Smoking rates among the LGBTQ+ population

A stethoscope rests on a rainbow pride flag.

The LGBTQ+ community faces a significant and often overlooked challenge: higher rates of tobacco use compared to their heterosexual and cisgender counterparts. According to the Centers for Disease Control and Prevention (CDC), about one in six lesbian, gay and bisexual adults smoke cigarettes, compared with about one in nine heterosexual/straight adults.1 Cigarette smoking is also higher among transgender adults than cisgender adults.

Tobacco use (including cigarettes, cigars, hookah, chewing tobacco and more) is linked to many types of cancer, including lung, colorectal, breast, throat, cervical, bladder, mouth and esophageal cancers. Smoking accounts for about 30% of all cancer deaths (and cigarette smoking causes about 80-90% of lung cancer deaths).

The problem of tobacco use in the LGBTQ+ community starts early. Smoking rates among LGBTQ+ youth are more prevalent than non-LGBTQ+ youth. Smoking prevalence is 38%-59% for LGBTQ+ youth, compared to 28%-35% for the general youth population, according to the American Lung Association.2

Why is this population smoking more? Bar culture, exploitative marketing and stigma contribute to this discrepancy.

Bar culture

Some safe spaces for LGBTQ+ community members include bars and clubs. Historically, these places have played an important role in enabling community members to find social connection. These environments can encourage higher rates of drinking alcohol (also linked to cancer) and smoking.


Tobacco companies have long targeted advertisements to the LGBTQ+ community. Examples of targeting include arranging colorful e-cigarettes into rainbow order and using phrases like, “take pride in your flavor.”

Beyond advertisements, the tobacco industry has sponsored events like Pride parades and has done community outreach and funded AIDS and LGBTQ+ organizations. Despite leaving an impression of caring about the community, the tobacco industry is really causing significant negative health impacts.


LGBTQ+ people can face higher levels of stress than the general population due to discrimination, social stigma and the pressure of coming out. All of these stressors can lead to people taking up smoking. Lesbian, gay and bisexual people who faced more discrimination had a greater probability of tobacco/nicotine use compared to others who experienced less or no discrimination, according to the National LGBT Cancer Network.3

Why this matters

Everyone deserves the chance for a long, healthy and happy life. If you smoke, it’s never too late to quit—and doing so will help you lead a healthier life, which you deserve. If you’re age 50 or older with a history of smoking, you should also ask your health care provider about routine lung cancer screening.

Beyond making lifestyle changes, it’s important to be a supporter for those in your life who need it. In the 2024 Prevent Cancer Foundation Early Detection Survey, 16% of respondents said they would prioritize their screenings if a friend or loved one came with them. Be that friend and encourage the people in your life to get the screenings they need.

Finally, if you’re seeing predatory practices from the tobacco industry, call them out by calling your representatives, posting on social media or getting involved with anti-tobacco advocacy groups. You can sign up for the Prevent Cancer Foundation Advocacy Newsletter to stay in the know about policies impacting tobacco control and related news.

For help quitting, call 1-800-QUIT-NOW.

READ ALSO: LGBTQ+ cancer resources

1. Tobacco Product Use Among Adults – United States, 2021. Morbidity and Mortality Weekly Report 2023.

2. Lee JG, Griffin GK and Melvin CL. Tobacco use among sexual minorities in the USA, 1987 to May 2007: A systematic review. Tobacco Control. 2009;18:275-282.

3. McCabe, S. E., Hughes, T. L., Matthews, A. K., Lee, J. G. L., West, B. T., Boyd, C. J., & Arslanian-Engoren, C. (2017). Sexual Orientation Discrimination and Tobacco Use Disparities in the United States. Nicotine & Tobacco Research, 21(4), 523–531.