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“The Illinois Tobacco Quitline is just busting at the seams this month,” said Sherrill Keefe, director of American Lung Association of Illinois-Greater Chicago. “People say, ‘This is the year I’m going to quit smoking.’”

But members of the LGBT (lesbian/gay/bisexual/transgender) community are 35 to 200 percent more likely to be smokers than the general public, according to the National LGBT Tobacco Control Network based in Boston.

Karyn Haney, a lesbian who quit smoking three years ago this January, is the project coordinator for Chicago's Howard Brown Health Center’s “It’s a Bitch to Quit” smoking cessation program. The center launched its current program at the beginning of the month.

“People in the program aren’t necessarily saying 'I’m smoking because I’m gay.' But there are stressors that push the LGBT numbers higher,” she said. “Every time I check my voicemail to see who wants to sign up for the program, it’s full.”

For some LGBT individuals, stress can stem from lack of acceptance, social isolation, low self-esteem and other psychological issues that often impact minorities can lead to coping behaviors such as smoking and even alcohol abuse, which is also more prevalent in the LGBT community.

Overall, smoking rates are down significantly from the past in the general population. And on the Jan. 1, one-year anniversary of the Smoke-free Illinois Act, which banned smoking in virtually all public places, many are expecting the number of smokers in the state of Illinois to drop below the current 21 percent level. That percentage matches the national average, according to the American Lung Association of Illinois-Greater Chicago.

By comparison, an estimated 30-40 percent of LGBT individuals smoke, according to the LGBT tobacco control network.

For many, the issue isn’t stress -- it’s social. Researchers cite frequent patronage of bars and clubs as a factor related to the higher prevalence of tobacco use in the LGBT population. Ever since the Jan. 1, 2008 ban, just ask one of the smokers huddled around a lighter 15 feet from a bar’s main entrance.

But things are changing, said Peter Ducker, a gay 40-something living and working in Chicago. “Before the smoking ban, or at least not too long before it, smoking was the vogue thing to do,” he said. “You’d go out, and you’d have a cocktail and a cigarette. It’s only in the past few years that it’s just not considered cool anymore.”

Culturally, smoking is now stigmatized. Yet at a “Teen Talk” session at the Center on Halsted, Chicago’s pre-eminent LGBT community center, eight out of 10 young adults, aged 18 to 23, admitted to smoking in an informal survey. Some of them noted they smoke as much as a pack a day. One 20-year-old participant, who came out of the closet at the age of 14, said he has smoked ever since as a way to make himself feel better. And he, like most of the other smokers in the group, has siblings who smoke.

Of course, it’s entirely possible for an LGBT individual to take up smoking irrespective of their sexual orientation or gender identity. But Scout (his full legal name), director of the National LGBT Tobacco Control Network, said one of the biggest challenges to mobilizing the community is the prevailing attitude within it that LGBT individuals do not smoke more than others.

Scout said the tobacco industry has developed ads to make the LGBT community feel that cigarette companies care about them. “They’ve been telling us how they support us, [while] not actually supporting us,” he said. “The tobacco industry has played us like a violin by framing advertising messages like civil rights messages.”

The American Cancer Society estimates that more than 30,000 LGBT individuals die each year of tobacco-related illnesses. “You have a documented smoking rate and documented barriers to accessing health care,” said Scout. “So it’s hard not to imagine that tobacco is cutting LGBT lives short.” 

Cigarettes are "the perfect addictive drug,” said Dr. Alan Leff, a pulmonologist and professor of medicine at the University of Chicago Medical Center.  

“It’s not like alcohol where you wake up and have a hangover the next day, “ he said, “You can smoke, and conduct a normal, productive, completely successful life for many years.” But Leff said he’s seen the socioeconomic demographics of his patients shift over the years, from white, professionals to working class, minority populations, as smoking has become less glamorized and more stigmatized. 

The highest rate of smoking among adults, 32 percent, is found in the American Indian/Alaska Native population, followed by blacks at 23 percent. The adverse health effects from smoking account for nearly one out of every five deaths every year in the United States, according to the U.S. Centers for Disease Control and Prevention.

Smoking is associated with cancers, predominantly lung cancer, cardiovascular diseases such as coronary heart disease and respiratory diseases that include chronic bronchitis and emphysema.