'Authentic' or 'corny': LGBTQ+ young adults respond to visual, thematic and semantic elements of culturally targeted tobacco public education advertisements.

Background: Lesbian, gay, bisexual, transgender and queer (LGBTQ+) young adults (YA) experience disparities in nicotine and tobacco use. Mass-reach health communications can prevent nicotine and tobacco initiation and progression, but LGBTQ+adults report low engagement. Although cultural targeting (CT) could reach LGBTQ+YA, we know little about the strategies that resonate with this population. We probed how LGBTQ+YA perceived CT content to inform tobacco public education campaigns on strategies to engage this population.

Methods: We conducted six focus groups with N=20 LGBTQ+YA (18-35) who had ever used vapes, cigarettes or both. We showed participants examples of CT tobacco public education campaigns, probed their opinions and perceptions and coded transcripts using a data-driven inductive approach.

Results: Participants were more inclined to view an ad as effective when they felt it was authentically created for the LGBTQ+community. Avoiding stereotyping, including diversity, using 'subtle' LGBTQ+iconography (ie, rainbows), and including personal experiences all contributed to the authenticity of the ad. Participants discussed the importance of visual appeal; bright colours made ads appear too corporate or like an ad for a tobacco product. Lastly, participants responded well to gain-framed messages rather than traditional risk messaging.

Conclusion: Tobacco public education ads featuring 'every-day' LGBTQ+people in candid or unposed shots, personal stories with gain-framed messaging, and subtle Pride iconography and colours may increase acceptability among LGBTQ+YA. Researchers should focus on cultivating authenticity in ads and avoid outdated trends by consulting with the community and moving with speed from development to implementation.