New Tips From Former Smokers Ad Features Effects of Tobacco & HIV

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     Felecia King

    Project Specialist

   The Network for LGBT Health Equity

 
 

This week, the CDC launched the next phase of the Tips From Former Smokers Campaign, and this time they are tackling the issue of tobacco and HIV. The ad features Brian, who smoked for 30 years, and suffered a stroke as a complication of his HIV and tobacco use. (read more about Brian’s story HERE)

Smoking is especially harmful to people who are living with HIV. For example, smokers with HIV:

  • Are at higher risk than non-smokers with HIV of developing lung cancer, head and neck cancers, cervical and anal cancers, and other cancers;
  • Are more likely than non-smokers with HIV to develop bacterial pneumonia, Pneumocystis jiroveci pneumonia (PCP), COPD, and heart disease;
  • Are more likely than non-smokers with HIV to develop two conditions that affect the mouth: oral candidiasis (thrush) and oral hairy leukoplakia; and
  • Have a poorer response to antiretroviral therapy.
  • People with HIV who smoke are also less likely to keep to their HIV treatment plan and have a greater likelihood of developing an AIDS-defining condition and dying earlier than non-smokers with HIV.

(the above examples are from Aids.gov <– Click the link for more info!)

For these reasons, smoking is a significant health issue for all individuals, but it is even more of a concern for people living with HIV, who tend to smoke more than the general population. According to the U.S. Centers for Disease Control and Prevention (CDC), approximately 19% of adults in the United States are smokers. However, the smoking rate is two to three times higher among adults who are HIV-positive.

 

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New Study Looks at Smoking Cessation among People with HIV

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Corey Prachniak is an LGBT rights, HIV policy, and healthcare attorney. He serves on the Steering Committee of the Network for LGBT Health Equity and tweets @LGBTadvocacy.

 

 

 

What makes smoking cessation successful among people living with HIV?  That was the question posed at an event last week at the American Legacy Foundation in Washington, DC.

Dr. Donna Shelley explained that ending smoking among people living with HIV is especially important because “smoking increases the risk of HIV-related infections” and leads to “poorer adherence to HIV meds, higher viral load,” and other health problems.  NAM, an HIV/AIDS organization, notes that HIV-positive “smokers are approximately three times more likely than non-smokers to develop the AIDS-defining pneumonia PCP” and that “oral thrush, a common complaint in people with HIV, is also more common amongst smokers.”  Dr. Shelley’s study focused on testing cessation strategies among people with HIV in New York.

When it comes to quitting smoking, it could be seen as a positive or negative that people living with HIV are already likely to have complicated medical adherence needs.  On the one hand, adding smoking cessation interventions and medications adds to the burden that many people living with HIV already face.  But on the other hand, many people living with HIV have found success at incorporating medication regimens into their lives and are used to managing their care, either on their own or with the support of a medical adherence team.  For people who are doing well adhering to their HIV-related medications and treatments, they may well be able to incorporate tobacco cessation measures with a high level of adherence.

In fact, that is what Dr. Shelley’s preliminary data suggested.  “Adherence at baseline to HIV meds,” meaning how well people remembered to take their HIV medications at the start of the study, “was closely correlated to adherence to cessation medications” by the study’s sixth week, she said.

Dr. Shelley also noted that the people for the study were recruited from healthcare clinics, which often are in more regular contact with their patients than are other types of medical providers.  That’s because these settings tend to offer multiple, highly coordinated services.  So, for example, if a client comes in to see her therapist but has missed an appointment with her primary care doctor, the staff person checking her in can make sure she reschedules with her doctor or gets the prescription refill or referral that she might need.

The research tested three adherence regimens: smoking cessation medication alone; medication and adherence text messages; and medication, text messages, and adherence counseling phone calls.  Interestingly, the research found that the group with the best adherence were those who received the medication and text messages, but not the phone calls, which many people reported as being “too much.”  People also stressed that they liked texts with positive reinforcement – like “stay on track” or “look how much money you’ve saved this month” – versus messages that just reminded them to take their medication.

It’s unclear whether the results are unique to people living with HIV, or would have been the same for others, as well.  But it’s worth noting that people who are already managing HIV-related care preferred quick positive reinforcement on quitting smoking rather than lengthy counseling on taking their meds or daily messages telling them to take their pill.

It’s true that HIV is not just a problem for the LGBT community.  But given that 63% of new HIV infections in 2010 were among men who have sex with men, and that LGBT people smoke at a rate that is 68% higher than the population in general, the intersection of smoking and HIV is a critical topic for LGBT health advocates to keep in mind.

#SaludLGBTT Summit: E-Cigs are a New Face for an Old Addiction

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Corey Prachniak is an LGBT rights, HIV policy, and healthcare attorney. He serves on the Steering Committee of the Network for LGBT Health Equity and tweets @LGBTadvocacy.

This is a series of posts covering Corey’s work in Puerto Rico for the Salud LGBTT conference.

