LGBTQ+ at OSU

“Minority stressors and tobacco use among a US sample of sexual and gender minority young adults” – new research led by Dr. Wilson Figueroa

| stanwick.10

In this new paper published in Drug and Alcohol Dependence, the relationship between minority stress and current tobacco use is examined amongst LGBTQ+ young adults. Major findings include trans young adults experiencing the highest levels of both general and minority stress, and increased odds of current tobacco use among trans young adults as minority stress increases. This study has implications for policy related to creating safe spaces for trans young adults to reduce minority stress, and also for tailored interventions that consider minority stress as a factor related to tobacco use.

Check out the full article here.

Authors: Wilson Figueroa; Emma Jankowski; Hayley Curran; Alysha C. Ennis; Tonia Poteat; Ethan Morgan; Elizabeth Klein; Rin Reczek; and Joanne G. Patterson

A Qualitative Assessment of LGBTQ+ Young Adults’ Responses to Culturally Targeted Tobacco Public Education Advertisements

| Ashley Meadows

Authors: Ashley Meadows, Emma Jankowski, Hayley Curran, Alysha C. Ennis, Sydney Galusha, Caitlin Miller, Grace Turk, and Joanne G. Patterson

 

Poster presented at the 2023 CASEL Tobacco Regulatory Science Conference

INTRODUCTION

  • LGBTQ+ young adults report higher rates of smoking and vaping compared to non-LGBTQ+ young adults.
  • Mass-reach tobacco public education campaigns are an effective strategy for preventing tobacco initiation and decreasing use in the general population.
  • Few published studies have examined the content and features that LGBTQ+ young adults prefer when viewing culturally-targeted tobacco public education campaigns.
  • This study qualitatively assessed LGBTQ+ young adults’ perceptions and reactions to culturally targeted tobacco education campaign materials.

METHODS 

  • Focus groups (N=6 groups; n=22 participants) of young adults aged 18-35 (76% non-Hispanic white, 52% bisexual, 86% assigned female at birth) were recruited from December 2022 – January 2023.
  • Participants viewed a randomly ordered set of culturally targeted tobacco public education advertisements. Semi-structured interviews assessed perceptions of images and language on each culturally targeted tobacco education ad.
  • We used template analysis to thematically analyze data. A priori deductive and inductive coding were applied to qualitatively understand LGBTQ+ young adults’ perceptions of visuals and semantics used in the FDA’s “This Free Life” and “Every Try Counts” tobacco public education campaigns.

RESULTS 

Qualitative Codebook for Focus Groups with Young Adults

Theme Code Definition
Ad Design
Font Participants discuss liking or disliking font choices/typography
Layout Participants discuss liking or disliking spacing, layout, or white space.
Colors Participants discuss liking or disliking colors
Graphic type Participants discuss liking or disliking the type of graphic (e.g. photograph vs. illustration/cartoon)
Brand Identity Discusses that the ad design matches or does not match the product being sold given what is known/presumed about a brand (e.g., of “not matching” brand identity:  Kandy Pens ad image of women/men being intimate and product not featured; “I like that they used their brand name as kind of like a play on words”).

 

“This ad tells me nothing about what this company is or does, or anything.”
Creativity Participants discuss whether an ad does or does not feel creative or clever with respect to its design (e.g., Bud Light ad where “L G B T” were highlighted).
Aesthetically pleasing Participants discuss whether  an ad is overall aesthetically pleasing or not
Ad Content: Imagery
Imagery – Representative Participants discuss feeling though the images in ad represent them/people they know (i.e., looks like me, acts like me) or feature real representation of LGBTQ people generally.
Imagery – Liking General like code for imagery
Imagery – Disliking General dislike code for imagery
Imagery – Subtle/Overt Participants discuss the subtlety or overtness of the LGBTQ elements within an ad
Imagery – Pride Flags and rainbows Discusses the liking or disliking of LGBTQ flags and colors within ads
Imagery – Who Participants describe liking or disliking having posed (“fake”)   vs. more natural looking (“real”) models in the ad.
Ad Content: Language
Language – Word choice Participants discuss liking or disliking word choice
Language – Efficacy of absolute risk vs. self-efficacy messaging Participants discuss liking or disliking absolute risk messages as compared to self-efficacy messages
Language – Slang use Participants discuss liking or disliking the use of slang in an ad (e.g. words like “slay”, “queen”)
Language- Humor Participants discuss liking or disliking the use of humor in advertisements
Language- slogans or taglines Participants discuss liking or disliking the use of slogans, taglines, or catch phrases in an advertisement (e.g., “Quitting isn’t a perfect process” or “Made with Pride”)
Ad Content: Representativeness
Inclusivity Participants discuss whether or not the ad is representative of LGBTQ identities

(L – G – B – T  – Q – NB)
Stereotyping Participants discuss feeling as though the ads represent stereotypes of the LGBTQ community, in imagery, language, content, etc.
Intersectionality Participants discuss whether or not ads are intersectional in terms of identities that are not within the LGBTQ umbrella such as racial identity or class status
Authenticity Participants discuss feeling as though ads are inauthentic/authentic; (e.g., feeling like ads have been created by those not within the LGBTQ community/ feeling as though ads have been created by those within the LGBTQ community

 

(authentic ads may take into consideration the feelings, wishes and traditions towards the LGBTQ community)
Fetishization of LGBTQ community Participants discuss ads sexualizing or fetishizing the LGBTQ community
Target Audience Discusses whom they believe an ad was targeted towards
Normalization/Visibility Participants discuss ads being used to normalize or make visible LGBTQ people and relationships. Word “representative” might be used by participants.
Context
Brand partnerships Participants discuss liking or disliking the inclusion of brand partnerships with LGBTQ organizations (e.g. GLADD, Rainbow Railroad)
Ad placement Participants discuss where they see culturally-targeted ads (e.g. social media, malls, TV)
Outdated/Current Discusses whether the language, content, and/or design of ad feels outdated or current (e.g., compared to the current time period/context).
Rainbow capitalism Participants discuss only seeing culturally-targeted ads during Pride Month, or being performative/used just to make money
Pandering Participants discuss feeling as though companies are trying to please the LGBTQ community by acting in a way they believe the LGBTQ community would want them to act
Corny/Trite Participants discuss advertisements feeling “corny” or trying too hard. (e.g. describing things as “tumblr-core,” “white woman’s instagram,” “millennial”, “mom”)
Necessity Participants discuss whether or not they view LGBTQ+ advertising as necessary/needed for LGBTQ community
General feelings Participants discuss how they feel about LGBTQ culturally targeted advertising generally; whether like, dislike, or neutral
Personal Experience Discusses how their personal experience influences their perception of an ad
Favorite Participant discusses an ad as their favorite
Purchasing Discusses buying and purchasing product advertised in the ad shown
  • LGBTQ+ young adults found the FDA’s “Every Try Counts” tobacco public education campaign effective. They responded positively to the campaign’s diverse and authentic representation of LGBTQ+ people and found subtle rainbow background color gradients aesthetically pleasing.
  • Participants had fewer positive reactions when discussing the FDA’s “This Free Life” tobacco public education campaign. Young adults perceived imagery representing LGBTQ+ people as inauthentic and stereotypical. Overuse of LGBTQ+ cultural imagery (e.g., overt rainbows), neon colors, and unclear slogans were viewed as less effective.

