because of the food limitations with ART medications and the use of snacking as a coping mechanism in cessation.


As I prepare for my departure from the Network to participate in my field internship at AIDS Action Committee, I will make sure to know my resources and to always ask if tobacco is used by my clients. Just a quick ask, suggestion, and resource referral can at least get the ball rolling and educate my clients so they can make the best decision for themselves possible!

June 9, 2010 Posted by | Presentations | , | Leave a comment

%d bloggers like this: