A new UC Merced study aiming to help LGBTQ2S+ adults quit smoking has paused recruitment pending legal challenges to the federal government’s funding decisions.
The study, unfolding in three phases, will generate a 12-week pilot program supporting LGBTQ+ individuals in rural communities who want to stop smoking.
It depends on a research grant from the National Institutes of Health (NIH). Earlier this year, the Trump administration canceled more than $1 billion NIH grants for diversity-related projects.
That move was challenged in court, and a Republican-appointed federal judge called the action discriminatory and illegal. The NIH funds public health research worldwide, including the project that developed medical treatment for HIV and AIDS.
The clinical trial is a partnership between the University of Oklahoma Health Sciences, UC Merced and community partners.
It is part of the Empowering our Community and Health Outcomes (ECHO) project, funded by a $600,000 grant from the National Institute on Drug Abuse (NIDA), a subsidiary of the NIH. A three-year grant to launch the study was awarded to the University of Oklahoma in December.
A stop-work order for the nicotine study has not been issued. But rather than operate with uncertainties, the study’s collaborators decided to pause recruitment efforts until more information becomes available regarding the presidential executive order.
“We don’t know the situation,” said Arturo Durazo, a co-investigator for the study and the director of the Nicotine and Cannabis Policy Center at UC Merced. “I find that the current administration is taking a lot of license administratively on targeting advances in health equity, especially when it comes to people of color, LGBTQ+ [people]. It’s picking on structurally-marginalized communities.”
The rural San Joaquin Valley is an area of interest in research efforts aimed at curbing nicotine addiction. Health-equity researchers consider the region a high-stigma environment for LGBTQ+ individuals, who are known to smoke tobacco at disproportionately higher levels than their cisgender and heterosexual counterparts.
“One of the things that we know is that LGBTQ+ people are being left behind regarding all the great campaigns there are in the U.S. to bring down smoking rates,” Durazo said.
Smoking tobacco is the world’s leading cause of premature death, causing more than 7 million deaths annually, according to the Centers for Disease Control and Prevention.
“The main focus is to help people who are smoking commercial combustible cigarettes to quit smoking, as that is still the leading killer of preventable disease,” Durazo said.
Increased stress levels reported among LGBTQ+ communities
UC Merced teamed up with CalPride Valle Central for the study, underscoring the need for targeted and community-centered interventions to help LGBTQ+ individuals quit tobacco and nicotine products.
CalPride provides gender-affirming, harm-reduction and preventative health care resources to residents in Merced County and the surrounding Central Valley and foothill areas.
This year, Katalina Zambrano, executive director of CalPride, said she noticed a curious trend among the center’s visitors.
Although some guests were coming in smoking every 15-20 minutes, they also reported smoking less while attending CalPride’s support groups, where they didn’t worry about belonging.
Zambrano highlighted stress as a motivating factor in nicotine dependence among LGTBQ+ people, and described how current rhetoric and policy against LGBTQ+ and immigrant communities – at the local, state and federal level – has her on edge lately.
“Speaking from experience, I haven’t smoked on a regular basis in 10+ years,” said Zambrano, a trans Latina. “And here I am going through a vape every two weeks, and that’s pretty heavy. So this program is really going to help all of us be able to step back and find better ways to kind of cope with things.”
The study builds upon the minority stress model by Ian Meyer, a public health expert, and considers how discrimination against LGBTQ+ communities triggers increased levels of nicotine and tobacco consumption.
“All those stressors that are related – where we internalize that we’re not good enough, or we’re not complete, or we’re broken – that’s what we call a minority stress,” said Durazo, the study’s co-investigator.
Both the San Joaquin Valley and Oklahoma are regions where two-spirit, or indigenous individuals with gender-diverse identities, reside. Therefore, researchers were intentional about including two-spirit communities, Durazo said.
Health-equity research shows that indigenous communities in North America have the lowest quit rates of all groups.
An NIH study linked the data to the colonization of tobacco, which, in the 19th century, resulted in the simultaneous process of the mass production of tobacco and the criminalization of ceremonial tobacco use by indigenous groups.
“However, commercial tobacco use was not illegal, contributing to the promotion of commercial tobacco use among First Nations and Métis peoples,” the report reads. “As a direct consequence of these policies, commercial tobacco products were introduced into ceremonial practices as a harmful and unsustainable replacement to sacred tobacco.”
Zambrano hopes the study will move forward and help LGBTQ2S+ individuals access healthy alternatives to cope with the increasing stress they are experiencing.
“There are days that I get off of meetings and it’s just like, ‘Is this ever going to end? Is this going to stop?’” Zambrano said.
Alma Villegas is a bilingual journalist from Los Angeles, covering English and Spanish community news stories across California. This story was first published by Merced FOCUS, a partner of The Intersection and CVJC.