 

CONCLUSIONS

  • Participants responded positively to “personal” and strengths-based messages, subtle cultural imagery, and authentic representation of LGBTQ+ people.
  • Participants responded more positively to the “Every Try Counts” campaign. 
    • “I think it’s effective…I could still believe that  a real person said this, even if it was definitely written by someone for this purpose.” (LGBTQ+ current smoker and vaper)
    • “I think with the quote and the age, it kind of ties everything together. Like, oh its that person, and they’re reaching out to you with their story…it makes it feel more personal.” (LGBTQ+ current smoker and vaper)
    • “It looks more relatable as opposed to in your face with an overproduced photoshoot.” (LGBTQ+ current smoker) 
    • “The flags are great, they are utilized very well here.” (LGBTQ+ current smoker) 
    • The composition is really nice…not stereotypically gay looking people.” (LGBTQ+ current smoker and vaper)
  • Participants responded less positively to the “This Free Life” campaign.
    • “What do you mean ‘dull your glow?’ What do you mean ‘Shine?’ Like what are these attributes that you are claiming? I genuinely don’t know…if it’s a good thing or a bad thing.” (LGBTQ+ current smoker and vaper)
    • “I don’t think a lot of people identify with the very bright rainbows…it’s like rainbow washing.” (LGBTQ+ current smoker and vaper)
    • “They are making it way more flamboyant than it needs to be.  And once again, it’s alienating.” (LGBTQ+ current smoker and vaper) 
    • “It reminds me of middle school in a way…it’s hard for me to take that one seriously.” (LGBTQ+ current smoker and vaper)
    • “It’s definitely giving throw back to my emo phase.” (LGBTQ+ current smoker)

 

IMPLICATIONS

  • LGBTQ+ culture is dynamic, and tobacco public education needs periodic updates to accurately represent culturally-specific semantics (slang, pronouns) and visuals (fashion, expression).
  • Future research should experimentally test the effect of exposure to tobacco public education that leverages visual and semantic strategies acceptable to LGBTQ+ young adults on behavior.
  • Developing best practice toolkits and modifiable LGBTQ+ culturally targeted campaign materials may support local and government public health agencies to implement LGBTQ+ specific campaigns across time and settings.

 

REFERENCES 

  1. Ridner S, Ma J, Walker K, et al. Cigarette smoking, ENDS use and dual use among a nationalsample of lesbians, gays and bisexuals. Tob Prev Cessat. 2019;5(December). doi:10.18332/tpc/114229
  2. Delahanty J, Ganz O, Hoffman L, Guillory J, Crankshaw E, Farrelly M. Tobacco use among lesbian, gay, bisexual and transgender young adults varies by sexual and gender identity. Drug Alcohol Depend. 2019;201:161-170. doi:10.1016/j.drugalcdep.2019.04.013
  3. Fallin-Bennett A, Lisha NE, Ling PM. Other Tobacco Product Use Among Sexual Minority Young Adult Bar Patrons. Am J Prev Med. 2017;53(3):327-334. doi:10.1016/j.amepre.2017.03.006
  4. Nayak P, Salazar LF, Kota KK, Pechacek TF. Prevalence of use and perceptions of risk of novel and other alternative tobacco products among sexual minority adults: Results from an online national survey, 2014–2015. Prev Med. 2017;104:71-78. doi:10.1016/j.ypmed.2017.05.024
  5. Osibogun O, Taleb ZB, Bahelah R, Salloum RG, Maziak W. Correlates of poly-tobacco use among youth and young adults: Findings from the Population Assessment of Tobacco and Health study, 2013–2014. Drug Alcohol Depend. 2018;187:160-164. doi:10.1016/j.drugalcdep.2018.02.024
  6. Stanton CA, Bansal-Travers M, Johnson AL, et al. Longitudinal e-Cigarette and Cigarette Use Among US Youth in the PATH Study (2013–2015). JNCI J Natl Cancer Inst. 2019;111(10):1088-1096. doi:10.1093/jnci/djz006
  7. Farrelly MC, Nonnemaker J, Davis KC, Hussin A. The Influence of the National truth® Campaign on Smoking Initiation. Am J Prev Med. 2009;36(5):379-384. doi:10.1016/j.amepre.2009.01.019
  8. Farrelly MC, Duke JC, Nonnemaker J, et al. Association Between The Real Cost Media Campaign and Smoking Initiation Among Youths — United States, 2014–2016. MMWR Morb Mortal Wkly Rep. 2017;66(02):47-50. doi:10.15585/mmwr.mm6602a2
  9. Sly D, Hopkins R, Trapido E, Ray S. Influence of a counteradvertising media campaign on initiation of smoking: the Florida “truth” campaign. Am J Public Health. 2001;91(2):233-238. doi:10.2105/AJPH.91.2.233
  10. Weiss JW, Cen S, Schuster D, et al. Longitudinal effects of pro‐tobacco and anti‐tobacco messages on adolescent smoking susceptibility. Nicotine Tob Res. 2006;8(3):455-465. doi:10.1080/14622200600670454
  11. Siegel M. What the FDA Gets Wrong About E-Cigarettes. Bloomberg. https://www.bloomberg.com/view/articles/2017-03-16/what-the-fda-gets-wrong-about-e-cigarettes?in_source=embedded-checkout-banner. Published March 16, 2017. Accessed July 25, 2023.
  12. Calabro KS, Khalil GE, Chen M, Perry CL, Prokhorov AV. Pilot study to inform young adults about the risks of electronic cigarettes through text messaging. Addict Behav Rep. 2019;10:100224. doi:10.1016/j.abrep.2019.100224
  13. U.S National Cancer Institute. A Socioecological Approach to Addressing Tobacco-Related Health Disparities | Division of Cancer Control and Population Sciences (DCCPS). A Socioecological Approach to Addressing Tobacco-Related Health Disparities; 2017. Accessed July 25, 2023. https://cancercontrol.cancer.gov/brp/tcrb/monographs/monograph-22
  14. Duke JC, Farrelly MC, Alexander TN, et al. Effect of a National Tobacco Public Education Campaign on Youth’s Risk Perceptions and Beliefs About Smoking. Am J Health Promot. 2018;32(5):1248-1256. doi:10.1177/0890117117720745
  15. Kranzler EC, Hornik RC. The Relationship Between Exogenous Exposure to “The Real Cost” Anti-Smoking Campaign and Campaign-Targeted Beliefs. J Health Commun. 2019;24(10):780-790. doi:10.1080/10810730.2019.1668887
  16. The Real Cost E-Cigarette Prevention Campaign. Published online July 21, 2023. Accessed July 31, 2023. https://www.fda.gov/tobacco-products/real-cost-campaign/real-cost-e-cigarette-prevention-campaign#:~:text=Our%20Goal%3A%20Educate%20youth%20about,addiction%20from%20using%20e%2Dcigarettes.
  17. This Free Life Campaign. Published online March 11, 2022. Accessed July 31, 2023. https://www.fda.gov/tobacco-products/public-health-education-campaigns/free-life-campaign

 

SUPPLEMENTAL MATERIALS

Sample of Media shown to Focus Group Participants

           

Example Questions Asked to Participants: 

  • “When you see this advertisement, what do you think?”
  • “Who is the target audience? Who is it missing?”
  • “Would this advertisement be effective at reaching LGBTQ people, why or why not?”
  • “Is this ad believable? Convincing?”
  • “What imagery do you like/not like?”
  • “What language do you like/not like?”

Responses to absolute and comparative risk messages among SGM and non-SGM young adults: Results from a mixed-methods formative evaluation

| jankowski.58

Authors: Emma Jankowski, Rebecca Henderson, Elle Elson, Alysha Ennis, Sydney Galusha, Grace Turk, Hayley Curran, Phoenix Matthews, Elizabeth Klein,​ Darren Mays, Theodore Wagener, Mike Pennell, Paul Nini, Mike Slater, Amy Ferketich, and Joanne G. Patterson

Poster presented at the 2023 CASEL Tobacco Regulatory Science Conference

INTRODUCTION​

  • Sexual and Gender Minority Young Adults (SGM YA) report higher dual use rates (smoking and vaping nicotine) than non-SGM YA. (1-6)
  • National tobacco risk communications have been proven to be successful at increasing knowledge about the harms of tobacco and decreasing use. (7-18)
  • No studies describe effective anti-tobacco message framing for SGM and non-SGM YA engaged in dual use, though understanding these nuances is important for developing inclusive anti-tobacco communications.
  • We tested absolute risk (AR; describing shared health harms of smoking and vaping) vs. comparative risk messages (CR; describing comparative health harms of smoking vs. vaping).

