Tobacco Harm Reduction & LGBTQ+ Young Adults

Tobacco tin & rolling paper with tobacco
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Compared to the general population, nicotine and tobacco (NT) use, especially smoking, is more common within LGBTQ+ communities, and within these communities, young adults may smoke the most. Given this situation, we need to understand how to best eliminate the burden of tobacco-related illnesses for LGBTQ+ young adults. Some research, including our own previous work, suggests that young people who use nicotine and tobacco products are developing strategies to reduce their own chances of tobacco-related illnesses. Because these strategies do not necessarily involve abstinence or cessation, they may be considered tobacco harm reduction strategies. Tobacco harm reduction (THR) approaches typically emphasize the substitution of less harmful forms of nicotine for more harmful combustible tobacco products, like cigarettes, for smokers who are unable or unwilling to quit. THR is hotly debated in tobacco control and, as such, remains under-researched. Yet, as the public health community continues to debate THR, some young people may already be engaging in practices that they consider harm reduction. The extent to which this practice has been adopted by young LGBTQ+ smokers remains unknown.

The Center for Critical Public Health’s Tobacco Harm Reduction Study is a 36-month qualitative project that explores LGBTQ+ young adults’ nicotine and tobacco use practices. In doing this, we are examining the extent to which THR is practiced by LGBTQ+ young adults. We will conduct 100 in-depth qualitative online interviews with LGBTQ+ young adults who either currently or used to smoke cigarettes. Narrative data from participants will respond to the following aims:

  1. Describe whether and how LGBTQ+ young adults demonstrate pathways and patterns of nicotine and tobacco use that are illustrative of tobacco harm reduction,
  2. Examine whether LGBTQ+ young adults describe the practice of tobacco harm reduction as a way to minimize the tension between the challenges of their everyday lives and their awareness of smoking-related harms, and
  3. Develop a theory of practice of tobacco harm reduction to inform prevention and treatment interventions responsive and compassionate to the unique needs of LGBTQ+ young adults and grounded in their experiences.

Project Contact

Em Sanders, Project Manager


This research was supported by funds from the Tobacco-Related Disease Research Program (TRDRP) of the University of California, grant number T30IR0890 (Tamar Antin, PI). The content provided here is solely the responsibility of the authors and does not necessarily reflect the opinions of TRDRP.