LGBTQ2S+ Communities

Research consistently shows that smoking rates among the LGBTQ2S+ communities are 2-3 times higher than the general population.1-4 Most of this research is from the United States; however, similar patterns have been found in limited Canadian studies.5

Lesbian – Gay – Bisexual – Transgender – Queer – Two-Spirit

LGBTQ2S+ designates a community of people whose sexual or gender identities create shared political and social concerns. The term also highlights the diversity of sexuality- and gender identity-based communities.6 This term may not encompass everyone and to recognize other inclusions, various forms of the term exist.7

Unique Stressors8

In general, we live in a very heteronormative society where heterosexuality is seen as the norm. Cisnormativity, or the assumption that our gender identity matches the sex we were assigned at birth, is another pervasive norm in our society.

These norms impact those who do not fit within them. They create intentional and non-intentional expectations, demands, and constraints. Not surprisingly, they also create unique stressors for LGBTQ2S+ populations, including: social stigma, coming out, homophobia, discrimination, and lack of inclusive health care. Smoking can be a way to cope with these stressors. Smoking can also provide a sense of belonging to a group.

In its marketing, the tobacco industry capitalizes on the LGBTQ2S+ communities’ stressors. (See: Thus, the industry creates ads that emphasize freedom and choice, and sponsors safe spaces in LGBTQ2S+ clubs and bars (thereby reinforcing smoking as a way of belonging and sharing a common culture).

This contrasts with typical health promotion campaigns which are not usually inclusive of LGBTQ2S+ individuals, and thus are less relevant and effective. Until more recently, there have been few campaigns tailored to LGBTQ2S+ populations.


For more information about terms and language used in this section, please see the Equity Glossary of Terms provided by the 519.

To learn more about the link between tobacco use and LGBTQ2S+ communities, visit


For LGBTQ2S+ friendly services to quit smoking, visit the quit resources on this site or check out the following partners:



  1. Greenwood, G.L., Paul, J.P., Pollack, L..M.,, Binson D., Catania, J.A., Chang, J., et al. (2005). Tobacco use and cessation among a household-based sample of US urban men who have sex with men. American Journal of Public Health, 95, 145-151.
  2. Tang, H., Greenwood, G.L., Cowling, D.W., Lloyd, J.C., Roeseler, A.G. & Bal, D. G.(2004). Cigarette smoking among lesbians, gays, and bisexuals: How serious a problem? (United States). Cancer Causes Control, 15, 797-803.
  3. Ryan, H., Wortley, P.M., Easton, A., Pederson, L. & Greenwood, G. (2001). Smoking among lesbians, gays, and bisexuals: A review of the literature. American Journal of Preventive Medicine, 21, 142-149.
  4. Lee, J.G., Griffin, G.K. & Melvin, C.L. (2009). Tobacco use among sexual minorities in the USA, 1987 to May 2007: A systematic review. Tobacco Control, 18, 275-282.
  5. Clarke, M. P. & Coughlin, J. R. (2012). Prevalence of smoking among the lesbian, gay, bisexual, transexual, transgender, and quit (LGBTTQ) subpopulations in Toronto – The Toronto Rainbow Tobacco Survey (TRTS). Canadian Journal of Public Health, 103 (2), 132-136.
  6. KW Counselling Services. (2017, Aug 2). What does LGBTQ+ mean? Retrieved from
  7. Liberate Yourself. (n.d.). Defining LGBTQ. Retrieved from
  8. Rainbow Health Ontario. (n.d.). Why we smoke. Retrieved from