I

Tobacco & LG= BT Populations

Draft text for Praxis Project Amicus Brief for = DOJ lawsuit

Prepared by Scout, Ph.D.<= /p>

On behalf of the National Coal= ition for LGBT Health

The lesbian, gay, bi= sexual and transgender communities have an interesting and difficult relationship = with the tobacco companies named in this suit.&= nbsp; In order to best understand this relationship, it is first important= to understand some key background information about these communities. These combined groups of sexual minorities and gender identity minorities cross every possible line within = the broader population; they encompass all racial and ethnic groups, all socio-economic classes, and all possible geographic diversity. These communities are sometimes bo= und by a common identity, and are sometimes divided by the breadth of within-group diversity. With all of this diversity, the LGBT communities are bound by an emblamatic experience; high levels of social exclusion based upon being LGBT^=
1-3.

How does this intera= ct with tobacco? In short, this commu= nity distinction of high social exclusion makes LGBT people predisposed to addic= tion as a form of stress-relief^{=
4, 5}. The seven pillars of fraud outlined in this suit have impacted this community d= irectly; sometimes through their broad application, sometimes through direct community-based marketing efforts. <= /span>In either case, the impact of these fraudulent actions becomes magnified for L= GBT people, because of this vulnerable population predisposition to use additio= ns as a coping skill.

As a result of succe= ssful tobacco industry efforts, LGBT people are 40-60% more likely to smoke than the gene= ral population^=
5.

As a result of highly effective tobacco industry youth marketing efforts, LGBT youth smoke at hig= her rates than any other youth group, and this prevalence is not dropping as fa= st as with other youth. One rece= nt study showed LGBT youth smoking at 59%.&nb= sp; Gay teens are also four times more likely than straight teens to use smokeless tobacco.^=
6

LGBT youth are parti= cularly susceptible to tobacco industry youth marketing practices, due to their own vulnerability as a result of social exclusion. “Industry documents reveal t= hat tobacco giant Philip Morris understands the unique psychological and social forces that may motivate gay teenagers and adults to start smoking. Research conducted for their Marlboro brand in 1994 concluded that, ‘In a soci= ety where male homosexuality is often interpreted to mean non-masculinity, Marl= boro is particularly appreciated as a cue to manhood. Marlboro’s success in this context depends wholly on the relevance of this cowboy image to the wo= rld (fantasy and real) of these gay consumers.’”^=
6

This media manipulat= ion is then compounded by ad placement at locations where LGBT youth are known to = congregate. Phillip Morris prides itself on be= ing the “one of the largest corporate contributors to the AIDS epidemic”, earning widespread LGBT community appreciation. They then spend $100 million dolla= rs to advertise this support, most often in media and placements providing exposu= re to a high number of LGBT youth^=
7.

In key act of youth marketing, tobacco companies often sponsor the pride events which are core = annual gatherings for LGBT people. P= rides are heavily attended by youth particularly because it is an all-ages option= for community gathering, and the LGBT youth groups participate in almost every = pride festival nationwide. As with struggling LGBT media, tobacco sponsorship has been key to the history of many LGBT pride celebrations nationwide, offering the industry exposure and loyalty-building opportunities among LGBT youth.<= span style=3D'mso-spacerun:yes'> Some pride events have now stopped taking tobacco money, but industry offers are difficult to refuse, as was experienced by one organizer of a recent North Carolina pride festival. In exchange for agreeing to tobacco sponsorship, he was offered a personal car, or “anything he wanted= 221;^=
8. This level of enticement is well beyond the range of routine, event organizers a= re much more conditioned to being rebuked by corporate sponsors, not offered personal cars. But for the to= bacco industry, this exposure to particularly vulnerably youth has and does pay o= ff handsomely. =

Likewise, the small = number of LGBT magazines and newspapers are inordinately dependent on tobacco advertising money, in1999 it was their primary source of ad revenue. This is another rich example of yo= uth targeting, since these community magazines are sometimes a key source of community contact for isolated youth. The language of these tobacco ads explicitly utilizes youth slang, as and example from a recent Lucky Strike ad, “Whenever someone yells, ‘Dude that’s so gay’, we’ll be there.”= ^=
7 = Other ads emphasize their corporate acceptance of LGBT people, as in this excerpt from Pride program ad by Phillip Morris “PM has maintained sexual orientation, anti-discrimination, and anti-harassment policies for 16 years.”^=
7 = No doubt this message resonates deeply with the LGBT youth, considering the fact tha= t 4 out of 5 LGBT youth report being harassed at school on this issue, and an overwhelming majority of them report that their schools/teachers do not intervene^=
9. It is not difficult to see how youth easily build loyalty to the company that boa= sts about accepting them in the pride festival program booklet. The unfortunate result is that LGBT youth are up to twice as likely to smoke as their straight counterparts.

