Marketing Strategies Used by Tobacco Companies Targeting the Queer Community

Abstract

Background: This study described the marketing strategies tobacco companies use to advertise tobacco products to the Queer community.

Methods: In this secondary qualitative analysis, 15 Queer participants were interviewed to explore their life experiences with tobacco product advertisements during the early days of the COVID-19 pandemic.

Results: Participants self-reported as male (n = 5), followed by female (n = 4), gender non-binary (n = 4) and, transgender (n = 2). In addition, most participants identified as Black/African American (n = 7) or White (n = 7). Many participants identified as Bisexual (n = 5) or Queer (n = 4). Using narrative analysis, the themes for this study were: (1) tobacco and vaping companies target minoritized and Queer people; (2) tobacco and vape companies maintain their presence by sponsoring local Lesbian, gay, bisexual, transgender, questioning, intersex, asexual, and other community (LGBTQIA+) bars and Pride events, often through giveaways and coupons; and (3) the use of social media influencers represents a new social marketing technique. As a result, Queer participants were more likely to encounter many different types of advertisements from tobacco companies and, most recently, social media influencers.

Conclusion: Social media influencers are a new factor that needs further study to understand the new tobacco advertising landscape.

Introduction

Despite an overall gradual reduction in smoking prevalence, the lesbian, gay, bisexual, transgender, questioning, intersex, asexual, and other community (LGBTQIA+) or “Queer” community remains a population that has disproportionately high smoking rates compared to their heterosexual counterparts. ¹ For this study, the term “Queer” will be used to refer to individuals within the LGBTQIA+ community. Queer is widely recognized as an inclusive and overarching descriptor for LGBTQIA+ people, often embraced in a positive context, ² due to the following reasons: its gender-neutrality and inclusivity of identities not covered by the “LGBTQIA+” term, ³ and its ability to encompass community members from cultures that articulate non-heterosexual, non-cisgender identities using diverse terminologies and traditions. Queer adults smoke tobacco products at significantly higher rates (33% to 45%) than heterosexual adults (14%).^4,5 Furthermore, Queer people are five times more likely to use e-cigarettes or vaping products than the general adult population⁵, increasing their susceptibility to preventable tobacco-related illnesses and cancers. ⁶

While Queer communities were already vulnerable before the COVID-19 pandemic, the pandemic may have exacerbated the negative experiences, stressors, and conditions they face,^7-9 further exposing them to increased minority stress. ⁸ While data on smoking during the pandemic among Queer individuals are limited, a qualitative study conducted by Valera et al. (2020) explored the experiences of Queer individuals who used tobacco products prior to and during the early days of the COVID-19 pandemic. ⁵ The study (N = 23) identified three key themes that are relevant to understanding tobacco use among Queer individuals during this time: heightened minority stress experienced by Queer individuals, limited familiarity with smoking cessation treatment, and how tobacco smoking may contribute to feelings of stress and anxiety. While the small sample size limits the generalizability of the findings, the themes identified in this study provide valuable context for understanding the potential impact of the COVID-19 pandemic on tobacco use among Queer individuals and underscore the need for further research in this area.

Targeting of queer groups by tobacco and vaping companies

Substantial documentation highlights the tobacco industry’s targeted marketing efforts toward the Queer community. In the early 1990s, tobacco companies were among the first corporations to advertise in Queer publications and offer sponsorship and philanthropy to Queer organizations. ¹⁰ These advertisements implied public support from tobacco companies, vastly different from the behaviors of other companies distancing themselves from Queer communities. ¹¹ Philip Morris pledged large donations (undisclosed) to AIDS research and health initiatives, ¹⁰ further cementing their influence within the Queer community. Since then, tobacco companies have used various strategies to target the Queer community, encompassing tactics such as advertising within gay press publications, portraying tobacco usage as a normalized aspect of Queer life, and leveraging corporate philanthropy to showcase support for justice-related work. Philip Morris’s emphasis on its steadfast commitment to Queer anti-discrimination and anti-harassment policies holds immense significance for the Queer community, which has long pursued such corporate recognition. ¹²

