Since 1988, for example, smoking prevalence for Californian adults has declined from 23.7% to 11.7% in 2013, which is a 51% reduction. But, these same reductions have not occurred within sexual and gender minority groups where prevalence of smoking remains high. Estimates from the 2013 California Adult Tobacco Survey suggest that sexual minority adults smoke more than twice as much — 27.4% compared to 12.9%.
And though similar data on smoking prevalence for transgender and gender nonconforming adults were not collected, older California and recent national estimates suggest that trans adults are twice as likely to use cigarettes compared with cisgender adults (that is adults whose gender identity corresponds to their sex assigned at birth).7, 8 So the evidence suggests that these groups of adults are much more likely to smoke compared to cisgender, heterosexual adults. Because of this inequity, sexual and gender minorities have come to be identified as a priority population in tobacco control.