HYPOTHESIS

  • Messages emphasizing comparative (vs absolute) risk of dual use will most effectively increase tobacco risk perceptions.

METHODS

  • Through a mixed-methods, formative evaluation we iteratively developed absolute risk messages (AR; describing shared health harms of smoking and vaping) and comparative risk messages (CR; describing comparative health harms of smoking vs. vaping).
  • For focus groups (N=3 groups; N=12 participants) and in-depth interviews (N=13), participants responded qualitatively to a randomized series of AR/CR messages on FDA regulatory topics.
  • In an online rating survey (N=326), participants viewed 5 randomly selected AR/CR messages from a total of 24, which they rated for perceived message effectiveness (PME; Range: 1-5) and psychological reactance (Range: 1-5).

RESULTS

Qualitative Codebook for Focus Groups with Young Adults 

Theme  Code  Definition  N (%) of all statements 
Content  Facts/statistics  Discusses the use of facts and statistics as an effective health communication tactic  32 (12.12%) 
Fear=effective  Discusses “fear” as an effective health communication tactic. May also use words like “scary” or “afraid”  27 (10.23) 
Shock value  Discusses “shock value” as an effective health communication tactic. Participants may discuss being “surprised” by a message, making it effective  6 (2.27%) 
Novelty=effective  Discusses “novelty” (i.e.., a new idea, or new information) as an effective health communication tactic  23 (8.71%) 
Short + simple  Discusses short+simple is an effective health communication tactic, either by saying a message would be better short or simpler, or liking a message for that reason  18 (6.82%) 
Personal experience  Discusses how their personal experience (either their own smoking or a peer/loved one) influences their perceptions of the message  6 (2.27%) 
Addictiveness relative to other drugs  Discusses the addictiveness or harms of nicotine/tobacco relative to other illicit drugs or alcohol use  6 (2.27%) 
Relative risk ecig v. cig  Discusses the relative risk of using e-cigarettes versus combustible cigarettes (or the messaging around relative risk)  23 (8.71%) 
Rate reduction  Discusses using information on how to decrease smoking on the path to quitting  18 (6.82%) 
Permissive  Discusses how messaging/content is permissive (i.e., makes it seem fine to use) either vaping or cigarette smoking, or both  12 (4.55%) 
Off- ramp  Discusses building an “off ramp” (i.e., steps to quitting smoking, potentially including what to do once you know smoking is bad for you) is important content to include  7 (2.65%) 
Language  Vape=universal language  Language of “vape” or “vaping” is considered universal (used by everyone/the “norm”)  9 (3.41%) 
Lay language  Discusses how using “lay” or “everyday” language is effective (e.g., heart disease vs. CVD).  6 (2.27%) 
Product specific language  Discusses how using product-specific language (e.g., formaldehyde vs. toxic chemical) is effective  6 (2.27%) 
Audience matters  Discusses how the message is effective for targeted audience  17 (6.44%) 
General audience  Discusses using language to appeal to a general audience  12 (4.55%) 
Person-forward language  Discusses using person-forward language (e.g., people who smoke) vs product-forward language (e.g., smoker)  14 (5.30%) 

 

 

Qualitative Codebook for Interviews with Young Adults 

Theme  Code  Definition  N (%) of all statements 
Message Framing  short + simple  discusses short + simple is an effective health communication tactic, either by saying a message would be better short or simpler, or liking a message for that reason  17 (2.62%) 
facts/statistics = effective  discusses facts and statistics as an effective health communication tactic  17 (2.62%) 
facts/statistics = ineffective  discusses facts and statistics as NOT or LESS effective   9 (1.39%) 
constituents = effective  discusses mentioning toxic constituents (formaldehyde, etc.) as effective  28 (4.31%) 
constituents = ineffective  discusses toxic constituents as NOT or LESS effective   9 (1.39%) 
fear = effective  discusses “fear” as effective. May also use words like “scary” or “afraid.”  17 (2.62%) 
fear = ineffective   discusses “fear” as NOT or LESS effective  2 (0.31%) 
shock value = effective  discusses “shock value” as effective. Participants may discuss being “surprised” by a message, making it effective.  4 (0.62%) 
shock value = ineffective  discusses “shock value” as NOT being effective  2 (0.31%) 
novelty = effective  discusses “novelty” (i.e.., a new idea, or new information, “outside the box” thinking) as effective  32 (4.93%) 
novelty = ineffective  discusses “novelty” (i.e.., a new idea, or new information, “outside the box” thinking) as effective  7 (1.08%) 
known truths = effective  discusses how “knowing” that something is “true” (e.g., smoking causes cancer) makes the message more effective (vs. something novel/new/unheard of)  39 (6.01%) 
known truths = ineffective  discusses how “knowing” that something is “true” (e.g., smoking causes cancer) makes the message NOT or LESS effective (vs. something novel/new/unheard of)  24 (3.70%) 
secondary effects=effective  discusses how referencing health harms or other impacts of smoking/vaping (e.g., financial) on family/friends/bystanders is effective  2 (0.31%) 
Contextual Factors  real-life context  discusses how real-life context or current events (e.g., opioid epidemic, COVID) influences their perceptions of the message  4 (0.62%) 
personal experience  discusses how personal experience (either their own smoking or a peer/loved one) influences their perceptions of the message  53 (8.17%) 
prior quit attempts  discusses how a history of prior quit attempts influences their perceptions of the message  3 (0.46%) 
audience  discusses how audience (i.e., whether target audience is smokers/vapers; established/not established users; adolescents, young or older adults) influences how effective or acceptable the message is  74 (11.40%) 
Product and Product Use Factors  comparative risk vapes vs. cigarettes  discusses the comparative risk of vaping versus smoking combustible cigarettes (or the messaging around comparative risk)  7 (1.08%) 
equivalent risk  discusses how smoking/vaping has similar risks; or how referencing smoking/vaping in same statement makes the risk seem equivalent  13 (2.00%) 
modified risk  discusses nicotine/vaping as a modified risk (healthier or lower harm) product than traditional combustible tobacco  32 (4.93%) 
general health  Discusses general health when viewing the message; generally discusses how the message evoked a thought about addiction, whether positive or negative.  46 (7.09%) 
general addictiveness  Discusses general addictiveness when viewing the message; generally discusses how the message evoked a thought about addiction, whether positive or negative.  35 (5.39%) 
harm reduction  discusses using nicotine/tobacco as a harm reduction strategy (i.e., Instead of other drug use, to manage mental health/stress)  4 (0.62%) 
switching  discusses using “switch” language to describe vaping in lieu of smoking. May use terms including, but not limited to: “turn to,” “change over,” “substitute,” “alternative,” or “use instead”.  9 (1.39%) 
rate reduction  discusses using information on how to decrease smoking on the path to quitting  14 (2.16%) 
offramp  generally discussed building an “off ramp” (i.e., steps to quitting smoking, potentially including what to do once you know smoking is bad for you) is important content to include  17 (2.62%) 
Language  permissive  discusses how messaging/content is permissive (i.e., makes it seem fine to use) either vaping or cigarette smoking, or both.  36 (5.55%) 
tone  discusses the tone of the message (e.g., “preachy” “friendly” etc.)  27 (4.16%) 
lay language  discusses how using “lay” or “everyday” language is effective (e.g., heart disease vs. CVD).  1 (0.15%) 
scientific language  discusses how using “scientific” or “professional” language is effective (e.g., cardiovascular disease vs. heart disease)  6 (0.92%) 
specific language = effective  discusses how using more specific language is effective (e.g., lung injury vs. wheezing)  22 (3.39%) 
broad language = effective  discusses how using broader language is effective (e.g., lung injury vs. wheezing)  7 (1.08%) 
person-forward language  discusses using person-forward language (e.g., people who smoke or “using cigarettes” [Implied person]) vs product-forward language (e.g., smoker)  2 (0.31%) 
general audience  discusses using language to appeal to a general audience  1 (0.15%) 

