Stress and targeted advertising are blamed for high smoking rates among gay Americans, the San Francisco Chronicle reported Aug. 6.

Gays and lesbians in California, for example, smoke at twice the rate as heterosexual residents: more than 30 percent of gays, lesbians, and transgendered Californians smoke, compared to 14 percent of the general population. Lesbians smoke at three times the rate of other California women; about one in three are smokers. Among lesbians ages 18-24, 47 percent smoke.

Gay smokers say there are many factors involved in their addiction, including the stress of coming out or staying closeted, involvement in the club and bar scene, relationship problems, lack of family connections, and the reinforcement of high rates of alcohol and drug abuse in the gay community.

"Gay people probably smoke longer because we're not as family-oriented. If you don't have kids and raise a family, you don't need to stop," said smoker John Daly, 41. "We don't have the same responsibilities. We can be reckless a little longer."

Added Kaiser Permanente tobacco researcher Elizabeth Gruskin: "It doesn't seem like the issues are different than with straight people, so maybe they're just more intense. If you said you smoke because of job stress, well, for an LGBT person, stresses can include 'Do I come out at the office?' and 'Am I going to get fired if they find out I'm gay?' There's sort of an added layer for LGBT people."

"There's a theory that smoking truly is a part of gay identity, whether that be a prop for a drag queen or a cigar for a woman who's part of the Women's Motorcycle Contingent," said Bob Gordon, director of the California LGBT Tobacco Education Partnership. "Perhaps smoking signals 'queer,' that I'm different from the mainstream."

For more than a decade, tobacco companies have also been focusing their marketing at the gay community. Ruth Malone, a UCSF medical sociologist, says that images of smoking are "just ubiquitous in the gay press.

"They appeared in illustrations with articles that had nothing to do with tobacco," she said. "Tobacco appeared in ads that had nothing to do with tobacco products."