 

 

“Que es?” Dr. Jeannette Noltenius asks the crowd as she “lights up” an electronic cigarette on stage. Despite its flashy look and hidden interior, it’s nothing more than another mechanism for delivering nicotine, she says.

Dr. Noltenius is here to finish up the plenary sessions at the first day of the Salud LGBTT summit. Her presentation focused on the timely issue of electronic cigarettes, or e-cigs, which I have been told have been growing very popular across Puerto Rico in the past few years.

In a regular package of cigarettes, there are 21 grams of nicotine. In one electronic cigarette, there can be as many as 26 grams – so in a few minutes, you could get a pack’s worth of the addictive chemical.

And these companies aren’t stopping with regular e-cigs. They’ve also developed a liquid version of the product that can be smoked inside an e-cig but also inhaled, mixed with drugs like Cialis, or consumed in any other number of ways. Furthermore, niche products like e-Hookah seek to draw in as many consumers as possible.

Dr. Noltenius explains that 95% of ads for e-cigs have featured the concept that they are healthier than cigarettes. Other marketing strategies include promoting that it reduces second-hand smoke and can be smoked anywhere, even indoors. But these claims ignore the addictive properties and unhealthy chemicals that define these products, as well as incidents of poisoning and even a few instances of explosions, one of which lit a three-year-old child on fire.

Distributors have been marketing heavily and handing out free products on the streets as a way of getting people hooked. By and large, they are unregulated in how they can advertise, unlike traditional cigarettes are today; the FDA hasn’t yet exercised its power to regulate them. They are targeting the LGBTT community with club promotions and sexy ads the same way cigarettes were pushed upon our community. And Dr. Noltenius cautions that they will be trying to “buy” the LGBTT community with offers of funding for issues like HIV prevention that allow them to infiltrate our social spheres. You will end up repaying them, she warns, in the long run.

Tobacco companies might have been threatened by the rise of e-cigs, but they solved that problem by buying them out. Today, most of the e-cigs are owned by the same corporations that have caused millions of smoking-relating death. Now they are marketing e-cigs as a safer alternative to their own more traditional products.

E-cig makers are seeking to re-normalize smoking, Dr. Noltenius says, with the tobacco companies now projecting that consumption of e-cigs will exceed that of traditional cigarettes in just ten years. If that’s the case, this issue will only become more important for us to tackle as a community.

Stay tuned to the Network blog and my twitter account, @LGBTadvocacy, for lots of live coverage of the summit!

Benson & Hedges Targets LGBTT Communities in Puerto Rico

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Juan Carlos Vega, MLS

Blogging for the Citizens’ Alliance Pro LGBTTA Health of Puerto Rico, National Latino Alliance Pro Health Equity and the Network for LGBT Health Equity

 

 

This is bad! As health professionals, community prevention programs, and the Puerto Rico Department of Health strive to reduce tobacco use prevalence among island inhabitants, we have busted Benson & Hedges, twice, targeting lesbian, gay, bisexual, transgender, and transexual (LGBTT) communities in San Juan area’s LGBTT clubs. Cute girls, in tight outfits, look to scan your driver’s license in order to continue to help folks initiate or facilitate access to low price cigarettes. If you fill out the survey that they present at these bars and allow them to scan your id, you can purchase a pack of Benson & Hedges from the bar at a huge discount. No wonder LGBTT smoking prevalence is two to three times higher than that of the general population.

Health Authorities Warn: Smoking Kills

Health Authorities Warn: Smoking Kills

Twice, I have been with gay guys who are trying to quit smoking for health and financial reasons and they have been accosted by such tobacco industry tactics. One time, we bought the cigarettes, the second time we resisted. Yes, I was included. After nine years of being smoke free, I have become an occasional social smoker for the past 3-4 years. It is so nasty, the smoke inhalation, the after taste, yet, after a few drinks, I see myself taking a “hit” or two from my friends’ cigarettes. I don’t blame the industry for my personal unhealthy choices, but they sure don’t help us quit for good!  Access to cheap smokes at bars should not be allowed! 

Last weekend, was the second consecutive month, we have seen this predatory practice in our local LGBTT bars. It was contrasting to see as we were distributing promotional flyers for the  3rd LGBTT Health Summit of Puerto Rico, April 4th and 5th at the School of Nursing of the Medical Science Campus of the University of Puerto Rico, free of cost for the general public and $45.00 fee for Continuing Education for Physicians and Nurses. Against the luring of the tobacco industry to get us to smoke again, the Citizens’ Alliance Pro LGBTT Healthefforts continue to fight the dangers of tobacco use with the support ofLegacy Foundation, the Network for LGBT Health Equity, theComprehensive Cancer Center at the University of Puerto Rico, and the local tobacco free coalition. For more information, on how tobacco affects the health of LGBTT communities, come to the 3rd LGBTT Health Summit of Puerto Rico: Tendencies Towards Health EquityApril 4th and 5th in San Juan. Come by, our Summit is cheaper than the pack of cigarettes sold those nights and you will get great information, make new friends and learn how to take better care of yourselves!