 

Results from the Online Rating Survey

      PME- Cigarettes    PME- Vaping    Reactance 
      LGBTQ  Non-LGBTQ    LGBTQ  Non-LGBTQ    LGBTQ  Non-LGBTQ 
ID#  Msg Type  Message  M  LL  UL  M  LL  UL    M  LL  UL  M  LL  UL    M  LL  UL  M  LL  UL 
7  AR  Cigarettes and vapes contain nicotine. Nicotine is an addictive chemical.      2.00  0.18  3.82  3.11  2.67  3.56    2.85  2.39  3.31  3.10  2.66  3.54    1.61  1.35  1.88  1.79  1.49  2.09 
6  AR  Even occasional smoking and vaping can lead to nicotine addiction.      2.62*  2.17  3.06  3.68*  3.26  4.10    2.59*  3.01  3.91  3.46*  2.11  3.07    2.04  1.66  2.42  2.11  1.73  2.50 
10  AR  Can’t sleep? Nicotine in cigarettes and vapes can lead to sleep problems, including insomnia.      3.17  2.69  3.64  3.73  3.31  4.14    3.04  2.56  3.52  3.41  2.99  3.82    2.13  1.73  2.53  1.95  1.59  2.30 
4  AR  Nicotine doesn’t cause cancer, but toxic chemicals in e-liquid and tobacco can.    3.42  2.97  3.88  3.12  2.60  3.64    3.29  2.82  3.76  3.09  2.60  3.58    2.08  1.70  2.46  2.48  2.07  2.90 
2  AR  Most people think smoking cigarettes and vaping nicotine are harmful to your health. They’re right.  3.44  2.98  3.89  3.54  3.12  3.96    3.41  2.95  3.86  3.33  2.89  3.78    2.05  1.70  2.41  1.99  1.70  2.28 
12  AR  Can’t find your keys? Nicotine in cigarettes and vapes can harm your brain and lead to memory loss.    3.45  3.08  3.82  3.53  3.07  4.00    3.19  2.79  3.61  3.41  2.94  3.87    2.83  2.42  3.25  2.74  2.33  3.15 
8  AR  Smoking cigarettes and vaping nicotine damages your DNA and  increases your risk for cancer.       3.76  3.37  4.15  4.09  3.75  4.43    3.39  2.94  3.84  3.63  3.18  4.09    2.41  1.98  2.84  2.11  1.69  2.53 
5  AR  Using cigarettes and nicotine vapes exposes you to heavy metals— like arsenic and lead.      3.85  3.47  4.24  3.90  3.52  4.28    3.74  3.42  4.06  3.51  3.06  3.96    1.77  1.44  2.10  2.15  1.81  2.50 
11  AR  Wheezing lately? Smoking cigarettes and vaping nicotine increases your risk for lung problems.       3.94  3.48  4.40  3.86  3.42  4.29    3.53  3.01  4.05  3.39  2.90  3.89    1.96  1.58  2.34  1.82  1.52  2.12 
3  AR  Cigarettes and some nicotine vapes contain formaldehyde, a chemical that causes cancer.     4.07  3.72  4.42  3.90  3.48  4.32    3.66  3.23  4.08  3.65  3.23  4.06    1.88  1.54  2.22  1.87  1.56  2.18 
9  AR  Smoking cigarettes and vaping nicotine increases your risk for heart disease.       4.34  4.1  4.59  4.07  3.65  4.49    3.59  3.15  4.04  3.73  3.26  4.19    1.80  1.44  2.16  1.96  1.55  2.38 
1  CR  Nicotine vapes are not a safe alternative to cigarettes.  2.86  2.33  3.39  2.66  1.45  3.16    3.08  2.51  3.65  3.75  3.33  4.16    2.33  1.87  2.80  1.99  1.61  2.37 
24  CR  Can’t find your keys? Research suggests that vaping nicotine can improve attention and memory during smoking abstinence.  2.69  2.21  3.17  2.60  2.16  3.04    1.93  1.54  2.32  2.06  1.64  2.47    3.30  2.88  3.73  3.41  3.00  3.82 
22  CR  Can’t sleep? People who vape and smoke report more sleep problems than those who only vape.   3.38  2.99  3.78  3.01  2.46  3.56    2.09  1.69  2.50  2.30  1.80  2.80    2.32  1.96  2.69  2.60  2.11  3.08 
14  CR  Many people think vaping nicotine is just as harmful as smoking cigarettes. Truth is, nicotine vapes are less harmful than cigarettes.  3.46  3.00  3.91  3.71  3.32  4.10    1.98  1.54  2.41  2.11  1.75  2.47    2.18  1.79  2.57  2.47  2.06  2.89 
19  CR  Nicotine vapes are addictive, but people who vape and smoke tobacco are 7 times more likely to be addicted to nicotine than those who only vape.  3.50  3.09  3.92  3.51  3.12  3.90    2.63  2.25  3.02  2.52  2.11  2.93    1.94  1.54  2.33  2.40  1.99  2.81 
18  CR  Vaping heats nicotine, resulting in lower levels of harmful chemicals than burned tobacco in cigarettes.  3.52  3.03  4.00  3.63  3.24  4.03    2.38  1.89  2.87  2.33  1.90  2.77    2.28  1.85  2.71  2.14  1.78  2.50 
13  CR  Vaping nicotine is harmful to your health, but it is less harmful than smoking.       3.71  3.25  4.17  3.77  3.43  4.11    2.39  1.96  2.82  2.48  2.08  2.89    2.02  1.65  2.39  2.46  2.15  2.78 
21  CR  People who smoke cigarettes and vape nicotine have a higher risk of developing heart disease than those who only vape.   3.73  3.33  4.13  4.07  3.66  4.49    2.46  1.93  3.00  3.03  2.57  3.48    1.96  1.57  2.35  2.07  1.72  2.43 
17  CR  Using cigarettes and nicotine vapes exposes you to more heavy metals—like arsenic and lead—than if you only vape.  3.82  3.43  4.21  3.50  2.95  4.05    3.06  2.61  3.52  2.90  2.34  3.47    2.13  1.74  2.53  2.18  1.72  2.64 
23  CR  Wheezing much? People who smoke cigarettes and vape nicotine report more lung problems than those who only vape.  3.89  3.51  4.28  4.35  4.09  4.61    3.11  2.64  3.59  3.23  2.69  3.77    2.11  1.78  2.44  2.13  1.70  2.56 
16  CR  Many people think nicotine in vapes and cigarettes causes cancer. Truth is, toxic chemicals in burning cigarettes are more likely to cause cancer.  3.97  3.58  4.36  3.78  3.36  4.20    2.63  2.19  3.07  2.63  2.10  3.16    1.88  1.56  2.20  2.38  1.96  2.80 
15  CR  Cigarettes contain more cancer-causing chemicals—like formaldehyde—than nicotine vapes.  4.01  3.60  4.42  4.13  4.42  4.48    2.10  1.71  2.50  2.53  2.04  3.01    1.95  1.59  2.31  1.84  1.49  2.18 
20  CR  Smoking cigarettes can increase your risk for lung, head, and neck cancer. Using nicotine vapes only may decrease your cancer risk.  4.04  3.69  4.39  3.94  3.48  4.39    2.34  1.85  2.84  2.34  1.88  2.81    2.11  1.63  2.59  2.58  2.11  3.04 
  • LGBTQ+ YA qualitatively described long-term physical harms (i.e., cancer) as effective.
  • Non-LGBTQ+ YA described novel messaging (i.e., insomnia, heart disease) as effective.
  • CR messages positively resonated with LGBTQ+ participants due to their implied harm reduction focus; however, non-LGBTQ+ YA expressed concern about CR messages being permissive for vaping.
  • LGBTQ+ YA described high-threat messages with “shock value” statements as effective.
  • Quantitatively, AR and CR messages scored PMEs above three, indicating promise for influencing cigarette smoking. Messages with greatest PME scores addressed heart and lung disease, toxic constituents, and cancer.
  • All messages scored below 3 for reactance, indicating low risk for counterarguing.

