Exploring Identities and Preferences for Intervention Among LGBTQ+ Young Adult Smokers Through Online Focus Groups

Purpose: LGBTQ+ young adults are disproportionately affected by tobacco use and associated health conditions. A culturally tailored intervention may improve smoking cessation with this priority population. We conducted focus groups to inform development of a social media intervention to help LGBTQ+ young adults quit smoking. Methods: We conducted two focus groups with LGBTQ+ young adults (N = 27) throughout the United States in a Facebook secret group online setting. An online survey characterized tobacco and other substance use. Questions posed to focus group participants addressed patterns and contexts of smoking, LGBTQ+ identity, and barriers and facilitators to participating in a culturally tailored smoking cessation intervention on social media. Focus group transcripts were coded and analyzed using directed content analysis. Results: Overall, young adults had mixed feelings about linking the identities of LGBTQ+ and smoking, and reflected differences in online and “real life” identities. Participants were generally receptive to a social media smoking cessation intervention with concerns about privacy in sharing their smoking status and LGBTQ+ identities with their online social networks. Gender nonconforming individuals had some unique concerns about Facebook policies. Conclusions: This study highlights important considerations in tailoring a social media intervention for LGBTQ+ young adults. We identified experiences of LGBTQ+ young adults that would support tailoring to a diverse community, and suggestions for how to make smoking cessation programs more appealing to this priority population.