A qualitative study of tobacco interventions for LGBTQ+ youth and young adults: overarching themes and key learnings

Abstract

BackgroundSmoking prevalence is very high among lesbian, gay, bisexual, transgendered and queer (LGBTQ+) youth and young adults (YYA) compared to non-LGBTQ+ YYA. A knowledge gap exists on culturally appropriate and effective prevention and cessation efforts for members of this diverse community, as limited interventions have been developed with and for this population, and there are very few studies determining the impact of these interventions. This study identifies the most salient elements of LGBTQ+ cessation and prevention interventions from the perspective of LGBTQ+ YYA.MethodsThree descriptions of interventions tailored for LGBTQ+ YYA (group cessation counselling, social marketing, and a mobile phone app with social media incorporated), were shared with LGBTQ+ YYA via 24 focus groups with 204 participants in Toronto and Ottawa, Canada. Open-ended questions focused on their feelings, likes and dislikes, and concerns about the culturally modified intervention descriptions. Framework analysis was used to identify overarching themes across all three intervention descriptions.ResultsThe data revealed eight overarching themes across all three intervention descriptions. Smoking cessation and prevention interventions should have the following key attributes: 1) be LGBTQ+ − specific; 2) be accessible in terms of location, time, availability, and cost; 3) be inclusive, relatable, and highlight diversity; 4) incorporate LGBTQ+ peer support and counselling services; 5) integrate other activities beyond smoking; 6) be positive, motivational, uplifting, and empowering; 7) provide concrete coping mechanisms; and 8) integrate rewards and incentives.ConclusionsLGBTQ+ YYA focus group participants expressed a desire for an intervention that can incorporate these key elements. The mobile phone app and social media campaign were noted as potential interventions that could include all the essential elements.Electronic supplementary materialThe online version of this article (10.1186/s12889-018-5050-4) contains supplementary material, which is available to authorized users.

Targeting cancer prevention and screening interventions to LGBTQ communities: A scoping review

“…The 20 articles included in this scoping review reported on 15 intervention programs, including a smoking cessation intervention for 'LGBT' smokers reported in two articles (Matthews, Breen, et al, 2019;Matthews, Steffen, et al, 2019), and a smoking cessation intervention for young LGBTQ people reported in three articles (Ramo et al, 2019;. Three of the articles described a single study that evaluated the acceptability of three hypothetical interventions, rather than delivery of actual interventions (Baskerville et al, 2016(Baskerville et al, , 2017(Baskerville et al, , 2018. We have organised the types of intervention described across this review into three categories: therapeutic (interventions based in clinic settings or involving therapeutic modalities; n = 9), online (interventions delivered via digital platforms and technologies; n = 7) and scene-based (interventions that took place at the material sites in which LGBTQ communities interact socially; n = 3).…”

“…We have organised the types of intervention described across this review into three categories: therapeutic (interventions based in clinic settings or involving therapeutic modalities; n = 9), online (interventions delivered via digital platforms and technologies; n = 7) and scene-based (interventions that took place at the material sites in which LGBTQ communities interact socially; n = 3). One article described the interventions spanning all three categories (Baskerville et al, 2018). Some articles did not explicitly include cancer prevention and/or screening as their primary rationale for the intervention but were included in this review because they aimed to reduce behaviours that we identified as being within the scope of cancer prevention for LGBTQ communities.…”

“…LGBTQ people who were already engaged with existing clinical or support programs (van den Berg et al, 2014;Grady et al, 2014). In terms of who was targeted, half of the articles (n = 10) were inclusive of both sexuality and gender diversity by recruiting 'LGBT' (Fallin et al, 2015;Matthews, Breen, et al, 2019;Matthews, Steffen, et al, 2019), 'LBGTQ' or 'LGBTQ+' (Baskerville et al, 2017(Baskerville et al, , 2018Ramo et al, 2019) or 'sexual and gender minority' participants (Grady et al, 2014;Vogel, Belohlavek, et al, 2019;Vogel, Thrul, et al, 2019). The remaining half of the articles (n = 10) targeted specific subpopulations: young gay and bisexual men (GBM) (Thompson et al, 2015), who were HIV negative or of unknown HIV status (van…”

“…There were some imprecise definitions regarding recruitment among the more inclusive groups, including one article that specified the targeting of 'sexual minorities' but which included participants who were 'transgender'; however, this should not be considered a sexuality (Schwinn et al, 2015). Of the studies that included focus group methodologies (Baskerville et al, 2017(Baskerville et al, , 2018Ramo et al, 2019), we found that recruitment was inclusive of gender diversity (e.g. transgender men and women, two-spirit, genderqueer, and other gender diverse people) and yet analyses were not reported separately due to relatively small numbers of participants.…”

“…Of the articles that reported a breakdown by demographic characteristics, the samples rarely contained equal representation of gender and sexuality diversity. For example, articles reporting on smoking cessation interventions for young LGBTQ people comprised a higher number of female bisexual participants (Baskerville et al, 2016(Baskerville et al, , 2017(Baskerville et al, , 2018Ramo et al, 2019;Vogel, Belohlavek, et al, 2019), while interventions delivered to LBGTQ people regardless of age had higher proportions of gay men (Matthews, Breen, et al, 2019;Matthews, Steffen, et al, 2019). Five studies in this scoping review included largely Caucasian participants in their samples of LGBTQ individuals (van den Berg et al, 2014;Grady et al, 2014;Matthews, Breen, et al, 2019;Matthews, Steffen, et al, 2019;Thompson et al, 2015) and therefore are not easily generalisable or applicable to other or intersecting subpopulations.…”