Smoking Spaces As Safe Spaces for Young and Emerging Sexual and Gender Minority (SGM) Adults

Background and Purpose: Cigarette smoking among adults reached an all-time low at 12.5% in 2020.¹ Yet young and emerging sexual and gender minority (SGM) adults continue to have higher rates of tobacco and tobacco product use compared to their heterosexual and cis-gendered peers.² The minority stress model³ posits that SGM-identified individuals experience an excess of multiple stressors, such as stigma, discrimination, and prejudice. Our study seeks to understand tobacco smoking spaces and how they may be viewed as spaces of safety and belonging among young/emerging SGM adults.

Methods: From November 2018 to March 2019, the research team conducted 42 semi-structured interviews among SGM-identified tobacco users as part of a larger mixed methods study.⁴ Sampling procedures for this study were based on a purposive recruitment strategy known as maximum variation sampling, which captures heterogeneity across a sample population. Eligibility criteria included: (a) residing in Los Angeles County; (b) spoke English; (c) were between the ages 18 to 29 years old; (d) self-identified as a sexual and gender minority (SGM); (e) used tobacco/nicotine product in the 30 days; and (g) provided verbal informed consent. The collected data was coded using Dedoose software⁵ by three members of the study team. Spradley’s ethnosemantic approach⁶ was used to identify common domains and themes relating to tobacco use initiation among participants.

Results: Based on analyses from 42 interviews among emerging SGM adults, our study found that tobacco smoking spaces were viewed as spaces where one can have: 1) a sense of belonging and community; 2) increased sociability; and 3) time for oneself. For participants interviewed in this study, therefore, tobacco smoking spaces appear to serve as safe spaces, away from scrutiny or judgement. Participants indicated that sharing a cigarette or smoking with others in a social setting can provide a space of safety and community, an opportunity to engage with other SGM young adults in conversation and decrease one’s social anxiety. Interestingly, participants noted that smoking spaces can also be a reprieve from others, allowing them some time to be alone.

Conclusions and Implications: Efforts to reduce tobacco use have resulted in smoking bans which has led to an overall improvement in population health. However, our study findings suggest that tobacco smoking spaces may have utility, particularly for young people and those who experienced isolation and displacement, such as members of the SGM communities. Social workers, public health practitioners and policy advocates working on tobacco cessation efforts may need to consider providing new “safe spaces” that allow for community connection and engagement with others. Additionally, providing alternative measures to decrease anxiety in social settings may help in reducing tobacco use in this population.