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Walter Armstrong Walter Armstrong

Video: The CDC Gives Big Pharma a Pass in First-Ever Gay Anti-Smoking Ads

This week a new series of PSAs is airing in the CDC's major "real people" anti-tobacco push. The first "face of gay smoking" is a longtime AIDS survivor whose sudden stroke is blamed on smoking and HIV—but not one word about his two decades on HIV meds.

2 Substance

For the time since the invention of combustible tobacco, the ever-expanding LGBTQIA (lesbian, gay, bisexual, transgender, queer, intersex, asexual) community in the US will be the explicit audience for an anti-smoking message by its own government. The ad launches this week as one of a series in the Centers for Disease Control’s ongoing “Tips From Former Smokers” campaign.

Keeping company with Brett, who lost most of his teeth to gum disease by age 42; Felicita, who lost all of her teeth to gum disease by age 50; Rose, who has had surgery, chemotherapy and radiation for lung cancer; Shawn, whose throat cancer requires him to breathe through an opening in his throat; and Amanda, who smoked during pregnancy and gave birth to a two-months-premature baby who had to spend weeks in an incubator, is 45-year-old, longtime AIDS survivor Brian, who suffered a stroke said to be caused by clogged arteries related to the combined conniving of his smoking addiction and his HIV disease.

“These new ads are powerful. They highlight illnesses and suffering caused by smoking that people don’t commonly associate with cigarette use,” said CDC Director Tom Frieden, MD, MPH. “Smokers have told us these ads help them quit by showing what it’s like to live every day with disability and disfigurement from smoking.”

And powerful these “real people” ads are, at least on the evidence of Brian’s dignified and painful account of his 30 years of nicotine addiction and the day of his stroke.

What the CDC neglects to mention, however, is that Brian’s HIV medication almost certainly played a major role in clogging those arteries. Many longtime survivors like Brian have been downing powerful chemotherapy every day for some 20 years. Usually one, often two and sometimes three of their three-drug cocktails they require in order to stop viral activity in their blood increase levels of fat in their bloodcausing a spike in cholesterol and triglycerides.

People with HIV have at least four times the rate of sudden heart attack and three times the rate of stroke than their uninfected peers.

A new CDC report shows that LGBTQIAs smoke at twice the rate of straight people, 30.8% compared to 20.5%. (It is based on data from the 2012 National Adult Tobacco Survey, which was the first of the annual surveys to ask a question about sexual orientation.) This discrepancy matches data from previous research, most notably a comprehensive 2009 review of the 42 extant studies that found that gay men had between 1.1 and 2.4 times greater odds of smoking than straight men, while lesbians had between 1.2 and 2.0 times greater odds of smoking than straight women.

It is interesting to note that the Bs—bisexual men and women—have the highest rates of smoking in the LGBTQIA conglomerate, ranging between 30% and 39.1%.

A 2012 Danish study found that smokers with HIV had a five-fold greater rate of non-AIDS-related deaths, with cardiovascular disease and cancer topping the list. Another list they topped was total years of life lost—12.3 years—compared to 5.1 years for nonsmoking HIVers and 3.6 years for smoking non-HIVers.

LGBTQIA health groups have made much of that stark discrepancy, and the CDC appears to have seized on this dramatic data point as one reason to choose a white, middle-aged, gay man with HIV as the “first face of LGBTQIA smoking.” (A previous “Tips” ad featured Ellie, a lesbian nonsmoker who had to quit her bartending jobs at gay and straight bars because she was diagnosed with asthma caused by secondhand smoke.)

But what about the Bs? In a community hypersensitive to identity politics, diversity and media representation, this decision is likely to result in some huffing and puffing—sans cigarettes, it is hoped—on the part of many members.

And what about Big Pharma? Whether the CDC’s disregard of the contribution to health harm made by the HIV medicines of the pharmaceutical industry, a lavish contributor to political campaigns, is less predictable.