Relationship Between Tobacco Retailers’ Point-of-Sale Marketing and the Density of Same-Sex Couples, 97 U.S. Counties, 2012

The reasons for higher rates of smoking among lesbian, gay, and bisexual (LGB) people than among heterosexual people are not well known. Research on internal migration and neighborhood selection suggests that LGB people are more likely to live in neighborhoods where the tobacco industry has historically targeted their marketing efforts (lower income, more racial/ethnic diversity). We used multi-level models to assess the relationship between the rate of same-sex couples per 1000 coupled households and 2012 marketing characteristics of tobacco retailers (n = 2231) in 1696 census tracts in 97 U.S. counties. We found no evidence of tobacco marketing at retailers differing by same-sex couple rates in census tracts with the exception of three findings in the opposite direction of our hypotheses: a small, significant positive relationship for the rate of same-sex male couples and the price of Newport Green (mentholated) cigarettes. For male and female same-sex couples, we also found a small negative relationship between tobacco advertisements and same-sex household rate. Tobacco retailers' tobacco marketing characteristics do not differ substantially by the rate of same-sex couples in their neighborhood in ways that would promote LGB health disparities. Further work is needed to determine if these patterns are similar for non-partnered LGB people.