Snuffing out the butts: campaigns to convince gay men and lesbians to ditch cigarettes try to cut through a long-held addiction.

In the past year antismoking campaigns have grabbed attention in gay bars, coffee shops, and community centers throughout California's Orange and Santa Clara counties. One features a reformed smoker proclaiming, "I didn't survive gay bashing so I could die from lung cancer. I had to stop smoking." Other ads replace the phrase "gay bashing" with "hustling," "crystal meth," "rape," and "HIV."

The "Cigarettes Are My Greatest Enemy" campaign was designed to have a raw, cutting-edge flavor, says Kristina Keck, tobacco control manager for the National Association of Lesbian, Gay, Bisexual, and Transgender Community Centers. The ads have been well-received: In one county 80% of respondents said they quit or considered quitting as a result of the ads. In another, 94% rated the ads' effectiveness as "good" or "excellent."

For years smoking cessation took a backseat to other gay and lesbian health issues such as HIV prevention. But in recent months, organizations nationwide have begun crafting attention-grabbing antismoking ad campaigns to counter the lure of tobacco addiction.

It's an uphill battle. Up to 50% of lesbians, gay men, and bisexuals continue to smoke, compared with 28% of the general population, according to the American Journal of Preventive Medicine. Other studies show that gay and bisexual men are two times more likely than straight men to smoke. Lesbians are more likely to be heavy smokers than straight women.

Bob Gordon, a longtime member of San Francisco's Coalition of Lavender Americans on Smoking and Health (CLASH) is confident the group's "How They Get Us to Screw Ourselves" campaign is working. "People mention it when they come in for class," he says, referring to "The Last Drag," the quitting classes he facilitates. "They say, 'I never thought about that.'"

The CLASH campaign has had national reach. Elizabeth Byrne, who leads smoking-cessation classes at Philadelphia's Mazzoni Center, says that this ad "seems to have really stuck with folks--enough that quite a few have reported hanging it on their fridge."

No one knows yet if other antismoking messages are getting through to gay men and lesbians across the country. Success or failure rates of campaigns are difficult to gauge, and tobacco education programs have only begun to share information nationwide.

"Data regarding file success of LGBT antismoking campaigns are not available," says Alyssa Easton of the Centers for Disease Control and Prevention. "We are looking at existing data sets to determine if we call derive some smoking estimates among LGBT people, and we've convened some work groups to provide guidance on how to collect the most accurate data on smoking prevalence."

Only recently have local and national LGBT leaders confronted the smoking issue together. "Last October more than 60 LGBT organizations convened for a two-day action plan meeting. Scout, the transgender health research coordinator for the Fenway Institute of Fenway Community Health in Boston, calls the gathering "historic" because it "represented the most ambitions response by the LGBT communities to the impact tobacco has had on us. It's been too easy for us not to add up the numbers."

Says Michele Eliason, Ph.D., RN, an affiliate of San Francisco-based Lesbian Health Research Center: "There is virtually no research on motives for smoking, attitudes toward smoking, quit attempts, or types of attempts [among LGBT smokers]. These things are all important to know if we want a comprehensive prevention program."

RELATED ARTICLE: Quit and quit again.

Research shows lesbians may have the toughest time giving up smoking.

Each time she decides to stop smoking, Imi Rashid starts on a Monday. But by Friday night the Chicago resident usually finds herself at a party or bar, and the addiction wins.

"I see people smoking on the street, in restaurants, bars, pool halls, basically everywhere I go," says the 31-year-old tax analyst. "It's the easiest thing in the world to just run across the street and buy a pack of smokes. That temptation is 20-fold when you're trying to quit."

Smoking is the leading cause of preventable death among women, and lesbians may face the toughest fight of anyone to kick the habit, according to the latest public health research. Here's why: Research has shown that women are more likely than men to smoke as a means of regulating mood, and "sexual-minority women face more stress in their lives," says Michele Eliason, Ph.D., RN, an affiliate of the Lesbian Health Research Center and an associate professor at the University of Iowa.

In addition, lesbians may be more resistant to antismoking messages that are deemed judgmental and may avoid regular doctor's visits, says Kathleen DeBold, executive director of the Mautner Project for Lesbian Health.

Rashid's most successful attempt came as a result of attending a 10-week lesbian support group called Bitch to Quit. But after 100 days of not smoking, Rashid bought a pack. That was two years ago.

For her, a short-term program may not be the solution. But she holds out hope. "If there was another LGBT-oriented cessation program that thought it through enough to have a real long-term plan for smokers to quit," she says, "I'd be the first in line."--J.D.

DuLong has written for Newsweek International, Rolling Stone, and Newsday.