 

CONCLUSIONS

  • Overall, participants responded positively to AR/CR messages including short and long-term health effects.
  • LGBTQ+ participants responded more positively to CR messages, which may reflect community experiences with minority stress and coping.
  • Experimental studies testing the long-term effect of exposure to AR/CR messages on dual use among LGBTQ+ YA are needed.

 

REFERENCES

  1. Ridner S, Ma J, Walker K, et al. Cigarette smoking, ENDS use and dual use among a nationalsample of lesbians, gays and bisexuals. Tob Prev Cessat. 2019;5(December). doi:10.18332/tpc/114229
  2. Delahanty J, Ganz O, Hoffman L, Guillory J, Crankshaw E, Farrelly M. Tobacco use among lesbian, gay, bisexual and transgender young adults varies by sexual and gender identity. Drug Alcohol Depend. 2019;201:161-170. doi:10.1016/j.drugalcdep.2019.04.013
  3. Fallin-Bennett A, Lisha NE, Ling PM. Other Tobacco Product Use Among Sexual Minority Young Adult Bar Patrons. Am J Prev Med. 2017;53(3):327-334. doi:10.1016/j.amepre.2017.03.006
  4. Nayak P, Salazar LF, Kota KK, Pechacek TF. Prevalence of use and perceptions of risk of novel and other alternative tobacco products among sexual minority adults: Results from an online national survey, 2014–2015. Prev Med. 2017;104:71-78. doi:10.1016/j.ypmed.2017.05.024
  5. Osibogun O, Taleb ZB, Bahelah R, Salloum RG, Maziak W. Correlates of poly-tobacco use among youth and young adults: Findings from the Population Assessment of Tobacco and Health study, 2013–2014. Drug Alcohol Depend. 2018;187:160-164. doi:10.1016/j.drugalcdep.2018.02.024
  6. Stanton CA, Bansal-Travers M, Johnson AL, et al. Longitudinal e-Cigarette and Cigarette Use Among US Youth in the PATH Study (2013–2015). JNCI J Natl Cancer Inst. 2019;111(10):1088-1096. doi:10.1093/jnci/djz006
  7. Farrelly MC, Nonnemaker J, Davis KC, Hussin A. The Influence of the National truth® Campaign on Smoking Initiation. Am J Prev Med. 2009;36(5):379-384. doi:10.1016/j.amepre.2009.01.019
  8. Farrelly MC, Duke JC, Nonnemaker J, et al. Association Between The Real Cost Media Campaign and Smoking Initiation Among Youths — United States, 2014–2016. MMWR Morb Mortal Wkly Rep. 2017;66(02):47-50. doi:10.15585/mmwr.mm6602a2
  9. Sly D, Hopkins R, Trapido E, Ray S. Influence of a counteradvertising media campaign on initiation of smoking: the Florida “truth” campaign. Am J Public Health. 2001;91(2):233-238. doi:10.2105/AJPH.91.2.233
  10. Weiss JW, Cen S, Schuster D, et al. Longitudinal effects of pro‐tobacco and anti‐tobacco messages on adolescent smoking susceptibility. Nicotine Tob Res. 2006;8(3):455-465. doi:10.1080/14622200600670454
  11. Siegel M. What the FDA Gets Wrong About E-Cigarettes. Bloomberg. https://www.bloomberg.com/view/articles/2017-03-16/what-the-fda-gets-wrong-about-e-cigarettes?in_source=embedded-checkout-banner. Published March 16, 2017. Accessed July 25, 2023.
  12. Calabro KS, Khalil GE, Chen M, Perry CL, Prokhorov AV. Pilot study to inform young adults about the risks of electronic cigarettes through text messaging. Addict Behav Rep. 2019;10:100224. doi:10.1016/j.abrep.2019.100224
  13. U.S National Cancer Institute. A Socioecological Approach to Addressing Tobacco-Related Health Disparities | Division of Cancer Control and Population Sciences (DCCPS). A Socioecological Approach to Addressing Tobacco-Related Health Disparities; 2017. Accessed July 25, 2023. https://cancercontrol.cancer.gov/brp/tcrb/monographs/monograph-22
  14. Duke JC, Farrelly MC, Alexander TN, et al. Effect of a National Tobacco Public Education Campaign on Youth’s Risk Perceptions and Beliefs About Smoking. Am J Health Promot. 2018;32(5):1248-1256. doi:10.1177/0890117117720745
  15. Kranzler EC, Hornik RC. The Relationship Between Exogenous Exposure to “The Real Cost” Anti-Smoking Campaign and Campaign-Targeted Beliefs. J Health Commun. 2019;24(10):780-790. doi:10.1080/10810730.2019.1668887
  16. The Real Cost E-Cigarette Prevention Campaign. Published online July 21, 2023. Accessed July 31, 2023. https://www.fda.gov/tobacco-products/real-cost-campaign/real-cost-e-cigarette-prevention-campaign#:~:text=Our%20Goal%3A%20Educate%20youth%20about,addiction%20from%20using%20e%2Dcigarettes.
  17. This Free Life Campaign. Published online March 11, 2022. Accessed July 31, 2023. https://www.fda.gov/tobacco-products/public-health-education-campaigns/free-life-campaign

 

SUPPLEMENTAL MATERIALS

Messages Shown to Interview Participants

RR-Tox3: Using cigarettes and nicotine vapes exposes you to more heavy metals—like arsenic and lead—than if you only vape. 

RR-Tox2: Many people think nicotine in vapes and cigarettes causes cancer. Truth is, toxic chemicals in burning cigarettes are more likely to cause cancer. 

RR-PhysL2: People who smoke cigarettes and vape nicotine have a higher risk of developing heart disease than those who only vape. 

RR-PhysL1: Smoking cigarettes can increase your risk for lung, head, and neck cancer. Using nicotine vapes only may decrease your cancer risk. 

RR-Tox1: Cigarettes contain more cancer-causing chemicals—like formaldehyde—than nicotine vapes. 

RR-Soc1: Many people think vaping nicotine is just as harmful as smoking cigarettes. Truth is, nicotine vapes are less harmful than cigarettes. 

RR-Gen1: Vaping nicotine is harmful to your health, but it is less harmful than smoking. 

RR-PhyS3: Can’t find your keys? Research suggests that vaping nicotine can improve attention and memory during smoking abstinence. 

RR-Addict1: Nicotine vapes are addictive, but people who vape and smoke tobacco are 7 times more likely to be addicted to nicotine than those who only vape. 

RR-PhysS2: Wheezing much? People who smoke cigarettes and vape nicotine report more lung problems than those who only vape. 

RR-PhysS1: Can’t sleep? People who vape and smoke report more sleep problems than those who only vape. 

RR-Tox 4: Vaping heats nicotine, resulting in lower levels of harmful chemicals than burned tobacco in cigarettes. 

AR-PhyL1: Smoking cigarettes and vaping nicotine damages your DNA and increases your risk for cancer. 

AR-Tox2: Nicotine doesn’t cause cancer, but toxic chemicals in e-liquid and tobacco can. 

AR-PhyS2: Wheezing lately? Smoking cigarettes and vaping nicotine increases your risk for lung problems. 

AR-Gen 1: Nicotine vapes are not a safe alternative to cigarettes. 

AR-PhyL2: Smoking cigarettes and vaping nicotine increases your risk for heart disease. 

AR-Addict1: Even occasional smoking and vaping can lead to nicotine addiction. 

AR-Addict2: Cigarettes and vapes contain nicotine. Nicotine is an addictive chemical. 

AR-Tox3: Using cigarettes and nicotine vapes exposes you to heavy metals—like arsenic and lead. 

AR-PhysS1: Can’t sleep? Nicotine in cigarettes and vapes can lead to sleep problems, including insomnia. 