Tobacco companies have also used predatory strategies targeted explicitly toward the Queer community, perceiving this community as being the most “brand loyal.”^12,13 A study conducted in 2008 found that 30% of non-tobacco advertisements in Queer publications featured tobacco use. ¹² These strategic measures, combined with the normative behavior of socializing at Queer-friendly venues, are speculated to have significantly contributed to the heightened prevalence of smoking within the broader Queer community. ¹¹

Tobacco and vaping companies sponsoring local LGBT bars, events, and venues

Bars, clubs, and the vibrant nightlife scene have historically been integral components of Queer culture, serving as safe havens where individuals within the Queer community could authentically connect, often aligned with smoking.^11-14 Research underscores the link between smoking and frequenting bars, particularly among those identifying as Queer. ¹⁴ Tobacco companies have embraced tactics such as organizing special events at LGBTQIA+ bars, distributing free items adorned with tobacco logos, and offering complimentary drinks. ¹² These strategic measures, combined with the normative behavior of socializing at such venues, are speculated to have significantly contributed to the heightened prevalence of smoking within the broader Queer community. ¹¹

Pride Month, encompassing the entirety of June, stands as a dedicated period to amplify Queer voices, embrace Queer culture, and champion Queer rights; throughout this month, planned events take place, including parades, protests, festivals, drag performances, theater productions, and commemorations for those affected by HIV/AIDS.^16-19 The tobacco industry’s presence within Pride events has deepened, notably through sponsorships at Pride festivals. ¹⁷ These promotional tactics are widely believed to substantially accentuate the disparities in smoking prevalence and smoking-related health issues within the Queer community. ²¹

Tobacco companies persist in using strategies such as sweepstakes or discounts customized for Queer populations. ²⁰ The tobacco industry allocates billions of dollars annually to the advertising and promotion of tobacco products, with a significant portion going towards price discounts such as sweepstakes aimed at lowering the cost of tobacco products for consumers.^20-22

Social media platforms like Facebook, Twitter, and Instagram are shared spaces for tobacco product advertisements, particularly e-cigarettes. ²³ While paid tobacco advertisements are generally restricted on platforms such as Instagram and Twitter, data from 2017 to 2019 highlight ongoing marketing of products like e-cigarettes by affiliate marketers and sponsored influencers on Instagram. ²⁴ With substantial followings, social media influencers wield significant influence over trends and are compensated for endorsing products, including e-cigarettes, on Instagram. In online exposure, encountering pro-tobacco content, especially on social media, has consistently been linked to heightened tobacco use risk. ²⁵ Furthermore, exposure to influencer marketing and other promotional strategies related to e-cigarette content on social media has been associated with an increased risk of e-cigarette use among adolescents and young adults. ²⁴ Implications of exposure for Queer individuals, however, remain largely unknown but are assumed to be significant, potentially exacerbating existing health disparities and contributing to increased tobacco use within this community.

Minority stress theory

Minority stress theory posits that Queer individuals experience unique stressors related to their minority status, including discrimination, victimization, and psychological distress.^26,29 These stressors can trigger maladaptive coping behaviors like cigarette use.^31-33 However, minority stress theory needs to be understood in the context of decades of specific marketing to sexual minority communities by the tobacco industry.^34-36 This marketing can exploit susceptibilities related to minority stress, ³⁷ thereby exacerbating disparities within the Queer community. ³⁸

Informed by the minority stress theoretical framework, this present study examines the experiences of Queer individuals and their perspectives on the marketing strategies employed by tobacco companies. Therefore, the research question of this study is: What strategies do tobacco companies use to target the Queer community?

