Someone in your corner: how a human touch helped LGBTQ+ smokers get screened and start quitting

Quitting smoking is hard. It’s even harder when the healthcare system doesn’t feel like a safe place. For many LGBTQ+ communities, going to the doctor comes with a history of being misunderstood, judged, or ignored. This makes it tough to ask for help, even when the stakes are high, as they are with lung cancer, the deadliest cancer in the country.

A research team in Seattle wanted to do something different. Dr. Matthew Triplette, an Associate Professor in the Public Health Sciences Division at Fred Hutch Cancer Center, led a pilot study to see if a more personal kind of support could make a difference for LGBTQ+ smokers eligible for lung cancer screening. Dr. Triplette and his team paired each person with a patient navigator who could “walk” alongside them for three months, helping them understand their screening options, quit smoking, and get through the healthcare maze without feeling alone.

The navigator was a trained individual, equipped with the right knowledge and the right attitude, offering one-on-one help to people who often fall through the cracks. The navigator helped book appointments, explained test results, offered smoking cessation counseling, and handed out free nicotine patches when needed. They kept in touch regularly, through phone calls, emails, and in-person visits. And while the navigators didn’t identify as LGBTQ+, they were trained in how to work respectfully and thoughtfully with the community.

The study enrolled 41 participants in King County, Washington. Everyone in the group was between 50 and 80 years old, identified as LGBTQ+, and had a long history of smoking. Many had faced discrimination or other barriers to care in the past. Most were smoking daily but only a little over a third had ever undergone lung cancer screening before. The question was whether this kind of personalized intervention could shift those numbers.

Before and after the intervention, participants completed surveys and a carbon monoxide breath test to confirm smoking status. The team also checked medical records to see who got screened for lung cancer. The main things they wanted to know were: Did people find the program helpful? Did it lead to more screenings? Did it help anyone quit?

The verdict? Most participants really liked the program. On a 5-point scale, the average rating for acceptability was 4.5, and satisfaction with the navigator’s support scored a high 40.8 out of 45. Participants felt respected and supported. They felt like someone was in their corner. That kind of feedback matters.

That warm reception translated into real-world action. At the start of the study, only 22% of participants were up to date with their lung cancer screening. After three months, that number jumped to 59%. That’s a meaningful change in a short period of time. It suggests that when you remove the usual roadblocks such as confusing systems, lack of support, and stigma, people are much more likely to take preventive steps for their health.

As for quitting smoking, the results were encouraging but more modest. About 41% of participants said they had gone at least a week without smoking at some point during the study, and 18% had confirmed 30-day abstinence by the end. While that may sound small, it’s higher than many similar programs, and especially impressive given that participants weren’t recruited specifically for wanting to quit.

Interestingly, the study didn’t find much improvement in participants’ knowledge about lung cancer screening. That could be because the navigator focused more on helping people take action than on delivering formal education. Many participants may have already understood what screening was but needed someone to help them get through the red tape.

This was a small study with no control group, so it can’t prove exactly how much of the change came from the intervention itself. But the early signs are strong enough to suggest that this kind of model could work more broadly. Dr. Triplette and his team hope future research will build on this model, maybe with larger groups, longer follow-up, and more diverse representation across the LGBTQ+ spectrum. They also hope to fine-tune the education component and figure out what kinds of navigator support work best.

This study isn’t just about lung scans and quitting cigarettes—it’s about trust. Healthcare often talks about outreach and inclusion, but too often the follow-through is shallow or impersonal. What this study shows is that real change doesn’t require reinventing the wheel; sometimes it just takes someone who will pick up the phone, answer questions, follow up, and make sure you’re not getting lost in the shuffle.

This study was supported by a grant from the LUNGevity Foundation.

Fred Hutch/UW/Seattle Children’s Cancer Consortium members Drs. Matthew Triplette and Jaimee Heffner contributed to this work.

Triplette, M., Omernik, B., Snidarich, M., Heffner, J. L., Brooks, E., Crothers, K., Brown, M. C., Murphy, N. R., & Louie, T. (2025). Tailored Patient Navigation to Support Lung Cancer Screening and Smoking Cessation in LGBTQ+ Individuals: A Pilot Study. Annals of the American Thoracic Society, 10.1513/AnnalsATS.202502-215OC. Advance online publication.