Rutgers Experts Explore Impact of E-Cigarettes, Vaping on Marginalized Populations

Recent deaths and illnesses linked to vaping have prompted New York to become the first state to ban flavored e-cigarettes. Other states are looking to follow suit, including New Jersey, where Gov. Phil Murphy has appointed a task force to recommend policies on e-cigarettes. 

But there has been a little public discussion about smoking and vaping rates among marginalized populations including those who identify as LGBTQ, people living with HIV/AIDS, and individuals involved in the criminal justice system, whose smoking-related risks are two to four times higher than the general population.  

Dean Perry N. Halkitis and Assistant Professor Pamela Valera, both at the Rutgers School of Public Health, talked to Rutgers Today about effects of vaping and e-cigarettes on marginalized communities.

Why are smoking rates so high among marginalized communities?

Marginalized populations are more likely to gravitate towards smoking because they face many barriers to finding effective smoking cessation programs. Studies reveal that various factors, including daily experiences of stigma and discrimination, contribute to why individuals from marganzlized groups, start and continue smoking.

Marginalized communities have limited access to smoking cessation treatment due to the cost of treatment, lack of health insurance, or knowledge about these types of programs. Moreover, many programs fail to address the cultural nuances that shape the lives marginalized groups, especially within the LGBTQ community. The current federal administration has also made it easier for some healthcare providers to discriminate against marginalized  groups based on religious exemptions. This has further complicated their access to quality healthcare as many forgo care in fear of discrimination or getting blamed for their health conditions and/or behaviors. Moreover, among gay men, the challenges of smoking, vaping, and/or use of e-cigarettes is complicated by the fact that this subpopulation is also burdened by HIV, making those living with the disease more vulnerable to pulmonary complications, respiratory diseases, and lung cancer.

How vulnerable are sexual and gender minority groups and marginalized communities to marketing gimmicks by big tobacco companies?

LGBTQ populations are more vulnerable because of minority stressors created by social conditions that catalyze and facilitate risky health behaviors, including smoking and vaping. In turn, aggressive marketing strategies by tobacco companies prey upon these vulnerabilities. Tobacco companies are known to sponsor LGBTQ Pride events and target LGBTQ friendly bars providing freebies and discounts. Marketing in and of itself is not sufficient, but is highly effective when targeting vulnerable populations.

How can marginalized communities and sexual and gender minority communities remain safe amidst the recent news about vaping-related illness and deaths?

The emergency department plays a vital role in treating all patients experiencing symptoms or life-threatening illness related to vaping, with or without basic health insurance. Like all, marginalized people should seek care in the nearest emergency room if they experience any unusual symptoms because of vaping or smoking e-cigarette products.

Unfortunately, many LGBTQ people, people living with HIV/AIDS, and those who are incarcerated or formerly incarcerated, face blame and subpar care in medical settings, complicating the delivery of effective care and treatment.

How will bans on flavored e-cigarettes affect marginalized communities and sexual and gender minority groups?

Bans can be helpful in decreasing risk-taking behaviors. Increasing access to culturally competent smoking cessation treatments that help marginalized populations overcome nicotine addiction must accompany these bans.

Additional resources need to be focused on expanding smoking cessation strategies and nicotine addiction therapies that treat and assist LGBTQ smokers, people living with HIV/AIDS, and individuals involved in the criminal justice system to overcome nicotine dependence and addiction. 

Public health and local campaigns need to address underlying smoking stressors, social isolation and inequalities among sexual and gender minority groups, people living with HIV, and those with criminal justice histories that drive these behaviors and tailor smoking cessation messages to marginalized population.

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