People in the LGBT community are two to three times more likely to smoke than their straight counterparts—but it can be a bitch to quit.
That's where Dr. Alicia Matthews comes in. The clinical psychologist and University of Illinois at Chicago professor is organizing LGBT-focused smoking cessation groups at Howard Brown Health Center as part of a larger research study.
Smokers between 18 and 65 can access free six-week sessions, followed by several months of individualized support and nicotine replacements. New groups start every few weeks.
Matthews recently sat down with Windy City Times to talk LGBT health and explain why willpower alone just isn't enough.
Windy City Times: Your study, Bitch to Quit, focuses exclusively on smoking within the LGBT community. Why is that?
Alicia Matthews: We know that, in general, smoking contributes to any number of poor health outcomes—various types of cancer, lung cancer. It also exacerbates chronic illnesses such as diabetes.
What is interesting and important is that we [as an LGBT community] have additional risk factors that make us even more vulnerable.
So, for instance, sexual minority women—that is, gay, lesbian, bisexual and queer-identified women—drink at higher rates than heterosexual women. The combination of heavy drinking and smoking is a significant risk factor for breast cancer and head and neck cancers.
The same thing goes with smoking and higher rates of obesity among LGBT women. That can lead to higher rates of cardiovascular problems like strokes and heart attacks.
Reduction of smoking is a really important area of research. It should be a priority for the community, yet there's been very little work to date.
WCT: What can you tell us about your research? [Matthews' study is the first of its kind.]
Alicia Matthews: This is a federally funded 5-year research grant. We want to answer the basic question: Is a culturally targeted [or LGBT-specific] program more successful in getting LGBT smokers to quit, than a non-targeted smoking cessation program? Which of the two programs is more successful?
We also want to know: What are some of the risk factors that make it difficult for LGBT folks to quit smoking?
WCT: What have you seen so far?
Alicia Matthews: We just started in 2012, so I can't come to conclusions yet. But we do know there is a greater tolerance for smoking in the LGBT community, which means there are fewer incentives to quit. A lot of people in smokers' social groups are smokers themselves, which is a big factor for relapse. There's just easier access to smoking.
LGBT individuals spend more time in bars and are more likely to drink alcohol, which can also lead to relapse.
And the stress associated with 'coming out' or discrimination based on sexual orientation or gender identity can be a unique and additional ongoing chronic stressor. Smoking is often done to stop stress.
WCT: What would you recommend for people who can't make it to Howard Brown, but still want to quit?
Alicia Matthews: The first thing they should do is contact their physician and schedule an appointment. Tell your doctor that you're interested in quitting and see if he or she can prescribe a nicotine replacement or some kind of other medication.
Frankly, the cold turkey approach—that is, just setting a quit date and trying to quit on one's own without any counseling, support or nicotine replacement—doesn't work well. The quit rates are about 1-3 percent.
That percentage goes up significantly with the use of medication. And it's much higher with a combination of medication and some type of counseling.
WCT: Why is quitting cold turkey so unsuccessful?
Alicia Matthews: A lot of people don't realize this, but tobacco, or nicotine, is one of the most addictive substances. Studies have shown people can find quitting smoking as difficult—if not more difficult—than kicking a cocaine or heroine addiction. It's a very, very powerfully addictive substance.
The idea is: You have to have willpower to quit.
Well, if that was the case… Seventy-five percent of all current smokers are interested in quitting, but in any given year, only a small percent actually do. So it's not an issue of willpower. It's an issue of evidence-based treatment.
WCT: Does how long someone's been smoking impact how hard it will be to quit?
Alicia Matthews: Nicotine addiction is really an addiction of adolescence. The vast majority of smokers pick up smoking in their teen years—a time when they're forming their identities and choosing their peer or social networks, which often include other smokers.
So, if a person starts smoking in their teens—and now they're in their 20s or 30s—they're heavily addicted. People describe [quitting smoking] as losing their best friend. 'I don't know what to do with myself if I'm not smoking a cigarette.'
It's a very strongly conditioned behavior. It's something that someone has done 10-20 times a day for 10-20 years.
WCT: What other factors come into play?
Alicia Matthews: The tobacco industry has played a very specific role in targeting the LGBT community. It specifically targeted women in the '50s, '60s and early '70s. The Virginia Slims "You've come a long way, baby" ads associated the image of a strong, successful woman with tobacco use.
The tobacco industry has done similar campaigns with the LGBT community. The industry has made tobacco seem like a normative part of what it means to be queer. The community should be aware that we're being exploited by the tobacco industry for profit.
Those who wish to see if they're eligible for the Bitch to Quit study at Howard Brown Health Center should call 773-388-8868 or visit www.bitchtoquit.org .