AR-Tox1: Cigarettes and some nicotine vapes contain formaldehyde, a chemical that causes cancer. 

AR-Soc1: Most people think smoking cigarettes and vaping nicotine are harmful to your health. They’re right. 

AR-PhyS3: Can’t find your keys? Nicotine in cigarettes and vapes can harm your brain and lead to memory loss. 

 

Messages shown to Focus Group Participants

T1a: Cigarette smoke contains 69 cancer-causing   chemicals.​

T1b: Cigarette smoke contains 69 chemicals known to ​cause cancer. ​

T2a: Cigarette smoke AND e-cigarette vapor contains cancer-causing chemicals, including formaldehyde.​

T2b: Cigarette smoke AND e-cigarette vapor contains chemicals that cause cancer, including formaldehyde.​

T3: E-cigarette vapor and tobacco smoke contains ​carbon monoxide–a deadly toxin that deprives your heart of oxygen. 

P1: Smoking cigarettes increases your risk for lung, head and neck, and other tobacco related cancers.  ​

P2: 1 in 5 people die each year from smoking cigarettes. ​​

P3a: Using both e-cigarettes and traditional cigarettes can increase your risk for cardiovascular disease. ​

P3b: Using both e-cigarettes and traditional cigarettes can increase your risk for heart disease.

P4a: Dual users of traditional cigarettes and e-cigarettes experience recurring respiratory issues—including wheezing, coughing, and excess phlegm. ​

P4b: Use e-cigarettes and traditional cigarettes can increase your risk for multiple respiratory issues—including wheezing, coughing, and excess phlegm. ​

P4c: Young people who vape nicotine and smoke cigarettes experience recurring respiratory issues—including wheezing, coughing, and excess phlegm. ​

P4d: Young adults who vape and smoke cigarettes experience recurring respiratory issues—including wheezing, coughing, and excess phlegm. ​

​P4e: Smokers who also vape experience recurring respiratory issues— including wheezing, coughing, and excess phlegm.

A1a: Approximately 2 in 3 cigarette smokers are dependent on nicotine. ​

A1b: Approximately 2 in 3 smokers are addicted to nicotine. ​​

A1c: Approximately 2 in 3 tobacco users are nicotine dependent.  

A2a. All tobacco products contain nicotine—a highly addictive chemical. ​​

A2b. All tobacco products contain nicotine—an addictive chemical.​​

A2c. All tobacco products contain nicotine—an addictive chemical that causes insomnia.​​

Ad. All tobacco products contain nicotine—an addictive chemical that increases heart rate and blood pressure.

RRT1a: Cigarettes contain 9 times more cancer-causing chemicals than e-cigarettes.​

RRT1b: Cigarettes contain 9 times more cancer-causing chemicals than nicotine vapes.​​

RRT1c: There are 9 times more cancer-causing chemicals in cigarettes than nicotine vapes.​​

RRT2: Cigarettes contain more cancer-causing chemicals— like formaldehyde— than e-cigarettes.​

RRT3a: Carbon monoxide-–a deadly toxin that deprives your heart of oxygen-–is higher in dual users of traditional cigarettes and e-cigarettes. ​​

RRT3b: Carbon monoxide-–a deadly toxin that deprives your heart of oxygen-–is higher in people who smoke and vape nicotine. ​​

RRT3c: Carbon monoxide-–a deadly toxin that deprives your heart of oxygen-–is higher in people who smoke cigarettes and vape.​

RRP1: Smoking cigarettes and other tobacco products can increase your risk for lung, head and neck, and other tobacco related cancers. ​​

RRP2: 1 in 5 people die each year from smoking cigarettes and other tobacco products.​

 ​RRP3: Smokers who also vape nicotine are more likely to develop cardiovascular disease.​​

RRP4a: Dual users of traditional cigarettes and e-cigarettes experience more respiratory issues—including wheezing, coughing, and phlegm—than people who use e-cigarettes only.​​

RRP4b: People who smoke and vape experience more respiratory issues— including wheezing, coughing, and phlegm—than people who use e- cigarettes only.

RRA1: People who vape and use cigarettes are 7 times as likely to be addicted to nicotine than those who only vape.​ ​

RRA2: Both combustible tobacco and e-cigarettes contain nicotine—a highly addictive chemical.​

 

LGBTQ+ Language Glossary & Resources

| Elle Elson

Local Resources 

OSU Student Organizations: https://lgbtq.osu.edu/community/involvement
Central Ohio: https://lgbtq.osu.edu/support/central-ohio-resources 

 

General Glossary
(updated 05.12.2023)

LGBTQ+: Lesbian, Gay, Bisexual, Transgender, Queer or Questioning (A ”+” sign to recognize the limitless sexual orientations and gender identities used by members of our community.) 

LGBTQIA+: Lesbian, Gay, Bisexual, Transgender, Queer or Questioning, Intersex, Asexual or Agender (A ”+” sign to recognize the limitless sexual orientations and gender identities used by members of our community.) 

AMAB: Assigned Male at Birth 

AFAB: Assigned Female at Birth 

Agender: A person who does not identify as male, female, or some combination of male and female. Some agender individuals see themselves as genderless or gender neutral. 

Ally: A term used to describe someone who actively supports LGBTQ+ people. It encompasses straight and cisgender allies, and those within the LGBTQ+ community who support each other. 

Asexual (ace): A spectrum of complete or partial lack of sexual attraction or interest in sexual activity.  

Androgynous: A person with characteristics or gender expression that are both or neither masculine and/nor feminine. 

BIPOC: Black, Indigenous, and People of Color 

Biological sex / Assigned sex: Sex assigned on a birth certificate, typically intersex, male, or female. 

Bigender: A person who has two genders they may experience at the same or different times. These identities can be binary, male and female, or include non-binary identities. 

Bisexual: Emotional, romantic, or sexual attraction to more than one sex, gender, or gender identity. Often interchanged with pansexual. 

Butch: A person, usually a lesbian or queer-identified woman, that identifies strongly with “masculinity”. Has been used historically in a derogatory manner. 

Cisgender: A person whose gender identity aligns with the sex assigned to them at birth. 

Demisexual: Part of the asexuality spectrum. A person whose romantic and/or sexual attraction only develops after an emotional connection has been made. 

Enby: Abbreviation for non-binary, the phonetic pronunciation of “NB”, which stands for non-binary. NB also represents Non-Black People of Color and many non-binary people use enby as an abbreviation. [See non-binary for more information.] 

Femme: A person, usually a lesbian or queer-identified woman, that identifies strongly with “femininity”. Has been used historically in a derogatory manner. 

Fluid / Flexible: A gender identity, often interchanged with gender-fluid, where a person does not identify with a single, fixed gender. Can also reference sexual orientation that is flexible or changing.  

Gay: A person who is emotionally, romantically, or sexually attracted to members of the same gender. Men, women, and non-binary people may use this term. 

Gender: A social construct used to classify a person as a man, woman, or another identity. Fundamentally different from sex assigned at birth and gender is often closely related to the role a person plays or is expected to play in society. 

Gender dysphoria: Clinically significant distress caused when a person’s assigned birth gender is not the same as how they identify. 

Gender-expansive: A person with a wider, more flexible range of gender identity and/or expression than typically associated with the gender binary. Often used as an umbrella term when referring to people exploring the possibilities of gender expression and/or gender identity. 

Gender expression: External appearance of one’s gender identity, usually expressed through behavior, clothing, body characteristics or voice, and may or may not conform to socially defined behaviors and characteristics, like masculine, feminine, or androgynous.  

Gender identity: A person’s own understanding of themselves in gendered categories, such as man, woman, transgender, non-binary, etc. How an individual feels inside and believes themselves to be. Can differ from an individual’s gender expression. 

Gender-fluid: A person who does not identify with a single fixed gender or has a fluid or unfixed gender identity/expression. 

