Lost in the smoke.

A new report on women and smoking skips over lesbians, leaving activists fuming 

Because they know that lesbians are more likely to smoke than straight women, lesbian health advocates were pretty surprised when a March 27 surgeon general's report on women and smoking made only a passing mention of lesbians.

"Lesbians are less likely to get regular health care because there are more barriers for [lesbian, gay, bisexual, and transgendered people]," says Kathleen DeBold, executive director of the Mautner Project for Lesbians With Cancer. "So [this report] concerns us greatly?

A study published in the April American Journal of Public Health indicates that 21.2% of lesbians currently smoke, compared with 16.1% of straight women. Other studies suggest that lesbians are at higher risk than other women for some kinds of cancer.

"Sadly, there aren't a lot of population-based studies we can point to and say, `One of eight lesbians will get cancer during her lifetime' or `One of five lesbians smokes,'" says Cheryl Fields, health education director for the Mautner Project. "This certainly illustrates the need to include questions about sexual orientation in national studies so we can get at this kind of data."

However, the surgeon general's report makes one thing clear: Smoking is up among the nation's women. DeBold says one reason is that cigarette companies are effectively targeting ad campaigns to female consumers.

"They position smoking as an accessory for all attitudes," she says. "If you want to be tough and butch, light up a smoke. Want to be femme and sexy? Take a long, slow drag and let the smoke curl around your hair. No matter what a kid or adult wants, the tobacco companies are saying they can provide it."