Trust in tobacco control: Critical perspectives from sexual and gender minority young adults in California, USA

Appendix II - Example narrative data





Alice (21 year-old white, queer, genderfluid person)

There's always these stupid anti-smoking ads on TV, and … they always have … like, this huge statistic where it's like, “It's just bad! Like, it's really bad!” … I just want to know what's in what I'm having. You know? Whatever that is. 'Cause … I feel like there's this kind of whole perception that people who smoke still think that it's good for you or something. And it's like, I'm not dumb. … I just wish there was more like, “Oh, well, here are the facts,” instead of like, “This is bad! This is bad and you're wrong for doing this!” … I don't want to be challenging my moral compass. I just want to be learning the facts.


Chantal (21 year-old mixed race Black and Indigenous pansexual cisgender woman)

…it seems like everyone who smokes tobacco is looked at like, very negatively and just looked down [on], which is kind of weird to me. 'Cause I get what they're doing [in the ads], like, we shouldn't be [smoking]. But I feel like … putting so much hate on it to these people, it's like, You're making them feel worse, and then with that, they're gonna want to smoke more. [… A]ll the commercials … they're … just like violent, just very descriptive, on just like, a hate towards people who smoke. … I know, of course, we shouldn't be doing it [smoking]. But the ways they want to go about, like, helping us, don't seem very helpful.


Rach (24 year-old white bisexual cis woman)

I guess one thing is just to not create these extremes. So, what I would consider one extreme is where someone who smokes is like, shunned … And I've felt that way. And I think that just does not serve. It's not effective in supporting somebody, or … helping someone in any way. It just kind of leads to sort of resentment on all sides. The other extreme could be like, “Oh! Smoking's the coolest thing. Like, everybody should smoke … .” That's also a negative – That's super negative, and I don't think that's prevalent at all, at least of people I know. … So, this … kind of polarization of viewpoint, I don't find as effective. ... I find something more persuasive if it's a nuanced argument … . There's so many cultural connections to smoking that to say like, "Ooh, it's bad," – I don't think that's effective.


Francis (24 year-old Mexican & Indigenous queer  nonbinary trans woman)

It's weird advertisement. … The majority – just disgusting ads. So like, ‘Oh, your mouth will be like this if you smoke tobacco.’ …  I mean, I get it. They're not lying [by] saying that tobacco isn't good for your health. [ … But] there's another way of advertising, you know, with information facts, instead of just – Because that, for example, is like propaganda. … It just sounds one-sided, and it shouldn't be.


Alice (described above)

I usually don't try and go to sites that I know are going to be biased, for instance, that Truth campaign, I'm not going to go there to get my information because I know that their whole point is to have people not be smoking anymore. So, they're probably going to do … whatever is in their best interest.


Claude (23 year-old white, queer, agender trans person)

A drug-prevention website isn't going to tell you the truth about what LSD does. You're going to look on Erowid and research the physiological effects and the history behind it. I just look for bias in a source, and I think, actual health resources, like WebMD, will give you a better idea of what symptoms are or what will happen if you like are smoking. And it's a better comparison, but it's just – those sources are still biased in the way of not wanting you to do something.


Ant (21 year-old bisexual white cis man)

There should be a bigger push to get people away from cigarettes. 'Cause, the city right next door … just banned flavored nicotine, and I have friends out there that can't get any. So, they went back to smoking cigarettes. And I don't know. I think that's a step in the wrong direction.


Tennis (23 year-old white, gay, cis man)

… restricting things is just going to cause them to go underground, which I can see with my black-market vapes that I sometimes get, and don't know where they're coming from, which is like, dangerous. 'Cause people are going to do what they want to do even if it's been banned or illegal. Hence, the whole illicit-substance-use trade. And so … I feel like the government message is like, all or nothing. … But I think of … minimizing harm rather than framing something as an abstinence [or] like an all-or-nothing situation.


Tom (20 year-old mixed race Latinx bisexual nonbinary person)

I see a lot of the anti-smoking-and-vaping ones, and … Like, you could tell that it's an old, white dude making the ads. (scoffing) … who probably is super against cigarettes or whatever, or is making those ads at a profit and smoking a cigarette, laughing to the bank. … Like, that's really how I look at those ads.


CH (22 year-old mixed race Indigenous queer trans woman)

I remember the big anti-vaping campaign in California about a year or two ago [circa 2019-2020], and I still see those very occasionally. But as I looked into that, I found it disingenuous. I don't think the government (and this might be outside the question) but I don't think the government wants us to stop smoking. The tax revenue for cigarettes is very high … . But then with the emergence of vaping, cigarette smoking went down. And so, I think that the big anti-vaping campaign was less of an effort to curb this epidemic of vaping and much more so a corporate, or even government financial project, to curb the downfall of cigarettes because (scoffing) they already spent that money that they projected to be increasing and not decrease.


Valentina (22 year-old Latinx bisexual cis woman)


[O]ther countries … I feel like they care about their people. Here in the United States, everything is just – is just the profit. [ … T]he government profits off everything we do and eat and all that stuff. So obviously, they're not gonna put those type of advertisements on the cigarette packs.[ ... W]e just live in such a corrupt country where … no one really cares about our health. … Like, in Canada, frickin' insulin is like, $12, and here, it's like a couple hundred dollars … it's crazy because we live in a country where we're like, the wealthiest country, and … somehow, we don't have funding for any of this kind of stuff. … Because they don't want to give it to us. When in reality, there's way more than enough funding. There's enough funding to house every single homeless person in this country. There's enough funding to feed every single person on this planet. … The government is just so greedy.


Camryn (21 year-old Black bisexual nonbinary person)

… the government could offer therapy and aid to anybody who is an addict to anything. But they don't. We could have public health. I feel like we don't have public health. The implication that we have public health would be the implication that everybody has some type of healthcare, would be able to get help for their health … which is like the furthest thing from the truth.


Journal of Critical Public Health, Volume 1, Issue 1