Methods

A narrative method was used to gain insight into how the tobacco industry targets Queer smokers and e-cigarette users, particularly during the early days of the COVID-19 pandemic. ¹ After completing the semi-structured interviews, the research team organized the stories of study participants according to themes that became apparent during the interpretivist approach. This approach encompasses various methods, including memoing, to reflect on and derive meaning from the different aspects and experiences shared by the participants. ³⁹ A pivotal aspect of the narrative approach lies in cultivating partnerships with the study participants. ³ In this partnership, Queer participants shared their experiences concerning their smoking behaviors while the researchers recorded these sentiments.

Reflexivity and researcher’s characteristics

The research team who conducted the interviews were Master’s level public health students who shared similar background characteristics with the participants (racial, ethnicity, and age). These interviewers did not self-identify as Queer, nor did they disclose prior or current tobacco or vaping use. The qualitative coders who participated in data analysis (distinct from the interviewers) shared particular identities with the participants, including sexual orientation and tobacco smoking. This approach, both in conducting interviews and in data analysis, aimed to empower the participants as experts in their lived experience while the research team worked to identify themes and patterns from the narratives presented by the participants. ⁴⁰

Ethical issues pertaining to human subjects

Institutional Review Board (IRB) approval was secured from Rutgers University. Study participants provided informed consent, and all data collected were de-identified to protect the participant’s identities and ensure strict confidentiality.

Data collection procedures

Due to the COVID-19 pandemic, recruitment strategies switched exclusively to digital channels. The flyers were shared across social media platforms to reach the larger Queer community. Prospective participants were screened through a telephone call to ensure they could participate.

During the COVID-19 pandemic, interviews and the screening of potential participants were conducted using Microsoft Teams, an IRB-approved video-conferencing software. For additional details on the data collection protocols and memoing procedures, please see Valera et al. ⁵

Screener, Semi-Structured Interview Guide, and Technologies

Screener

Participants completed a screener that included 11 questions to collect demographic characteristics information such as age, race, ethnicity, sexual orientation, gender, etc. The screening tool was used to identify potential participants eligible for inclusion. The criteria for eligibility include the following: (1) self-identification as lesbian, gay, bisexual, or transgender; (2) age between 18 and 34; (3) able to speak, read, and write in English well enough to understand consent procedures; (4) smoked at least five cigarettes per day over the past seven days, as confirmed by self-report; (5) current e-cigarette or vaping use; and (6) a willingness to take part in a semi-structured interview.

Semi-structured interview

The interview guide included questions to assist participants in exploring their smoking and e-cigarette or vaping behaviors, how their smoking habits intersected with their Queer identity, their perceptions of tobacco marketing, and their thoughts on smoking cessation. Examples of interview questions for this analysis were: ‘What messages do you perceive from tobacco and e-cigarette advertising?’ and ‘What do you interpret the flashy and bright colors to represent?'  For this study, Queer participants were interviewed remotely, with interviews durations ranging from one to one and a half hours. Participants were compensated with a US$50 Amazon gift card.

Smoking questionnaire

In addition to the interview, participants also answered a cross-sectional smoking behavior questionnaire. This questionnaire helped researchers gather information about participants’ substance use history, medical and psychological background, past quit attempts, and smoking behavior and history.

Qualitative data management

NVivo was used as a data analysis management tool for organizing data, coding, and assessing inter-coder reliability. The interview data underwent transcription using automated transcription software through NVivo. Subsequently, a manual review was conducted to rectify errors and eliminate identifying information. The memos created by interviewers were also integrated into NVivo and coded to enhance the overall rigor of the study. Using thematic analysis, researchers extracted meaning from study codes and subcodes, facilitating the creation of the codebook and overarching themes.^41,42

Qualitative data analysis

Codebook

Developing the codebook entailed analyzing data from interviews and memos to identify recurring categories and themes. These findings were used to create codes. Codes were re-evaluated to ensure they reflected the stories and lived experiences participants shared during their interviews. Our codebook included the main code of the tobacco marketing industry and had multiple codes that branched off from it. For instance, we had a ‘Pride’ code to address tobacco advertisements associated with Pride events. A separate code was created for tobacco advertisements outside of Pride Month.

