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

Abstract

Sexual and gender minority (SGM) groups experience nicotine and tobacco (NT) related inequities that persist despite reductions in NT use across the general population. Although institutional trust has important implications for how public health policies are received, few studies have explored trust in tobacco control institutions, especially among SGM communities that are not benefitting equitably from existing approaches. Analyzing narrative data from open-ended interviews with 100 young adults in California, USA, who currently or formerly smoked tobacco and identify in ways that classify them as SGM, we interpret participants’ perceptions of tobacco control efforts in relation to characteristics of trustworthy institutions. Our findings suggest that trust in tobacco control institutions may be compromised by some of the tactics used to denormalize NT use, abstinence-only approaches to NT-related messaging and policymaking, and distrust of the broader establishment of which tobacco control is perceived to be a part. Highlighting trust-compromising consequences of some current mainstream approaches to tobacco control, these findings are important to consider in the development of community-informed messaging strategies and policy interventions to address tobacco-related inequities among SGM populations.