LGBTQ smoking statistics show a consistent gap in US data: in the 2021 National Health Interview Survey (NHIS), 15.3% of lesbian, gay or bisexual (LGB) adults currently smoked cigarettes compared with 11.4% of heterosexual adults, and 13.2% used e-cigarettes compared with 4.1%. Overall, 27.4% of LGB adults used some tobacco product versus 18.4% of heterosexual adults. This guide sets out the adult and youth figures with each survey kept separate, explains the barriers to quitting that the CDC describes, and points to free help you can use today.
LGBTQ smoking statistics: the short answer
The CDC’s report on tobacco product use among US adults in 2021, published in the Morbidity and Mortality Weekly Report (MMWR), analyzed NHIS data and found that tobacco use was higher among several groups, including lesbian, gay or bisexual people (see the MMWR on adult tobacco use in 2021). The survey classified respondents as LGB if they answered “gay”, “lesbian or gay” or “bisexual” to a question on how they think of themselves.
The gap is not specific to one year or one survey. CDC pages on LGBTQ+ people and commercial tobacco cite 2020 adult figures and 2021 youth figures that point the same way. The sections below keep each survey and year separate, as the sources do, because the surveys use different samples and definitions and should not be combined into one number. For the wider US picture, see what percentage of Americans smoke.
Adult smoking by sexual orientation: NHIS 2021
The table reproduces the 2021 NHIS figures by sexual orientation from the MMWR report. Each value is the percentage of adults in that group who currently used the product, with the 95% confidence interval.
| Product | Heterosexual or straight | Lesbian, gay or bisexual |
|---|---|---|
| Any tobacco product | 18.4 (17.7 to 19.1) | 27.4 (24.1 to 30.9) |
| Cigarettes | 11.4 (10.9 to 11.9) | 15.3 (12.9 to 17.9) |
| E-cigarettes | 4.1 (3.8 to 4.5) | 13.2 (10.6 to 16.1) |
| Cigars | 3.5 (3.2 to 3.8) | 4.1 (2.8 to 5.8) |
| Pipes (including hookah) | 0.9 (0.7 to 1.0) | 2.3 (1.3 to 3.7) |
| Smokeless tobacco | 2.2 (2.0 to 2.5) | 1.2 (0.6 to 2.1) |
| Two or more products | 3.2 (3.0 to 3.5) | 7.2 (5.4 to 9.3) |
Two things stand out. First, the e-cigarette gap is large: LGB adults used e-cigarettes at more than three times the rate of heterosexual adults. Second, smokeless tobacco goes the other way, with lower use among LGB adults, which shows the pattern is about specific products rather than tobacco in general. The confidence intervals for the LGB group are wide because the group is smaller in the sample, so treat single figures as estimates.
As a simple ratio of the figures above (our own arithmetic), LGB adults smoked cigarettes at about 1.3 times the rate of heterosexual adults, used any tobacco product at about 1.5 times the rate, used two or more products at about 2.3 times the rate and used e-cigarettes at about 3.2 times the rate. The gap is therefore widest for vaping, which matters for quit planning because many people who vape also smoke or have smoked. If you vape and want to stop, talk to a clinician or quitline about a plan that fits your use.
The CDC’s LGBTQ+ health burden page, dated May 15, 2024, cites earlier adult figures from 2020 (MMWR 2022): 16.1% of lesbian, gay or bisexual adults smoked cigarettes compared with 12.3% of heterosexual adults, and 25.1% versus 18.8% used any commercial tobacco product (see the CDC LGBTQ+ health burden page). Those 2020 numbers are from a different survey year than the table above, so compare them in direction, not in exact value.
Young people: sexual and gender minority students
The same CDC page reports youth data from the National Youth Tobacco Survey. In 2021, 17.4% of gay, lesbian or bisexual high school students currently used any tobacco product compared with 11.4% of heterosexual high school students. For e-cigarettes in 2020, the page says about 1 in 5 lesbian, gay or bisexual middle and high school students currently used them, compared with about 1 in 8 heterosexual students.
Gender identity is less often reported than sexual orientation in national data. A 2026 study in Nicotine and Tobacco Research analyzed 14,457 students aged 9 to 19 and older in the 2023 National Youth Tobacco Survey (Nicotine and Tobacco Research, 2026). It found that gender minority heterosexual youth used more than twice as many tobacco or nicotine products over their lifetime as cisgender heterosexual peers, with an adjusted incidence rate ratio of 2.47 (95% CI 1.10 to 5.56), and that gender and sexual minority youth also used about twice as many (aIRR 2.05, 95% CI 1.40 to 2.98). The wide first interval reflects a small group, so the direction is clearer than the exact figure.
Video: a CDC former smoker story
The CDC Tips From Former Smokers campaign includes a video titled “Smoke and the LGBT Scene” featuring a former smoker, Ellie N. It is a personal story rather than data, and worth watching alongside the numbers.
Why rates differ, according to the CDC
The statistics do not explain themselves, so it helps to read what public health agencies say about context. The CDC page on barriers to quitting lists several factors, including that anti-smoking messages rarely appear in media designed for LGBTQ+ people, that some LGBTQ+ people may think of smoking as a way of rebelling against traditional roles, and that tobacco use may rank as a lower health priority than other issues affecting the community (see the CDC page on barriers to quitting).