Inter-coder reliability

Two research team members independently applied the codebook to code five transcripts to validate inter-coder reliability. With the use of NVivo’s comparison query, the coders were able to compare their coding to measure reliability. The Kappa coefficient formula was employed to calculate the percentage of agreement between the coders. The agreement between the coders exceeded 70% for each code, except for the ‘social determinants of health’ category. The codes with the highest level of agreement included ‘COVID-19,’ ‘vaping history,’ and ‘smoking agreement.’ Discrepancies in coding were thoroughly discussed with the research team to ensure the validity of the coding process.

Narrative analysis

Narrative analysis is a qualitative analytical approach that uses stories from participants’ lived experiences. ⁴³ This approach helped researchers develop themes more profoundly while simultaneously considering the social context of the participants. (Table 1).

Table 1.

Codebook.

First Code	Second Code	Third Code	Fourth Code	Inclusion	Exclusion	Example
Tobacco marketing and industry	Branding of tobacco products	Advertising in LGBT magazines and media	Event sponsoring	Any mention of tobacco product marketing, advertising, events, etc.	No mention of anything to do with tobacco product marketing, advertisement, events, etc.	“… People are gonna watch testimonials on YouTube where, you know, things like it’s not really advertising it. I feel like the tobacco advertisement is completely pointless. Advertisement, you know, influencers are more effective in this era.”
	Flashy and bright colors		LGBT bar nights
	Targeting LGBT people
	Tobacco advertising
	Vaping companies	Outreach efforts	Pride

Findings

Table 2 describes the demographic characteristics of the Queer participants who were part of the study during the early days of the COVID-19 pandemic. Approximately 33.4 percent of participants identified as male, followed by female (26.7%), non-binary at 26.7 percent, and transgender (13.2%). The most reported sexual orientation among participants was Bisexual followed by Queer. Most participants identified as either Black/African American or White/Caucasian.

Table 2.

Demographics of Queer participants during early days of COVID-19 pandemic (n = 15).

Variable	n (%)
AGE
18-24	6 (40.0)
25-29	3 (20.0)
30-34	6 (40.0)
RACE
Asian	1 (6.6)
Black or African-American	7 (46.7)
White or Caucasian	7 (46.7)
HISPANIC OR LATINO
Yes	1 (6.6)
No	14 (93.4)
HIGHEST EDUCATIONAL ATTAINMENT
High school or General Education Diploma (GED)	1 (6.6)
Some college/technical school	5 (33.4)
Bachelor’s Degree	6 (40.0)
Graduate Degree	3 (20.0)
GENDER
Female	4 (26.7)
Male	5 (33.4)
Transgender	2 (13.2)
Gender Non-binary	4 (26.7)
SEXUALITY
Bisexual	5 (33.4)
Gay	3 (20.0)
Heterosexual	1 (6.6)
Pansexual	2 (13.3)
Queer	4 (26.7)
EMPLOYMENT STATUS
Employed	9 (60.1)
Unemployed	3 (20.0)
Homemaker/caretaker	1 (6.6)
Student	2 (13.3)

The study identified the following themes: (1) tobacco and vaping companies target minoritized and Queer people; (2) tobacco and vape companies maintain their presence by sponsoring local Lesbian, gay, bisexual, transgender, questioning, intersex, asexual, and other community (LGBTQIA+) bars and Pride events, often through giveaways and coupons; and (3) the use of social media influencers represents a new social marketing technique.

Theme one: Tobacco and vaping companies target minoritized and Queer people

Throughout the interview, participants discussed how tobacco companies targeted marginalized groups, particularly those who are Queer. All participants belonged to marginalized communities and could recognize instances where tobacco companies aimed their strategies at either their group or others. For instance, a non-binary participant, who also identified as gay, shared the following perspective:

“I believe that they [tobacco industry] primarily target Black, brown, indigenous people. I believe that they impact the LGBTQ community. But I also think that all of these things align with classism. Right. Because most of those people are in the service industry jobs, they’re in labor jobs, because those populations also have less access to education and resources.”