Not only do LGBT peo= ple smoke more, there are substantive reasons to hypothesize they quit less. Concomitant issues related to soci= al exclusion are well documented within LGBT populations, especially: stress, = co-occurring addictions, mental health problems, underinsurance, and barriers to accessi= ng medical care^{=
2, 3, 10}. These concomitant issues interact negatively with tobacco addiction, creating sup= plemental barriers to successful tobacco treatment.&= nbsp; If LGBT are less able to successfully combat their tobacco addiction= s, it only further magnifies the aggregate injury done to these populations as= a result of the fraudulent actions discussed in this suit.

Baldfacedly, LGBT pe= ople have been successfully targeted by big tobacco, they are much more likely to smoke than the general population, and there is evidence to support that th= ey are less likely to be able to quit. In direct relation to the fraud named in this suit, LGBT youth have = been directly and effectively targeted by big tobacco. Communitywide, the results of this targeting are devastating as LGBT youth show some of the highest tobacco prevalence rates of all populations.

Thus any discussion = of tobacco industry reparations needs to include strategies to specifically un= do the harm caused to the vulnerable and especially hard-hit LGBT communities.=

Reparations that are= needed for the LGBT communities include, but are not limited to:=

Ongoing community-specific youth countermarketing advertising
Funding for community-tailored treatment o= ptions for all LGBT people impacted by this, especially those not close to la= rger cities.
Funding for research and advertising about= the tobacco industry community targeting.= (Current information on this issue is largely anecdotal, there = is no quantifiable assessment of the tobacco industry LGBT sponsorship mo= ney that compromises community-level responses to this health threats.)
Funding for implementation of current community-wide anti-tobacco efforts, particularly the LGBT Communities= Anti-Tobacco Action Plan. =
Funding for culturally appropriate treatme= nt for people who are dually and triply affected, either by tobacco and other health issues, or by nature of their membership in more than one targe= ted group, e.g. LGBT people of color.&nbs= p;

1. &nbs= p; In Harm's Way: Suicide in America. http://www.nimh.= nih.gov/publicat/NIMHharmsway.pdf. Accessed February 14, 2005.

2. Gay and Lesbian Medical Association. The healthy people 2010 companion document= for LGBT health. San Francisco, CA: GLMA; 2001.

3. Scout. Social Determinants of Transgender Health. New York: Sociomedical Sciences, Columbia University; 2005.

4. WHO Regional Office for Europe. Social determinants of health: the solid facts. 2nd:http://www.euro.who.in= t/document/e81384.pdf. Accessed February 6th, 2005.

5. Ryan H, Wortley PM, Easton A, Pederson L, Greenwood G. Smoking among lesbians, g= ays, and bisexuals: a review of the literature. American Journal of Preventive Medicine. Aug 2001;21(2):142-149.

6. Constantino J. Gay Teens and Smoking. http://ww= w.nalgbtcc.org/documents/GayTeensandSmoking.pdf. Accessed May 10, 2005.

7. Stevens P. LGBT Populations and Tobacco. 2nd:http://www.ttac.org/lgbt/pdfs/2nd/LGBT2ndedition.pdf. Accessed May 10, 2005.

8. Personal communication from Sheryl Scott to Scout, May 10, 2005.

9. Kosciw JG. The 2003 National School Climate Survey: The school-related experiences= of our nation’s lesbian, gay, bisexual and transgender youth. New York: GLSEN; 2004.

10. Dean L, Meyer IH, Robinson K, et al. Lesbian, gay, bisexual, and transgender Hea= lth: some findings and concerns. JGLMA. October 2000;4(3):101-151.