The CDC pages cited here do not quantify the role of stress or stigma, so this article does not quote a figure for it. What the data do show clearly is who is more likely to smoke and vape. They do not show that any individual is more likely to fail, and many LGBTQ+ people quit successfully. For the mental health link, read our guide to smoking and mental health data.
Quit attempts and getting help
The CDC page on quitting reports that most people who smoke want to quit and “more than half try to do so each year”, but it gives no LGBTQ+-specific quit-attempt rate. It does give a measure of help-seeking from 2015: 14.5% of gay, lesbian and bisexual adults who smoked reported using counseling and/or FDA-approved medicines to quit, compared with 31.7% of straight adults who smoked. The page notes that “LGBTQ+ people often fear or experience discrimination or disrespect from medical professionals” and says “Tailored cessation resources and improved access to these resources could be helpful.”
A 2026 analysis of the Population Assessment of Tobacco and Health (PATH) Study in the journal Healthcare followed 4,449 US adults who smoked for one year. It found that smoking intensity and psychological distress were among the strongest predictors of quitting, and that cessation outcomes varied across groups defined by race, sex and sexual orientation (Healthcare, 2026). The authors say sexual minority adults “experience higher cigarette smoking prevalence and poorer cessation outcomes than heterosexual adults, yet few empirically supported cessation programs are tailored to SM populations.”
Put together: the gap in cessation is real in these data, but it tracks barriers to care, income, stress and dependence rather than anything about who a person is. That is also why support that feels safe matters. See our quit rates by demographic for more breakdowns.
Where to get free help
This guide does not name a specific LGBTQ-tailored quitline. These general options are free and open to everyone:
- Smokefree.gov. The US government site offers SmokefreeTXT, free daily text messages in a 6 to 8 week program, and the quitSTART app (see Smokefree.gov).
- A state or national quitline. You can ask whether they offer coaches trained to work with LGBTQ+ callers or a language-affirming service. It is fine to ask before you commit.
- A clinician you trust. If you fear a poor reception, look for an LGBTQ+-affirming clinic or telehealth provider. A prescriber can advise on medicines and counseling options.
For a ranked look at free tools, see free quit smoking apps and resources.
Where iQuit fits
iQuit is free on Google Play and the App Store. It will not replace a counselor or clinician, but it can help with the day-to-day side of quitting. You can log cravings with their triggers, use the SOS tools when an urge hits, chat with the AI coach for free daily messages, and read moderated community stories if you want to hear from others. You choose the quit method that fits you, cold turkey or gradual reduction. iQuit has no sexual-orientation or gender-specific mode, so think of it as a companion you can use on your own schedule alongside the support described above.
What these statistics do not show
- Transgender adults. The national surveys cited here do not give a current adult prevalence figure for transgender or gender-diverse people, so none is quoted.
- Outside the US. The figures are from US surveys, and this article does not cover other countries.
- Trends. The sources cited here give single years, not a long trend by orientation.
- Causes. These are associations from surveys, not proof of why rates differ.
Frequently Asked Questions
Do LGBT people smoke more than heterosexual people?
In US data, yes. In the 2021 National Health Interview Survey, 15.3% of lesbian, gay or bisexual adults currently smoked cigarettes compared with 11.4% of heterosexual adults (CDC, MMWR 2023).
What percentage of LGBTQ adults vape?
In the 2021 NHIS, 13.2% of lesbian, gay or bisexual adults used e-cigarettes compared with 4.1% of heterosexual adults, more than three times the rate (CDC, MMWR 2023).
Do LGBTQ youth use more tobacco?
The CDC reports that in 2021, 17.4% of gay, lesbian or bisexual high school students currently used any tobacco product compared with 11.4% of heterosexual students, based on the National Youth Tobacco Survey (CDC LGBTQ+ health burden page, 2024).
Are gender minority youth at higher risk?
In the 2023 National Youth Tobacco Survey, gender minority heterosexual youth used more than twice as many tobacco or nicotine products over their lifetime as cisgender heterosexual youth, with an adjusted incidence rate ratio of 2.47 (Nicotine and Tobacco Research, 2026).
Do LGBTQ smokers use quit treatment less?
A 2015 figure cited by the CDC found 14.5% of gay, lesbian and bisexual adults who smoked used counseling or FDA-approved medicines to quit, compared with 31.7% of straight adults who smoked (CDC, LGBTQ+ quitting page, 2024).
Why is quitting harder for some LGBTQ people?
The CDC lists fear of discrimination from medical professionals, tobacco being a lower priority than other issues, and few anti-smoking messages in media designed for LGBTQ+ people, and says tailored cessation resources could help (CDC, May 2024).
Where can I get free help to quit?
Smokefree.gov offers SmokefreeTXT, free daily text messages in a 6 to 8 week program, and the quitSTART app. You can also ask a quitline or clinician about LGBTQ-affirming support (Smokefree.gov).
Try iQuit as a companion
Quit at your pace, with support that feels safe
iQuit is free on Google Play and the App Store. Log cravings, use the SOS tools, chat with the AI coach and read moderated community stories while you build your own plan.
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