Tobacco and vaping companies also target poor people, as tobacco marketing strategies often emphasize cheaper and more affordable products. Consequently, any minority group is particularly vulnerable to these marketing messages. Reflecting on this, a transgender male participant stated:

“ I think those of low socioeconomic status as well. Cause you'll see a lot of marketing towards what products are cheaper and more affordable. And that's where I think that it targets that class as well. So, any sort of minority group would also be really vulnerable to those types of messages.”

Theme two: Tobacco and vape companies maintain their presence by sponsoring local Lesbian, gay, bisexual, transgender, questioning, intersex, asexual, and other community (LGBTQIA+) bars and Pride events, often through giveaways and coupons

Throughout the interviews, participants commented on how tobacco companies advertised in spaces exclusively to Queer people. For example, one non-binary participant who is Queer discussed how gay bars are targeted:

“In St. Louis, there’s a street that's known for, like, the queer community. But there is this one club, that changed ownership. So, it’s different. You can tell it’s bringing in different people, and they [tobacco companies] usually have advertisements for e-cigarettes.”

Pride is a sacred event for many Queer individuals. However, many tobacco and vaping companies exploit these events for their benefit by maintaining a presence there. ²⁰ Advertising at Queer-centered spaces can effectively bolster sales for these tobacco companies. Another cisgender female participant who is lesbian discussed their experiences seeing tobacco advertisements at Pride events:

“When I went to NY Pride, I saw a lot of JUUL promoting like kind of things.”

A cisgender female participant who is pansexual said:

“When I’m at a Pride event, they’ll have a booth there with vaping or the chew packets. I don’t know what they’re called the flavor burst packet.”

Another participant, who identified as a bisexual cisgender female, talked about the Pride-themed tobacco advertising that tobacco companies had available: “They'll give you smoking like fun tools…like they're just for tobacco use only and they’ll be like little multicolored pipes or different like nice little light lighters. I think they use a lot of color to attract people.”

“Yeah. And it overlaps with you know, LGBT and you know, symbols like the rainbow. And then you see that flag and they’re like now taking their product and associating it with it.”

Along with using Pride as an advertising strategy, tobacco companies also visit communities with coupons to reduce the product’s price.

Subtheme: coupon giveaways

The use of tobacco products is costly for those who use them continuously. On average, a pack of cigarettes can cost between four and ten dollars across the United States. ⁴⁵ In some states, such as New York and Utah, excise taxes were put in place to raise the price of the products and discourage consumption. ⁴⁶ Participants encountered some tobacco companies in Queer-centered spaces that offered coupon discounts. One cisgender male participant who identifies as Queer stated: “There were reps that came to our local bar that showed up and were given out coupons for like different cigarettes from different companies.” Another cisgender male participant who is bisexual explained their experience of getting coupons at a club:“ [I did] surveys to get like coupons for two or three dollars off of a pack of cigarettes…” This participant also discussed how the tobacco company representatives would gather contact information to send out “promotional items” to those who received the coupons. These coupons can help customers access tobacco products more efficiently and allow them to try a new product they never would have before. The tobacco companies are also helping to build a community for new tobacco products by having their representatives in Queer-focused locations.

Theme three: The use of social media influencers represents a new social marketing technique

Participants stated they had not seen any advertisements except on social media. One transgender female participant said:

“… So, it's watching this influencer advertise a tobacco or vape product. And it’s not an issue. People are gonna watch testimonials on YouTube where, you know, it’s not really advertising it. I feel like the advertisement is completely pointless. And influencers are more effective in this era.”

