Date Available

5-12-2025

Year of Publication

2025

Document Type

Doctoral Dissertation

Degree Name

Doctor of Philosophy (PhD)

College

Arts and Sciences

Department/School/Program

Psychology

Faculty

Jessica L. Burris

Faculty

Shannon Sauer-Zavala

Abstract

Due to multilevel factors, including a high prevalence of tobacco use, the burden of some cancers is disproportionately higher in the lesbian, gay, bisexual, transgender, and queer (LGBTQ) community than the general population. Evidence-based tobacco treatment delivery with high rates of tobacco cessation would be a powerful tool for secondary cancer prevention in the LGBTQ community, yet few studies have explored this issue. The current study aimed to 1) uncover both positive and negative aspects related to the lived experience and treatment of LGBTQ cancer survivors who use tobacco, 2) elucidate barriers and facilitators of tobacco treatment and cessation, and 3) explore tobacco treatment preferences for a program integrated into cancer care. The study utilized a concurrent mixed-methods approach. Cancer care providers (n=8) and LGBTQ cancer survivors who reported recent tobacco use (n=3) were recruited into the study. After consent, individual semi-structured interviews occurred, and survivors also completed a survey. Questions asked of providers assessed their attitudes and practices regarding the care of LGBTQ cancer survivors. Interview questions for survivors assessed their perceptions of cancer care (including tobacco treatment), specifically related to their LGBTQ identity. The survey captured details about survivors’ tobacco use, with other measures tapping into themes expected to arise in the interview. Data analysis primarily involved thematic analysis of providers’ data and case analysis of survivors’ data. For providers, major themes that arose included little knowledge about the LGBTQ population’s tobacco-related burden and hesitation to consider LGBTQ identity during cancer care delivery. For survivors, major themes included issues around discrimination versus inclusion in healthcare settings (including tobacco treatment) and multilevel contributors to tobacco use. Overall, evidence was found to support additional training of providers and the need to address high levels of stress and psychological distress and incorporate peer support in tobacco treatment among LGBTQ cancer survivors

Digital Object Identifier (DOI)

https://doi.org/10.13023/etd.2025.206

Funding Information

This research was supported by a pilot grant from the University of Kentucky Center for Health, Equity, and Transformation

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