Sexuality Matters: Differential Receptivity of Smoking Prevention Ads Among the LGBT Population

Theoretical Background and research questions/hypothesis: The Lesbian, Gay, Bisexual and Transgender (LGBT) community smokes at rates up to 200% higher than the heterosexual population. Although public health organizations have called for efforts to reduce LGBT community tobacco consumption, there is little understanding of the effectiveness of different types of anti-smoking messages among this population or which messages can be used in digital campaigns that target to LGBT populations.

Methods:  To gain insight into anti-smoking messages that may be most effective in reducing tobacco use consumption among the LGBT population, we conducted a study among 203 LGBT adults, 16-45 years of age, recruited from three cities across the United States: Southern Nevada (n=95), Salt Lake City (n=36), and Albuquerque (n=72). Subjects were recruited from Pride festivals in Southern Nevada and Albuquerque and were obtained from LGBT bars and nightclubs in Salt Lake City. Existing smoking prevention ads (n=18) were collected from seven different LGBT tobacco prevention campaigns and categorized into three groups: 1) ads without people; 2) ads with non-provocative LGBT people; and 3) ads with provocative LGBT people (such as kissing, wearing beach attire, or sexually suggestive poses. For ads with people in them, males and females received ads that portrayed individuals of their same sex.  For participants reporting dual attraction, they chose to view either male- or female-specific ads. After exposure to ads, participants were asked to rate their receptivity to the ads through a series of three questions, each on a 5-point Likert scale. Qualitative discussion followed that focused on message content and presentation format to discuss its relevance to LGBT populations and perceived effectiveness. 

Results:  Across both sexes, receptivity on all three measures to anti-smoking messages were increased when viewing ads with people as opposed to those without people by a factor of almost two (p<0.05). Additionally, both males and females were more receptive to ads with provocative LGBT people as opposed to non-provocative situations. Through qualitative discussion, participants expressed an appreciation of ads that openly embraced the sexuality of LGBT lifestyles. Messaging that directly addressed values and struggles of being LGBT were also perceived to be more relatable. Messages demonizing the tobacco industry were not received well. However, ads that highlight the anti-LGBT rights political contributions of the tobacco industry were perceived to be effective.  

Conclusions:  The effectiveness of digital ads to the LGBT community can be greatly influenced by both the messages used and how the messages are presented. Results suggest that ads that display individuals in situations with a member of the same sex and reflect an understanding of the lifestyle, values and struggles of being LGBT are more effective than those that do not contain such imagery or acknowledgements. 

Implications for research and/or practice:  Public health practitioners may benefit from use of provocative LGBT images in interventions to reduce tobacco use consumption among the LGBT population. Researchers should gather additional research on the use of provocative images to defend their use by government agencies that may be uncomfortable with these images.