If We Build It,Will They Come? Challenges of Adapting and Implementing a Smoking Cessation Program for the LGBTQ Community in Southcentral Texas

Abstract

Studies indicate that tobacco use among lesbian, gay, bisexual, transgender, or queer (LGBTQ) community members is consistently higher than the general population. The Last Drag is a tobacco cessation program developed and implemented in 1991 in San Francisco, California, that has shown promise in assisting LGBTQ members with tobacco cessation. This article describes the practical challenges of adapting The Last Drag to be implemented in a southcentral Texas community. Primary challenges included short time line to expected implementation, issues with culturally insensitive language, and barriers to participant recruitment. Acknowledging and overcoming these challenges can assist public health educators who are addressing tobacco cessation in LGBTQ populations.

Keywords

smoking cessation LGBTQ health promotion programs program adaptation

Get full access to this article

View all access options for this article.

References

Ascension Seton. (2019). Community health needs assessment: South Region 1: Hays County. Retrieved from https://www.seton.net/wp-content/uploads/2019/05/Hays-CHNA-May-2019.pdf

Baskerville

N. B.

Dash

Shuh

Wong

Abramowicz

Yessis

Kennedy

R. D.

(2017). Tobacco use cessation interventions for lesbian, gay, bisexual, transgender, and queer youth and young adults: A scoping review. Preventive Medicine Reports, 6, 53-62.

Baskerville

N. B.

Wong

Shuh

Abramowicz

Dash

Esmail

Kennedy

(2018). A qualitative study of tobacco interventions for LGBTQ+ youth and young adults: Overarching themes and key learnings. BMC Public Health, 18, 155

Bell

M. L.

Whitehead

A. L.

Julious

S. A.

(2018). Guidance for using pilot studies to inform the design of intervention trials with continuous outcomes. Clinical Epidemiology, 10, 153-157.

Benozzo

Pizzorno

M. C.

Bell

Koro-Ljungberg

(2015). Coming out, but into what? Problematizing discursive variations of revealing the gay self in the workplace. Gender, Work & Occupation, 22, 292-306.

Berger

Mooney-Somers

(2017). Smoking cessation programs for lesbian, gay, bisexual, transgender, and intersex people: A content-based systematic review. Nicotine & Tobacco Research, 19, 1408-1417.

Bias

T. K.

Abildso

C. G.

Vasile

E. V.

Coffman

(2017). The impact of community input in community health needs assessments. Journal of Public Health Management, 23(Suppl. 4), s29-s33

Bryant

Damarin

A. K.

Marshall

(2014). Tobacco control recommendations identified by LGBT Atlantans in a community-based participatory research project. Progress in Community Health Partnerships, 8, 269-279.

Buchting

F. O.

Emory

K. T.

Scout Kim

Fagan

Vera

L. E.

Emery

(2017). Transgender use of cigarettes, cigars, and e-cigarettes in a national study. American Journal of Preventive Medicine, 53(1), e1-e7.

10.

Burkhalter

J. E.

(2015). Smoking in the LGBT community. In Boehmer

Elk

(Eds.), Cancer and the LGBT community: Unique perspectives from risk to survivorship (pp. 63-82). New York, NY: Springer.

11.

Centers for Disease Control and Prevention. (2015). Best practices user guide: Health equity in tobacco prevention and control. Atlanta, GA: Author.

12.

Centers for Disease Control and Prevention. (2018). Current cigarette smoking among adults—United States, 2016. Morbidity and Mortality Weekly Report, 67(2), 53-59.

13.

Eliason

M. J.

Dibble

S. L.

Gordon

Soliz

G. B.

(2012). The Last Drag: An evaluation of an LGBT-specific smoking intervention. Journal of Homosexuality, 59, 864-878.

14.

Emory

Buchting

F. O.

Trinidad

D. R.

Vera

Emery

S. L.

(2019). Lesbian, gay, bisexual, and transgender (LGBT) view it differently than non-LGBT: Exposure to tobacco-related couponing, e-cigarette advertisements, and anti-tobacco messages on social and traditional media. Nicotine & Tobacco Research, 21, 513-522.

15.

Gonzales

Henning-Smith

(2017). Health disparities by sexual orientation: Results and implications from the Behavioral Risk Factor Surveillance System. Journal of Community Health, 42, 1163-1172.

16.

