Stop-smoking service provision for LGBT communities in Scotland

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In July 2010, PATH published a report into smoking within the Lesbian, Gay, Bisexual and Transgender (LGBT) population in Scotland. The report is downloadable here (pdf; 1.2Mb; 32pp).

The report aimed to address several issues:

to establish the number of people living in Scotland who identify as lesbian, gay, bisexual or transgender;
to establish the prevalence of smoking within the Scotland-wide LGBT community;
to provide evidence of existing LGBT-specific or tailored stop-smoking services in Scotland;
to look at existing policies which may help tackle LGBT-related inequalities;
to establish what the future needs might be of LGBT people in Scotland with respect to stopping smoking or using tobacco;
to provide recommendations for future work for all PATH partners (Scottish Government, NHS Health Scotland and ASH Scotland) and for LGBT community organisations/services.

Although there is currently little reliable data which gives the true size of the LGBT community within Scotland (estimates range between 5-10% of the population), evidence does suggest that smoking prevalence rates are higher for this cohort than for the the nation as a whole. This indicates that encouraging LGBT people to access stop-smoking services may not only help reduce a basic health inequality, but also help health boards to better meet their HEAT (Health improvement, Efficiency, Access and Treatment) tartgets around client engagement and quit rates.

To fully benefit from this, however, boards need to ensure that the services they offer are designed to reflect the diverse needs and lifestyles of their clients. Voluntary organisations - particularly those which serve the LGBT community, or a section of it - can also help drive down inequalities by raising the issue of smoking and tobacco use with their clients; this extends to sexual health and HIV-specific settings.

The recommendations drawn from the report reflect these challenges:

Recommendation for the Scottish Government:

o that research is undertaken to provide a more accurate picture of the LGBT community within Scotland, and to identify smoking prevalence rates within it. Such research should take into account all relevant socioeconomic factors and broader equality and diversity strands.

Recommendations for health boards and NHS services:

o that NHS services (including stop-smoking initiatives) undertake equality and diversity training to ensure that the health needs of LGBT people are appropriately met, and to ensure delivery of a non-judgmental and inclusive service. This could link in with Equality Impact Assessments (EQIAs), to evidence that NHS boards are addressing the health needs of the whole community.

o that local health plans and tobacco control strategies (where they exist) include and reflect the identified health needs of the LGBT community (once known), including those relating to tobacco use and stopping smoking.

o that through relevant community groups, NHS boards specifically engage with and encourage their local LGBT population to access stop-smoking services, which may also help boards meet their HEAT target relating to smoking prevalence.

o that services for people living with HIV (including, but not limited to, sexual health settings) are encouraged to raise the issue of smoking and tobacco use with their clients, and signpost them on to stop-smoking services where appropriate.

Recommendations for PATH and ASH Scotland:

o that PATH conducts needs assessments with LGBT community organisations, to explore what issues should be addressed (including, but not limited to, training) in order to raise the issue of smoking and tobacco use with their service users.

o that PATH and ASH Scotland’s tobacco-related work links in with LGBT community organisations (including those for young people), to widen its reach amongst the voluntary sector.

Recommendation for research:

o that the Gay Men’s Health/LGBT Centre for Health & Wellbeing model, which shows some promise, be examined more closely to determine whether there are aspects of its delivery which could be reproduced in other settings (NHS and/or LGBT community-based).

During the summer and autumn of 2010, PATH (via its Projects Officer based within ASH Scotland) will endeavour to engage with LGBT community-led organisations and services, to explore what issues need to be addressed in order to raise the issue of smoking and tobacco use with their clients and to identify what other links can be made to ensure that LGBT voices are heard within the wider tobacco control community in Scotland.

If you would like to contribute to this discussion, or have any questions about the report or its recommendations, please contact Linda Bates (PATH Projects Officer) via lbates@ashscotland.org.uk or on 0131 220 9481.

page last updated: 13 July 2010