There’s a cloud over our community... and it’s smoky. While many have kicked the cigarette habit or replaced it with the flavoured undertones of a vape pen, smoking still has a grip on us. In fact, rates of smoking in LGBTQ+ community are significantly higher than in the general population.

The Office for National Statistics 2019 report found that smoking rates within our community were as high as 23% for gay, lesbian and bisexual people, higher than our heterosexual counterparts. Not only does this have well documented physical health impacts, it also has a serious knock-on effect on our mental health. Let’s look at why...

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What’s the link?

As well as being a leading cause of heart disease, cancer and other health conditions, smoking can have a negative impact on our mental health and wellbeing. Research shows that smoking increases anxiety and stress and that smokers are also at higher risk of depression. People with a mental health condition are much more likely to smoke than the general population, tend to smoke more heavily and are at higher risk of addiction.

Poorer mental health can also lead people to smoke and smoke more often. 46% of LGBTQ+ people that smoked believe that it helped relieve stress and 41% believed that smoking helped them calm down, when we know that smoking actually increases stress levels and makes it harder to quit.

But what unique challenges does the LGBTQ+ face when it comes to smoking?

What are the challenges?

As LGBTQ+ people we face some unique challenges that other people outside of our community might not face as often. And it’s these challenges that increase our likelihood of taking up smoking. Stop Smoking London has some theories on why this is the case:

Stress and anxiety

Experiences of discrimination, stigma, and social exclusion can lead to more stress and stressful situations, which many LGBTQ+ people seek to manage through smoking. As mentioned above, as much as 46% believe smoking helped them alleviate stress.

Lack of representation

Many LGBTQ+ people can feel that mainstream stop-smoking campaigns don’t speak to their experiences. The messaging in campaigns often focuses on fertility or family health, which are topics that may not connect with all LGBTQ+ people. Also, if we don’t see ourselves in campaign visuals, we may be less likely to engage with the message.

Cultural and social norms

Smoking has historically been more visible and accepted in LGBTQ+ social spaces, such as bars and clubs. This cultural association can reinforce smoking as a social norm within the community. 

Targeted marketing

Tobacco companies have historically targeted LGBTQ+ communities with tailored advertising, contributing to higher uptake and normalisation of smoking. 

Barriers to accessing support

Some LGBTQ+ people say that they feel uncomfortable or misunderstood in mainstream stop-smoking services, highlighting the need for more inclusive support that acknowledges the unique experiences of LGBTQ+ people that smoke.

The science behind coping

Why is smoking used as a coping mechanism? It’s because nicotine stimulates the release of dopamine in the brain, an important driver of the brain’s reward system. It might feel like smoking a cigarette helps to relieve smoking only provides a temporary feeling of calm, which is usually for around 20 minutes, before withdrawal symptoms and cravings set in and you want to reach for another cigarette. 

This negative cycle of dependency can be very hard for smokers to break. On top of this, worries about the impact of smoking on your physical health or the financial cost of smoking could negatively affect your mental health.

“When you take an inhilation of a cigarette, the nicotine attaches to receptors and you release something called dopamine,” explains Dr Agatha Nortley-Meshe, the Regional Director for Primary Care in London, NHS England. “People start to feel better because dopamine is a feel-good hormone. But it only lasts about twenty minutes, that dopamine effect, so it’s not permanent, it’s a temporary effect, which is why then people need more cigarettes. If we look at the longer term benefits of stopping smoking, not just on your physical health but also your mental health, actually longer term is reduces your stress levels, if you’re a non-smoker.”

The benefits of quitting

What are the mental health gains wen you quit smoking? Sure, you can breathe more easily and you smell much better, but there are some tangible brain benefits to stubbing it out for good. When you stop smoking, you experience many positive effects on your mental health, including:

• Reduced anxiety, stress and depression levels
• Improved mood, self-esteem and quality of life

If you are taking medication for a mental health condition, such as antidepressants, you might find that you can reduce the dosage when you quit smoking. Changes to your medication should only be done in consultation with your doctor.

Stopping smoking is a journey, however, and you might find that you experience mood swings and that your mental health gets worse rather than better in the short term. Nicotine withdrawal symptoms, such as irritability, anxiety and restlessness, might last 2-4 weeks.

“I’ve quite many things over the years,” former smoker Sam tells us, “but cigarettes were definitely the hardest thing I’ve ver quit. It was just consuming all of my time trying to stop, trying to find ways to hife the cigarettes from myself or smoke less. I was introduced to a smoking cessation service. I think having the support from the team and them giving you different things to try and helping you out with it in the beginning stages helped quite a lot, really.”

How to quit

When you quit smoking, it’s normal to experience withdrawal symptoms due to reduced levels of nicotine within the body. If you smoke and have a mental health condition, you might believe that it will be harder for you to quit smoking. However, with the right support, it’s possible. We understand that there isn’t a one-size-fits-all approach to quitting. But there are different methods you can try.

Stop Smoking London has an app called Smoke Free created specifically to help people, including LGBTQ+ people, on their stop smoking journey.

The app is a judgement-free zone where you can focus on your health goals without worrying about discrimination or misunderstanding. Whether it’s stress from workplace discrimination, family tension, or anxiety in social situations where you’re not sure you’ll be accepted, Smoke Free helps you identify and manage your specific triggers without judgment. 

Your support system matters and the app knows that chosen family and community connections are often crucial for LGBTQ+ people. The app allows you to connect with supportive communities and track your progress in ways that honour the relationships that matter most to you. 

Your identity is complex. You’re not just “a smoker trying to quit”, you’re a whole person with intersecting identities. You can set goals and celebrate victories in ways that feel authentic to who you are. It provides:

• Personalised cravings management
• Connection with others
• Progress tracking
• Relapse support
• Ways to reclaim physical and mental health 

You can download the app by searching ‘Smoke Free’ on the app store. It’s free for people who live in London.

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Find out more and get the Smoke Free app by visiting www.stopsmokinglondon.com/lgbtq-week