Gender nonconforming: A person who does not adhere to the traditional gender expectations, in terms of their appearance or behavior, of their assigned gender. Some individuals identify as transgender, but others many not (for example, masculine lesbians). 

Genderqueer: A person who rejects notions of static categories of gender and embraces fluidity of gender identity. Can also relate to a fluid sexual orientation. People who identify as genderqueer may see themselves as being both male and female, neither male or female, or falling completely outside of these categories. 

Gray: A person who identifies with gray asexuality and exists under the asexuality umbrella. Also referred to as gray-A, gray ace, grace, and gray sexuality. This is a sexual orientation on the asexual spectrum, but individuals feel that there are parts of their experience that aren’t fully described by the word asexual. 

Gynesexual: A sexual orientation that describes someone who is attracted to females or female body parts, regardless of whether that person identifies as female. 

Heterosexual: A person who has emotional, romantic, or sexual attraction to individuals of the opposite sex. Also known as a straight person. 

Homosexual: A person who has emotional romantic, or sexual attraction to individuals of the same sex. This term is outdated and disfavored in the LGBTQ+ community. 

Intersex: A person born with sex characteristics that do not fit strictly into male or female categories. Sex characteristics are physical features relating to sex (including chromosomes, genitals, hormones, and other reproductive anatomy), as well as secondary features that emerge from puberty. Intersex is an umbrella term, and intersex characteristics or traits are not always apparent or identified at birth. 

Lesbian: A woman who is emotionally, romantically, or sexually attracted to other women. Women, non-binary people, and transgender people may use this term to describe themselves. 

Non-binary (enby): A person who does not exclusively identify as a man or a woman. They may identify as being both a man and a woman, somewhere in between, or falling outside these categories. While many non-binary people also identify as transgender, not all people do. Non-binary can be used as an umbrella term encompassing identities such as agender, bigender, genderqueer, or gender-fluid. 

Pansexual / Omnisexual: Someone who has emotional, romantic, or sexual attraction to people of any gender, not necessarily simultaneous. Sometimes used interchangeably with bisexual. 

QPOC / QTPOC: Queer Person of Color / Queer and Transgender People of Color 

Queer: A term people used to express a spectrum of identities and orientations that are counter to the mainstream. Queer is often used as a catch-all to include many people, including those who do not identify as exclusively straight and/or folks who have non-binary or gender-expansive identities. This term was previously used as a slur but has been reclaimed by many in the LGBTQ+ community. 

Questioning: People who are in the process of exploring their sexual orientation, gender identity, or gender expression. 

Same-gender loving: Term some people prefer to use instead of lesbian, gay, or bisexual to express attraction and love of people of the same gender. 

Sexual orientation: An inherent or immutable enduring emotional, romantic, or sexual attraction to other people. Sexual orientation is independent of gender identity. 

Straight: A person who has emotional, romantic, or sexual attraction to individuals of the opposite sex. Also known as a heterosexual. 

Transgender (trans): An umbrella term for people whose gender identity and/or expression is different from cultural expectations based on the sex they were assigned at birth. Being transgender does not imply any specific sexual orientation or gender identity. Transgender people may identify as straight, gay, lesbian, bisexual, genderqueer, non-binary, etc. 

Trans man: A person who was assigned a female sex at birth (or intersex) and identifies as male. This person may or may not actively identify as trans. 

Trans woman: A person who was assigned a male sex at birth (or intersex) and identifies as female. This person may or may not actively identify as trans. 

Transition: A process that some transgender or gender-expansive people may undergo to live more fully as their true gender. This typically includes social transition (like name changing and pronoun change), medically (like hormone therapy or gender affirming surgeries), and legal transition (like legal name changes and sex changes on government documents). Transgender people may choose to undergo some, all, or none of the processes. 

Two-spirit: An identity label used within many American Indian and Canadian First Nations indigenous groups to describe a person that possesses both masculine and feminine spirits. Coined by contemporary LGBTQ+ Native Americans to describe themselves and the traditional roles they are reclaiming. 

UndocuQueer: Identity label claimed by some individuals in the United States who are both queer and undocumented to show that these two aspects of their identity are not only intersectional, but also inseparable. 

 

Systems of Oppression 

Bias: Negative feelings about a social group based on the person’s life experience or expected stereotype of the group or individual.  

Cisnormativity: The assumption that everyone is, or should be, cisgender. 

Heteronormativity: The assumption that everyone is, or should be, heterosexual. 

Homophobia: Discrimination or prejudice against homosexual individuals or groups. 

Intersectionality: A lens to examine how systems of oppression are interconnected and inseparable. 

Oppression: The systematic subjugation of a group of people by another group with access to social power, the result of which benefits one group over the other and is maintained by social beliefs and practices. 

Privilege: A system of advantages that gives people from more powerful social groups access to resources and opportunities that are denied to others simply because of the groups they belong to. 

Prejudice: The process of judging someone or something and making your own facts, instead of knowing the real truth about a person or a thing. 

Transphobia: Discrimination or prejudice against transgender individuals or groups. 

 

Research Related 

LBQ+: Lesbian, Bisexual, and Queer women 

MSM: Men who have sex with men, MSM, comprise a diverse group in terms of behaviors, identities, and health care needs. Clinically used to refer to sexual behavior alone, regardless of sexual orientation. 

SGM: Sexual and Gender Minority 

SMW: Sexual Minority Women 

WSW: Women who have sex with women, “WSW” comprise diverse groups with variation in sexual identity, practices, and risk behaviors. Clinically used to refer to sexual behavior alone, regardless of sexual orientation. 

WSWM: Women who have sex with women and men, “WSWM”, comprise diverse groups with variation in sexual identity, practices, and risk behaviors. Clinically used to refer to sexual behavior alone, regardless of sexual orientation. 

 

Romantic Orientations 

Aromantic (aro): A person who experiences little to no romantic attraction to individuals of any gender. 

Biromantic: A person who experiences romantic attraction to more than one gender. 

Demiromantic: A person who does not experience romantic attraction until a close emotional bond has been formed. 

Gray romantic: A person who does not often experience romantic attractions. Part of the aromantic spectrum. 

Heteroromantic: A person who experiences romantic attraction toward people of a different gender. 

Homoromantic: A person who experiences romantic attraction toward people of the same gender. 

Panromantic: A person who experiences romantic attraction towards a person regardless of gender. 

Polyromantic: A person who has romantic attraction to multiple, but not all genders. 

 

Relationship / Lifestyle

Monogamous: Relationship style where the people in the relationship agree to not engage in sexual and romantic relationships outside of each other. Typically involves two people. Society’s expectation for romantic relationships. 

Ethically non-monogamous (ENM): Umbrella term that covers relationships where everyone involved agrees they can seek out some combination of sexual and/or romantic relationships. Can be used interchangeably with consensual non-monogamy. 

Open relationships: Often involve a hierarchical relationship that has priority, with each person free to pursue sexual relationships outside of the partnership, either one of one or with the hierarchical partner. 

Swinging: A sexual practice that can fall under the ENM and/or open relationship spectrum. Typically defined as having multiple sexual partners outside of an established relationship that does not include romantic or emotional attachments. Swingers can engage in sexual activities with or without their established relationship. 

Primary relationship: A person’s closest relationship where priority is given in terms of time, energy, attraction, and commitment.  

Polyamory: Often involves the potential to be in multiple sexual and/or romantic relationships at the same time. Contains a wide variety of interactions, commitments, and approaches. 

Solo poly: Relationship type of polyamory where people consider the most important relationship to be with themselves and relationships with other are important but not necessarily something to make decisions around. 

Hierarchical polyamory: ENM practice that gives relationships an order or hierarchy for priority in decision making, time spent together, or certain relationship privileges (like marriage). 

Non-hierarchical polyamory: ENM practice that does not give relationships more weight or priority than others. Similar to relationship anarchy type. 

Relationship anarchy: ENM practice that is founded on non-hierarchy and non-possession of relationships and honoring each connection as it comes. Relationship anarchists may include familial, friend, work, romantic, and sexual relationships in this practice. 

