If anyone has a reason to smoke, gay people do. Gays have higher rates of PTSD, depression, and anxiety—all of which lead to the urge for a cigarette. And a tragically high number of gay people are told that they are diseased, aberrant, intrinsically disordered throughout their youths, fostering a self-loathing that can lead, if not to suicide, than to nearly suicidal activities.
It’s dismaying but not surprising, then, to learn from a new study that a startling 33 percent of LGBTQ people smoke—a rate 68 percent higher than the general U.S. population. Even worse, the LGBTQ community spends an astonishing $7.9 billion every year on tobacco, about 65 times the amount of money spent on all LGBTQ lobbying. And the numbers carry a dark footnote: HIV-positive smokers lose an average of 12.5 years off their lives, compared with 5.1 years lost for HIV-positive nonsmokers.
A decade ago, numbers like these would be utterly unremarkable. And even in 2014, they’ve generally been received with little more than a yawn. Smoking, after all, is one of the less harmful ways troubled gay people can destroy their bodies in a vain attempt to exorcise their demons. A pack of cigarettes is certainly less toxic than meth, binge drinking, and frequent, anonymous unprotected sex—all nostrums with which some suffering gays attempt to treat their mental wounds.
But tobacco isn’t all that much better. After so many years of over-earnest PSAs, it’s easy to write off the risk of cigarettes. The fact remains, however, that smoking—even occasional social smoking—is one of the most toxic, destructive, and ridiculously harmful things you can do to your body. One out of every five human deaths is due to smoking, and smokers die an average of 10 years earlier than nonsmokers. A third of all cancer deaths every year are linked directly to smoking, while a full 85 percent of lung cancers in the United States are a result of tobacco use. And smoking destroys the body in myriad subtle but horrifying ways: Hindering kidney function, contributing toward heart disease and stroke, ruining virtually every organ in the human body.
At this stage, of course, all Americans know that cigarettes kill you, LGBTQ people included—and in a sense, that’s part of the problem. We can wave CDC morbidity studies around all day, but a gay person struggling with self-loathing won’t particularly care. In fact, in a perverse way, the hazard is the draw for gay kids who see no reason to continue living. Merely reminding the LGBTQ community that smoking is awful will do nothing to curb it. The root of the problem—self-loathing cultivated by years of being told you’re a disordered monster—goes too deep to be resolved by scolding PSAs, tempting as that quick fix might seem.
Instead, the solution to the LGBTQ smoking crisis is, essentially, to do nothing—nothing more, that is, than we’re already doing to promote gay rights across the country. Every time a states’ citizens give the thumbs-up to gay marriage, every time a federal judge grants basic equality to gay people, a new generation of LGBTQ youth becomes a little less prone to self-hatred and self-destruction. Supreme Court Justice Anthony Kennedy’s insistence that gay people deserve equal dignity probably did more to curb smoking among gay youth than any anti-smoking ad ever could. As gay people become more accepted in mainstream life, so, too, will gay teens feel less tempted to exorcise their agony with risky behavior like smoking. But until gay people are truly welcomed in all facets of society, gay kids will keep turning to those vices that, in the midst of such overwhelming bleakness, provide a fleeting (and ruinous) moment of relief.
Mark Joseph Stern is a Slate contributor. He writes about science, the law, and LGBTQ issues.