Gonzales

Przedworski

Henning-Smith

(2016). Comparison of health and health risk factors between lesbian, gay, and bisexual adults and heterosexual adults in the United States: Results from the National Health Interview Survey. JAMA Internal Medicine, 176, 1344-1351.

17.

Guillory

Wiant

K. F.

Farrelly

Fiacco

Alam

Hoffman

. . . Alexander

T. N.

(2018). Recruiting hard-to-reach populations for survey research: Using Facebook and Instagram advertisements and in-person intercept in LGBT bars and nightclubs to recruit LGBT young adults. Journal of Medical Internet Research, 20(6), e197.

18.

Hoffman

Delahanty

Johnson

S. E.

Zhao

(2018). Sexual and gender minority Cigarette smoking disparities: An analysis of the 2016 Behavioral Risk Factor Surveillance System data. Preventive Medicine, 113, 109-115.

19.

Kates

Ranji

Beamesderfer

Salganicoff

Dawson

(2018). Health and access to care and coverage for lesbian, gay, bisexual, and transgender individuals in the U.S. Retrieved from http://files.kff.org/attachment/Issue-Brief-Health-and-Access-to-Care-and-Coverage-for-LGBT-Individuals-in-the-US

20.

Lee

J. G. L.

DeMarco

M. E.

Beymer

M. R.

Shover

C. L.

Bolan

R. K.

(2018). Tobacco-free policies and tobacco cessation systems at health centers serving lesbian, gay, bisexual, and transgender clients. LGBT Health, 5, 264-269.

21.

Lee

J. G. L.

Matthews

A. K.

McCullen

C. A.

Melvin

(2014). Promotion of tobacco use cessation for lesbian, gay, bisexual, and transgender people: A systematic review. American Journal of Preventive Medicine, 47, 823-831.

22.

Mantovani

Pizzolati

Gillard

(2017). Engaging communities to improve mental health in African and African Caribbean groups: A qualitative study evaluating the role of community well-being champions. Health and Social Care in the Community, 25, 167-176.

23.

McCabe

S. E.

Hughes

T. L.

Matthews

A. K.

Lee

J. G.

West

B. T.

Boyd

C. J.

Arslanian-Engoren

(2019). Sexual orientation discrimination and tobacco use disparities in the United States. Nicotine & Tobacco Research, 21, 523-531.

24.

Mizra

S. A.

(2018). Discrimination prevents LGBTQ people from accessing health care. Retrieved from https://www.americanprogress.org/issues/lgbt/news/2018/01/18/445130/discrimination-prevents-lgbtq-people-accessing-health-care/

25.

Patterson

J. G.

Jabson

J. M.

Bowen

D. J.

(2017). Measuring sexual and gender minority populations in health surveillance. LGBT Health, 4, 82-105.

26.

Pennel

C. L.

McLeroy

K. R.

Burdine

J. N.

Matarrita-Cascante

(2015). Nonprofit hospitals’ approach to community health needs assessment. American Journal of Public Health, 105(3), e103-113.

27.

Samuels

Schudrich

Altschul

(2009). Toolkit for modifying evidence-based practice to increase cultural competence. Orangeburg, NY: Research Foundation for Mental Health.

28.

Shafer

J. D.

Coleman

Feldman

Garofalo

Hembree

Radix

Sevelius

(2016). Barriers to health care for transgender individuals. Current Opinion in Endocrinology, Diabetes and Obesity, 23, 168-171.

29.

Smalley

K. B.

Warren

J. C.

Barefoot

K. N.

(2016). Differences in health risk behaviors across understudied LGBT subgroups. Health Psychology, 35, 103-114.

30.

Soliz

G. B.

(2015). The Last Drag: A lesbian/gay/bisexual/transgender/HIV positive stop smoking program facilitator guide. San Francisco, CA: Coalition of Lavender-Americans on Smoking and Health.

31.

Tucker

C. M.

Arthur

T. M.

Roncoroni

Wall

Sanchez

(2015). Patient-centered, culturally sensitive health care. American Journal of Lifestyle Medicine, 9(10), 63-77.

32.

Walls

N. E.

Wisneski

(2011). Evaluation of smoking cessation classes for the lesbian, gay, bisexual, and transgender community. Journal of Social Service Research, 37, 99-111.

33.

White-Hughto

J. M.

Murchison

G. R.

Clark

Pachankis

J. E.

Reisner

S. L.

(2016). Geographic and individual differences in healthcare access for U.S. transgender adults: A multilevel analysis. LGBT Health, 3, 424-433.