BY AJ TRAGER
In an effort to end nicotine and tobacco addiction for LGBT Michigan residents, LGBT community centers across the state have teamed up to provide a multitude of programs and cessation techniques to help smokers quit.
Tobacco consumption is responsible for nearly 480,000 deaths annually in the United States, nearly 10 percent of which are due to secondhand smoke, according to the Center for Disease Control. While overall rates of consumption have been slowly reduced over time, rates in certain target groups, such as the LGBT community, remain higher than average.
While 21 percent of Michigan residents continue to engage in tobacco consumption, nearly 30 percent of LGBT individuals in the state consume tobacco, making tobacco use a leading cause of excess, preventable mortality among LGBT people.
LGBT community centers across the state are currently engaging with their constituents to educate them about these tobacco cessation initiatives. With support and coordination from the Michigan Department of Health and Human Services (MDHHS), the centers have collected wellness data from over 1,400 LGBT individuals. The program provided specialized training to both state of Michigan staff and professionals at the state-sponsored Quitline, an evidence-based support tool to assist people in smoking cessation. The training seeks to ensure LGBT cultural competency and a positive quitting experience for LGBT people who seek help via the QuitLine or other state resources.
But what else are they doing?
LGBT Detroit and HIV/AIDS Affected Communities
“Breaking the Cycle is a campaign that I’m very proud of and highlights three areas of our work: ending HIV/AIDS, seeking and providing mental health counseling and ending tobacco use,” said Curtis Lipscomb, Executive Director of LGBT Detroit. “Weekly and daily messages are sent out via social media to reach people where they are — on their devices.”
Through data based research, LGBT Detroit’s program, Breaking The Cycle, addresses issues of substance abuse and recovery in the LGBT community. In partnership with the Michigan Department of Community Health Tobacco Section, LGBT Detroit disseminates information about tobacco usage in the LGBT/HIV community, how to quit, stay healthy and seek HIV/AIDS testing sites and care providers. Breaking The Cycle is a state of Michigan licensed program for substance abuse with bi-monthly tobacco use and prevention meetings.
LGBT Detroit has now been accredited by the University of Massachusetts Medical School Center for Tobacco Treatment and Research Training and has been licensed by the state of Michigan Substance Abuse Department to be an authority on the conversation surrounding tobacco cessation, specifically in HIV/AIDS affected communities. As an LGBT organization rooted in HIV education and prevention, Lipscomb says the challenge is to systematically work against smoking as it impacts everyone, specifically HIV/AIDS affected communities.
Tobacco users are at a heightened risk of developing lung cancer and other cancers, heart disease, chronic obstructive pulmonary disease (COPD), asthma and other diseases and early death. The CDC reports that smoking causes nearly one out of every five deaths in the U.S. each year. For these reasons, smoking is a significant health issue for all individuals, but it is even more of a concern for people living with HIV, who tend to smoke more than the general population. According to the CDC, approximately 19 percent of adults in the U.S. are smokers. However, the smoking rate is two to three times higher among adults who are HIV-positive.
“In Detroit, with marijuana, you see these institutions that encourage smoking — it’s people inhaling smoke, and people believing that hookah usage is safer,” Lipscomb said. “There’s a lack of education on that and there’s very little education on the effects of smoking. People know it causes cancer. But there’s no advertising for quitting or respiratory damage. For those of us that are working in organizations that are targeting LGBT people, it’s hard to engage with this public habit. It’s a legal substance that people can buy at a convenience store and use publicly.”
LGBT Detroit has launched its first survey addressing smoking rates of LGBT Detroiters affected by HIV/AIDS. With support from the Michigan Department of Community Health, LGBT Detroit will gather data to create messaging for furthering tobacco prevention in these populations.
Perceptions and Targeting Multiple Communities
Perceptions, the LGBT community center serving the Great Lakes Bay Region, has partnered with MDHHS on the HIV/TOBACCO Program. The program is designed to provide awareness and education for the general public and the AIDS Service Organizations (ASOs) not only in the Great Lakes Bay Region, but reaching the northern communities of Traverse City and Marquette.
Perceptions is creating focus groups for LGBT members thinking about or trying to quit smoking. The organization has offered cessation-focused presentations in the past and is looking to develop a more strategic approach with the programming.
In the meantime, Perceptions is partnering with DOW Chemical and their health services arm to develop some educational materials that will be used within the company itself as well as the surrounding community.
“There are a number of people that want to quit. That’s the messaging we’re receiving,” said Perceptions Board Chair Chris Lauckner. “Between the work of Perceptions and the work with partners including the ASOs, the Central Michigan District Health Dept. and Sacred Heart in Saginaw, I would say that we are in the midst of gathering that data at this point.”
The organization covers an extremely diverse and wide number of communities including the Great Lakes Bay Region of Midland, Saginaw, Bay City and Isabella; the northern tier counties of the state including Clare and Gladwin and even reaches out to folks in the Tuscola and Huron counties.
“The dispersion of the community in the area is so wide. It’s very different when you live in the southern part of the state where the population is so centralized. The LGBT community is much more isolated because of the dispersion,” Lauckner said.
Grand Rapids Pride Center, Tobacco Marketing and Youth Tobacco Use
In conjunction with MDHHS, ASOs and other LGBT community centers throughout the state, the Gand Rapids Pride Center, formally known as The Network, has launched “Proud to Quit” in an effort to reduce the loss of LGBT lives to tobacco use. The initiative releases information, spurs conversation and connects LGBT people with smoking cessation resources.