Polyfidelity: Multiple people are in a committed, exclusive relationship with each other, such as a throuple where three partners only have romantic and/or sexual relationships with each other. 

Polycule: All of the people linked through their ENM relationships, usually romantic and/or sexual, to one or more members of a polyamorous group. 

Metamour: Term in ENM relationships for a one partner’s partner, with whom you have direct or indirect relationships. 

Consent: Agreement between participants to engage in an activity, usually sexual activity. Should be given clearly, verbally, enthusiastically, while sober, not while underage, and not under coercion, threat, or intimidation in unequal power dynamics. Consent can be revoked at any time. 

Kink: Consensual, non-traditional sexual, sensual, and intimate behaviors.  

BDSM: Type of kink behaviors such as Bondage, Discipline, Sadism, Masochism, Domination and Submission. 

 

Pronouns 

Pronoun: A word that stands in for a noun, often to avoid the need to repeat the same noun over and over. Individuals can use a variety of pronouns, may prefer one to be used to represent th

eir changing gender expression, have multiple pronouns they alternate with, or use no pronouns. Below are some examples of how to correctly use pronouns. **(Not every individual person uses pronouns the same way, ask for clarification if necessary.) 

Neopronouns: A word(s) created to serve as a pronoun without expressing gender, like “ze” and “zir”. Can also be called noun-self pronoun, which a pre-existing word is drafted to use as a pronoun. Noun-self pronoun examples are: “bun/bunself”, “fae/faer/faeself” or “vamp/vampself”. 

They, them, theirs: They went to the party celebrating

 their partner. 

She, her, hers: She went to the party celebrating her partner. 

He, him, his: He went to the party celebrating his partner. 

She/they: They went to the party celebrating her partner. [Not all individuals with dual pronouns like to alternate between them consistently.] 

He/they: He went to the party celebrating their partner. [Not all individuals with dual pronouns like to alternate between them consistently.] 

Ze, hir: Ze went to the party celebrating hir partner. [Ze is pronounced like “zee” and can be spelled zie or ze. Hir is pronounced like “here”.] 

Other examples: 

Ze/zir 

Fae/faer 

It/its 

Xe/xem 

Xey/xem 

E/em 

Ey/em 

Ae/aer 

 

 

 

References 

https://www.hrc.org/resources/glossary-of-terms 

https://www.aecf.org/blog/lgbtq-definitions 

https://lgbtq.multicultural.ufl.edu/programs/speakersbureau/lgbtq-terms-definitions/ 

https://www.them.us/story/gender-neutral-pronouns-101-they-them-xe-xem 

https://www.cdc.gov/std/treatment-guidelines/wsw.htm 

https://littlegaybook.com/relationship-styles/ 

https://www.rainn.org/articles/what-is-consent 

https://lgbtq.unc.edu/resources/exploring-identities/asexuality-attraction-and-romantic-orientation/ 

What makes an LGBTQ+ inclusive campus?

| Joanne

Today, I am celebrating because I work at an institution that is positively contributing to the health, wellbeing, and education of LGBTQ+ people.  The Ohio State University was selected as one of 40 institutions nationwide for the Campus Pride “Best of the Best” index for LGBTQ+ students. The university received a 5-star rating on an index that rates institutional commitment to LGBTQ-inclusive policies, programs and practices. According to Campus Pride, campuses are scored from 0 to 100 on the Campus Pride Index, which assesses the presence of LGBTQ-inclusive policies, programs, and practices. Forty institutions scored 93 percent or higher and received a 5/5 ranking and place on the “Best of the Best” list. This rating is especially noteworthy given that OSU is a public university situated in a more socio-politically conservative state.

Image from https://www.campuspride.org/

What makes an LGBTQ+ inclusive campus? The LGBTQ+ Campus Pride Index was developed by Campus Pride with a team of national LGBTQ researchers. The tool includes 50+ self-assessment questions, which (according to the CPI website) correspond to 8 LGBTQ-friendly factors:

  1. LGBTQ Policy Inclusion
  2. LGBTQ Support & Institutional Commitment
  3. LGBTQ Academic Life
  4. LGBTQ Student Life
  5. LGBTQ Housing
  6. LGBTQ Campus Safety
  7. LGBTQ Counseling & Health
  8. LGBTQ Recruitment and Retention Efforts

Individual questions are weighted to emphasize specific components, which are determined to be more additive to an LGBTQ+ inclusive, welcoming, and respectful campus. All 8 LGBTQ-friendly factors are equally weighted in the overall score.

What’s missing? While I’m celebrating today, as a public health scientist focused on LGBTQ+ health, I’m also aware the Campus Pride Index is not without gaps. In all transparency, I have never seen the full CPI instrument, so it’s challenging to evaluate its strengths and limitations. However, there are broad areas for potential bias we should all be aware of.

To start, the CPI relies on an opt-in method; campuses self-elect to participate, leading to selection bias. The item is also a self-report survey, which is filled out by campus administration, which increases the risk for self-report bias due to social desirability, or the tendency for people (or institutions) to generally present themselves in a favorable fashion. The CPI only rates the presence of positive/supportive policies and programs. Now, I’m all for being strengths-based (we need a little joy in the world!), but it’s important that we also understand how these strengths-based, LGBTQ+ programs and policies are enacted in real life. Unfortunately, the CPI does not include student, faculty, or other staff experiences, perspectives, or attitudes. This is problematic because the presence of policies does not necessarily reflect people’s lived experiences of those policies. Take these examples:

  • A university may have a policy that supports inclusive housing for transgender and gender diverse students; however, the process of accessing those services may or may not be challenging for students depending on how the information is disseminated and who is running the program. For a while I worked at an institution that had an LGBTQ-supportive dorm housing program, which was known to LGBTQ+ and allied faculty, but not well advertised on campus
  • A college may have paid staff responsible for LGBTQ support services; however, there is often not enough staff to meet demand. I have worked with multiple students (across college and university institutions in three states) and all have experienced challenges accessing LGBTQ+ supportive counseling services through campus health. Sure, all of these institutions had LGBTQ+ supportive paid staff, but most were under-staffed and with waitlists. When LGBTQ+ students were referred to counselors not trained specifically in LGBTQ+ needs, they were often met with microaggressions or, worse, outright hostility.

Finally, none of the CPI ranking indices take into account the experiences of multiple minoritized LGBTQ+ students, including BIPOC LGBTQ+ students, LGBTQ+ students with disabilities, neurodivergent LGBTQ+ students, and first gen LGBTQ+ students. These groups’ experiences of campus climate, policies and programs are unique, as these students experience intersectional discrimination and oppression because they hold multiple minoritized identities. Their lack of specific inclusion in the CPI measures is a HUGE gap in this instrument and needs addressed in future iterations.

Let me say it again… the presence of an LGBTQ+ policy or program does not necessarily reflect ALL LGBTQ+ people’s lived experiences of those policies. That is, the presence of an LGBTQ+ supportive policy does not automatically confer LGBTQ+ people’s safety and wellbeing on campus. BUT, policies and programs are critical foundations for increasing LGBTQ+ people’s safety and wellbeing at our university.  

So… are we still celebrating? Yes, we’re still celebrating! There are few measures of campus climate for LGBTQ+ people; even fewer through which we can compare institutions nationwide. The Ohio State University is doing an excellent job putting in place foundational policies and programs to support LGBTQ+ people on campus. OSU is also doing the work of conducting their own campus climate assessments (see the 2019 Campus Sexual Violence Survey and the 2020 LGBTQ+ campus climate survey, led by the Undergraduate Student Government) to accompany national rankings, like the CPI. My hope is that as we learn about our strengths and limitations as an academic community, that we continue to ACT to improve our policies, programs, and their implementation to benefit diverse groups of LGBTQ+ students, staff, and faculty.

Looking for info on LGBTQ+ programs at OSU? Visit the LGBTQ+ at Ohio State Website.