Tobacco companies recognize that traditional advertising methods that were effective in the past no longer resonate with contemporary audiences. This change can be due to new values and legislation or a shift in tobacco culture, and to navigate these constraints, social media influencers are used to target the emerging generation of potential tobacco users while avoiding existing regulations. ²³

Discussion

This study explored the experiences of Queer participants concerning the use of tobacco marketing in their communities after the start of the COVID-19 pandemic. Participants consistently reported that they saw fewer advertisements from companies in their day-to-day lives but recognized the strategies used by tobacco companies to promote their products. Tobacco companies also know the Queer community is an underserved market that they can tap into for a profit. Additionally, minority stress theory elucidates how economically disadvantaged, minoritized, and Queer people are targeted by tobacco companies, as these groups may seek out tobacco products for relief. ⁴⁷ Because some members of the Queer community are more likely to experience discriminatory and stigmatizing practices, which could lead them to adverse coping measures, including using tobacco products.^49,50 For example, one study noted that 60% of its Queer participants were experiencing some level of emotional distress during the COVID-19 pandemic. ⁵¹ Another study noted an increase in tobacco product use as a coping mechanism for Queer men during the pandemic. ⁵²

Furthermore, participants expressed that they felt tobacco companies exploit the Queer community and other marginalized groups without offering anything in return. This is evident through the presence of tobacco company booths at Pride events, where they distribute tobacco paraphernalia and coupons. Previous literature has highlighted that tobacco company advertisements specifically target marginalized populations. ⁴⁸ However, for many tobacco companies, advertisements and giveaways have shifted to an online medium during the COVID-19 pandemic. The pandemic forced many tobacco advertisers to change their strategies to reach minoritized and Queer people. Study participants mentioned viewing tobacco product advertisements on YouTube and other social media platforms.

Virtual advertisements were also popular with the introduction of social media influencers. These collaborations between tobacco companies and social media influencers are a way to get around the legislation that is in place to restrict tobacco advertisements. ²³ Some social media influencers also have a large youth following.^15,24 According to Vassey et al., ⁵³ over 15 million daily users access these streaming videos. Most of the audience is male and between the ages of 16 and 24. For example, Twitch, a popular streaming platform that social media influencers use to stream video games, has been used to entice young people. Tobacco advertisements have been identified through the Twitch platform, including free samples or influencers using the product while gaming. Due to the lack of regulation on tobacco advertisements online, a large population of youth may be gaining exposure to tobacco products through streaming videos.

Strengths and limitations

Our study has several notable strengths. We employed a rigorous coding process in our qualitative research, encompassing intercoder reliability, the creation of a comprehensive coding book, coding, recoding, and other meticulous, analytical methods to investigate the strategies employed in tobacco advertising targeting Queer individuals. Our participant sample also included a diverse population.

Conversely, there are a few limitations that need to be taken into consideration when interpreting the findings of the study. Gathering more data on how Queer individuals engage with tobacco advertisements via social media influencers could drastically augment the landscape of tobacco research. Second, interviewers could have introduced their own bias into the interviews due to their unidentified sexual and gender identity and the sensitive nature of participants disclosing their own Queer identity. Participants may not have been comfortable disclosing their experiences with the interviewer. In the future, the Queer community can consult to design an interview guide that helps create an environment that fosters an open conversation.

Implications

Our research has implications for future research. One crucial finding during our study was the potential relationship between social media influencers and tobacco companies. The COVID-19 pandemic increased interest in social media platforms, and these advertisements are changing.

Additionally, research is needed to understand tobacco smoking and vaping behaviors of subpopulations such as youth within the Queer community. Developing programs that cater to the needs of different Queer populations can also provide contexts for tobacco and vaping use. This would also require more research into Queer subpopulations to be conducted. It is also essential that members of the Queer population are involved in research development to foster trust, develop the interview questions, and use appropriate language.

Conclusion

Tobacco companies employ diverse events and media to promote their products. Through various advertising strategies, these companies effectively target Queer communities to cultivate brand loyalty. Social media influencers are a new factor that needs further study to understand the new tobacco advertising landscape. Collecting first-hand accounts of how tobacco companies use these strategies to further their profits from the Queer community can help create resources to combat and promote new advertisement strategies. ^{27 , 28 , 30 , 44 , 53}