In 2018, the Greater Manchester Health and Social Care Partnership teamed up with LGBT Foundation to improve and promote inclusive stop smoking services for all. The partnership funds a Making Smoking History Programme Co-ordinator and it’s their role to engage with the LGBT community across Greater Manchester to encourage smokers to quit.
Tom Chew has been in post since December 2020, and we spoke to him to find out more about more about his role in helping LGBT (lesbian, gay, bisexual, transgender) smokers to quit.
Tom said: “My role with Greater Manchester Health & Social Care Partnership and LGBT Foundation is to support Greater Manchester’s ambition to be the first city to be smokefree by 2030. We believe we can achieve this by supporting different communities across the city-region. It’s vital that we engage with each of them by providing the support and encouragement they need to stop smoking.
“In Greater Manchester, the number of people who smoke is steadily reducing, but within certain communities smoking rates remain higher than the general population. This is the case with the LGBT community as people are disproportionately affected by smoking and are more likely to be in lower socioeconomic groups. LGBT people also experience higher rates of mental health problems such as stress, anxiety and depression, and may turn to smoking, so it’s really important we understand the issues they are facing.”
According to the Integrated Household Survey from 2016, 24.6% of people who described themselves as either gay or lesbian are smokers, compared to, at the time, 18.8% of individuals who described themselves as heterosexual[i].
Tom added: “LGBT people are not only more likely to smoke but also less likely to access help. Historically, the LGBT community is marginalised, and LGBT people were subject to systemic discrimination, homophobia and transphobia. Even though things have progressed and society has come a long way, LGBT people are still victims of discrimination.
“Many have a distrust of health services due to past experiences of not being listened too, a fear of being treated differently and not feeling included. For some people smoking is a taboo subject, especially within certain ethnic groups, so it is difficult to encourage them to engage with smoking cessation services.
Smoking acts as both a coping mechanism and a tool of assimilation within the LGBT culture. As many people associate it with coming out as when they started to go to pubs and clubs, they saw smoking as way to meet people, so they started smoking to fit in with their peers. Therefore, people may be more reluctant to stop smoking as they feel that quitting will exclude them from a group they finally belong to.
“The pub and club scene is strongly associated with the LGBT community, as it has acted as a safe space for many LGBT people. LGBT communities and culture have thrived in these settings, where often these ‘underground’ spaces were the only places they could meet. Smoking was closely linked to these spaces, so it became established as the cultural norm.”
As part of Tom’s role, he has delivered LGBT inclusivity training to colleagues working in public health as well as smoking cessation services, as this is a barrier to LGBT people engaging with support services. Tom educates staff on all aspects of LGBT inclusion and diversity including gender identity, sexual orientation and pronouns to ensure staff know how to communicate with LGBT people in the appropriate way.
Tom added: “Training staff is really important as the LGBT community want to feel included and do not want to be treated any differently from the general population. It is important to educate staff on how to engage with LGBT people by understanding how to approach them and the questions to ask them to identify their needs. No one should ever have to explain themselves or their gender, so it is important everyone is treated equally.
“In addition, I’m continually working with the LGBT community to make them aware of local smoking cessation services and the benefits of getting support to quit. As I work with historically seldom heard communities it is important to emphasise that they need to want to quit and feel ready to engage with the service before accessing support.”
As Pride is an important annual event in the LGBTQ+ community, staff from LGBT Foundation have attended previous Pride festivals across Greater Manchester to engage with attendees to better understand their smoking behaviours and what they would want from stop smoking services.
Tom is ensuring that all of the staff working at LGBT Foundation, as well as their several hundred volunteers, have the knowledge, skills and confidence to talk about smoking with service users and offer signposting to help and support. The LGBT Foundation played a key role in developing eLearning in Understanding Tobacco Addiction.
Tom said: “We’re committed to ensuring that each and every person who works or volunteers for LGBT Foundation has the tools and skills that they need to provide a sympathetic ear to people who smoke and signpost them to the services that will help them to quit.”
Visit YouCanGM.org to find details of stop smoking services and support across all 10 boroughs of Greater Manchester or call the NHS Stop Smoking helpline free on 0300 123 1044.
[i] ‘Integrated Household Survey (Experimental statistics): January to December 2014’ https://www.ons.gov.uk/peoplepopulationandcommunity/culturalidentity/sexuality/bulletins/integratedhouseholdsurvey/2015-10-01 accessed 23/02/21