The center became involved in the initiative two years ago when Michigan LGBT community centers gathered data on the wellness experiences of LGBT folks. The Proud to Quit campaign was designed with the understanding that not everybody is ready to quit, so it focuses instead on making information and tools available to LGBT people and emphasizing that LGBT lives matter.
“When we started digging in, we had a good look at the data, about how many LGBT lives are lost to smoking, and about how smoking was actually the greatest preventable killer of our community, ahead of things like hate crimes. We also came to understand that, while most of America is just learning to embrace openly LGBT people living in our communities, tobacco marketing had extremely sophisticated hooks into our community and had them for many years already,” Pride Center member Mira Krishnan, Ph.D., told BTL.
On top of its education initiatives, raising tobacco education and awareness in the LGBT community via social media and its website, the GRPC has also offered the first round of tobacco cessation classes at the center. The first round included four weeks of cessation programming with a special presentation by a cessation expert.
The next step for GRPC will be to follow up the launch with additional cessation programming designed by the state to be a non-confrontational way to engage people in tobacco cessation.
“We know that the LGBT community has young smokers. Particularly we have at risk young adults and the trans population which tends to be younger as well. We also have a lot of smokers that match the demographic that the state has been seeing, which is people 40-45 years old who have been smoking for 20 years, Krishnan pointed out. “We’re trying to learn how to engage professionally and engage with people who might not be ready to quit but are ready to hear that we care about their health and that caring about their own health is about being a proud, out, LGBT person.”
Smoking becomes a part of someone’s lifestyle and begins to affect every part of the day between driving in the car and hanging out with friends to managing stress relief. Krishnan notes that it’s not uncommon for her to see a group of smokers outside before and after the trans support groups she attends at the center. While smoking can play a role in navigating quick and easy conversations with new people, Krishnan believes it’s time to redefine the LGBT lifestyle.
“One of the things we have to think about is to prove to our community that we belong,” she said. “We have to take better care of ourselves and create affirming spaces for those struggling with tobacco and alcohol to help them stay sober and off tobacco.”
The Kalamazoo Gay and Lesbian Resource Center
“The Kalamazoo Gay Lesbian Resource Center has been very excited about the growing momentum behind LGBT tobacco cessation in Michigan!” the KGLRC Director of Community Engagement, Meg Bauer, said. “We’ve incorporated tobacco-use realities into all of our inclusivity trainings and have been eager to deliver cessation messages and resources to all of our partners. From therapists and medical providers to homeless shelters and ASOs, the pro-equality and anti-tobacco messages are becoming indivisible.”
The KGLRC actively participates in an anti-tobacco social media campaign which urges positivity and strength in making quit attempts. Thanks in larger part to the organization’s Facebook posts, a donor recently decided to quit once and for all and was able to do so. Last Baur heard, the donor was 45 days tobacco free.
In order for the LGBT community to thrive, it has to first survive. With tobacco use for parts of the LGBT community being over three times as high as the state average, the KGLRC says it has an obligation to prioritize tobacco use reduction among the LGBT and HIV communities. The organization will host four contemplation/pre-contemplation classes for current tobacco users in June and July and encourages anyone in the area who is interested to contact Bauer at [email protected]
Affirmations works to address the high rates of tobacco use within LGBTQ communities by promoting the Michigan Tobacco Quitline, by conducting focus groups, and by creating social media campaigns about effective ways to quit for LGBT people.
The Affirmations What’s Your Why? campaign was launched in the fall and attempts to switch the typical anti-tobacco messaging from fear-based tactics to a focus on the positive reasons people decide to quit. The campaign is designed by LGBT people for LGBT people and features local community members both in the making of the materials and in the posters themselves.
“We intently used a very positive approach to it, so it’s a pro-health message and not a shaming, ‘Why don’t you just quit?” message,” Affirmations Director of Programs Lydia Ahlum Hanson said. “A lot of our current cessation work is building on that.”
In addition to the social media campaign, Affirmations also hosts a monthly Healthy Living Series that explores a variety of health-based activities to offer community members an opportunity to identify new habits and healthy living alternatives to tobacco use. The April meeting will focus exclusively on tobacco cessation.
“There’s definitely a lot of resistance within the LGBT community to really talk about our significantly higher use of tobacco than the general population. We don’t want to be doing that in the shaming way that would increase stigma, but instead to offer support and acknowledge how incredibly hard it is to quit,” Hanson said.
Affirmations regularly meets with local and state policymakers to discuss current tobacco policy. Current conversations include increasing the age one can purchase tobacco, getting e-cigarettes to be classified as a tobacco product and increasing taxes on tobacco products so that cigarettes and mini cigars are taxed the same.
Affirmations has two contracts with the state of Michigan. One they’ve had for several years that funded the What’s Your Why? campaign, and a second contract is dedicated to working on tobacco cessation in HIV affected communities.
“In many ways, Affirmations was the only LGBT group at the table (when discussing tobacco cessation and HIV/AIDS affected populations with the state of Michigan). If the state really wanted to make change in these communities, we figured they had to give grants to other organizations — not just Affirmations — and widen that reach. And the state then found other money and now LGBT Detroit, the KGLRC, Perceptions and the Grand Rapids Pride Center are all on board. It’s a really great model for Michigan to have taken,” Hanson said.