How can we use HIV prevention techniques to lower smoking rates?

How can we use HIV prevention techniques to lower smoking rates?
Photo: AP Photo/Gerald Herbert

Many members of the LGBTQ community are already reacting to the looming Trump presidency (understandably) with a sense of fear, panic, and catastrophe.  How this public figure is intending to challenge our legal protections, medical rights, and basic physical safety, are still unknowns. 

But there is one thing we know for certain:  If people continue to smoke cigarettes at the current rate, then at least 30,000 members of our community will die from tobacco related illnesses every year.  And this is something that we are completely doing to ourselves. 

I only recently learned about the impact of smoking on the LGBTQ community after teaching on a harm-reduction panel in Washington DC. There, on a hot August afternoon, I had an opportunity to talk to a group of lobbyists about PrEP and TasP, and how these combined prevention tools could effectively end the traumatizing HIV plague that we have been coping with for 35 years. 

I explained how we now have an unprecedented opportunity to use these biomedical interventions to reduce and eliminate HIV; all we need to do is provide the education and resources to make this happen over the next decade.  The crowd was inspired and captivated when they saw the potential that already exists to expand the quality and quantity of life for hundreds of thousands of LGBTQ members. 

One of the members of the group contacted me afterwards.  He appreciated the message of hope and joy that PrEP and TasP offers.  But then he asked me what I thought about smoking in our community.  I didn’t have much of an opinion to share.  Although I was aware that gay people smoked more than our heterosexual counterparts, I hadn’t given much thought about its impact.  My focus for most of the past four years has been on PrEP, sexual health, access to healthcare, and seeing how improvement in these factors had resulted in record low new HIV infections and HIV-related deaths.  Cigarettes really weren’t part of my terrain. 

“What if I told you that our community had twice as many deaths from cigarettes than HIV,” he asked. 

I didn’t think that was possible.  Sure I know gay people smoke a lot, I see it at every meeting, conference, event, bar, club, social gathering around the world.  But the reality of more individuals dying from tobacco than HIV?  As a therapist and a sexual health educator, wouldn’t I have been told that at some point?

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