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Juan Carlos Vega shows a tobacco cessation material in Spanish “Tobacco is a murderer that does not discriminate”

FDA Launches Youth Anti-Smoking Campaign, with LGBT Effort to Follow

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Corey Prachniak is an LGBT rights, HIV policy,
and healthcare attorney. 
He serves on the Steering Committee
of the Network for LGBT Health Equity
and tweets @LGBTadvocacy.

 

This morning at the National Press Club in Washington, the Food and Drug Administration unveiled a $115 million anti-smoking campaign aimed at youths – the first-ever such campaign in the FDA’s history.  Commissioner of Food and Drugs, Dr. Margaret Hamburg, explained that the effort would specifically target “on-the-cusp youth smokers,” aged 12 to 17, who either had recently begun smoking or who were open-minded to trying it.

Mitch Zeller, Director of the FDA Center for Tobacco Products, noted that when compared to regular smokers, these “at risk teens are even harder to reach because they don’t even see themselves as smokers.”  Instead, they believe that they are only casual users who will not get hooked.

I had the opportunity to ask the panel about their plan to prevent smoking among LGBT youths.  Much as Director Zeller noted that at risk youths don’t consider themselves smokers, many youths might not consider themselves LGBT, and are instead are still processing how they feel or working on coming out.

Responding to my question, the Center’s Director of the Office of Health Communication and Education, Kathy Crosby, said, “We understand that there are sensitivities and we understand that there are cultural issues, as well,” in reaching LGBT teens.  Crosby noted that while the campaign on the whole targeted youths aged 12 to 17, they will launch a subsequent LGBT campaign that may instead focus on 17 to 18-year-olds who are more likely to identify as LGBT.  The hope is that by targeting that subgroup, the message will trickle down to younger teens who are entering the LGBT community.

Ms. Crosby noted that this LGBT sub-campaign is still in the initial stages of development, and will likely take one to two years to take off.  Director Zeller added that the LGBT effort will have “similar themes” to the broader campaign being launched this month, but will be “more targeted” to LGBT youths.100_4885

Directing anti-smoking efforts at LGBT youths is necessary given that the LGBT community has long been a target of tobacco corporations – and has disproportionately high rates of tobacco use to show for it. According to research recently compiled by the Network, LGBT people smoke at a rate that is 68% higher than the population as a whole.  Although the LGBT community spends $7.9 billion – with a “b” – on tobacco products each year, crucial Surgeon General reports on smoking did not even mention LGBT people until a 2001 document entitled “Women and Smoking.”

The new FDA campaign, entitled “The Real Cost,” will “highlight the real costs and health consequences of tobacco use” by focusing on things that young people care about, such as outward appearance and having control over their lives, said Commissioner Hamburg.  The FDA’s research – which will continue for two years as they track 8,000 teens exposed to the ad campaign – revealed that these concerns are more relevant to young people than are long-term consequences, such as heart and lung health, that seem too distant to be real threats.

“It’s different than what we’ve heard before,” said youth activist Daniel Giuffra, “and I think teens will respond to this.”  By using social media in addition to traditional media buys, Mr. Giuffra believes the campaign will “get a conversation started, something we haven’t been able to do before.”

It is a conversation that the LGBT community – and their advocates – desperately need to have.

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We’re working toward a tobacco-free future for LGBT communities!

Here at the National LGBT Cancer Network Summit in NYC, we wanted to get in on the Surgeon General Report excitement! #SGR50photo

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Sassy new ad and infograph highlight LGBT smoking disparity in California

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Brian Davis, Project Director
Freedom From Tobacco
 

 

 

 

 

New video and infographic resources were unveiled by California’s anti-tobacco partners for the LGBT community to address the disproportionate impact of tobacco within the community.  In California, the LGB community has one of the highest smoking rates of any group; lesbian, gay and bisexual individuals are twice as likely to smoke as the straight population, based on data collected as part of the California Adult Tobacco Survey (CATS) from 2005 to 2010 through the Behavioral Risk Factor Surveillance System.

CATS does not currently identify Transgender status.  Future versions of the survey will hopefully rectify this problem, so that we will have more complete data on all of our communities in subsequent reports.  Although this limitation is by no means confined to California data, we do know from multiple sources that the LGBTQ population nationally smokes anywhere from 50% to 200% more than the general population.

Issues of highest concern:

  • The smoking prevalence of the California LGB population is twice as high as heterosexual adults (27.4 percent vs. 12.9 percent)
  • Lesbians smoke almost 3 times as much as straight women and gay men smoke almost two times as much as straight men.
  • LGB Californians are nearly twice as likely as straight Californians to let someone smoke in their homes even if they don’t smoke.

The goal of these materials is to inform and drive conversations to help the LGBT community come together to fight tobacco. The groundbreaking new video, which premiered to appreciative audiences at the San Francisco LGBT Film Festival last June, sends the all-important message that our community members can help each other break free from tobacco. Hopefully the video will help change the perception of tobacco addiction from primarily being viewed as an individual problem to instead being regarded as a serious concern for the entire community to address.

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 Check out TobaccoFreeCA for more info and ads!