Home > Sexual orientation identity and tobacco and hazardous alcohol use: findings from a cross-sectional English population survey.

Shabab, Lion and Brown, Jamie and Hagger-Johnson, Gareth and Michie, Susan and Semlyen, Joanna and West, Robert and Meads, Catherine [BMJ Open] . (2017) Sexual orientation identity and tobacco and hazardous alcohol use: findings from a cross-sectional English population survey. BMJ Open, 7 (10)

URL: http://bmjopen.bmj.com/content/7/10/e015058


Objectives To assess the association between tobacco and hazardous alcohol use and sexual orientation and whether such an association could be explained by other sociodemographic characteristics.

Design Cross-sectional household survey conducted in 2014–2016 in England.

Participants Representative English population sample (pooled n=43 866).

Main outcomes Sexual orientation identity (lesbian/gay, bisexual, heterosexual, prefer-not-to-say); current tobacco and hazardous alcohol use (defined as Alcohol Use Disorders Identification Test Score ≥8). All outcomes were self-reported.

Results Due to interactions between sexual orientation and gender for substance use, analyses were stratified by gender. Tobacco use prevalence was significantly higher among lesbian/gay (women: 24.9%, 95% CI 19.2% to 32.6%; men: 25.9%, 95% CI 21.3% to 31.0%) and bisexual participants (women: 32.4%, 95% CI 25.9% to 39.6%; men: 30.7%, 95% CI 23.7% to 30.7%) and significantly lower for prefer-not-to-say participants in women (15.5%, 95% CI 13.5% to 17.8%) but not men (22.7%, 95% CI 20.3% to 25.3%) compared with heterosexual participants (women: 17.5%, 95% CI 17.0% to 18.0%; men: 20.4%, 95% CI 19.9% to 21.0%; p<0.001 for omnibus test). Similarly, hazardous alcohol use was significantly more prevalent for lesbian/gay (women: 19.0%, 95% CI 14.0% to 25.3%; men: 30.0%, 25.2%–35.3%) and bisexual participants (women: 24.4%, 95% CI 18.7% to 31.3%; men: 24.3%, 95% CI 17.9% to 32.1%) and lower for prefer-not-to-say participants (women: 4.1%, 95% CI 3.0% to 5.4%; men: 13.7%; 95% CI 11.8% to 16.0%) compared with heterosexuals (women: 8.3%, 95% CI 7.9% to 8.7%; men: 18.4%, 95% CI 17.9% to 18.9%; p<0.001 for omnibus test). However, after adjusting for sociodemographic confounders, tobacco use was similar across all sexual orientation groups among both women and men. By contrast, sexual orientation differences in hazardous alcohol use remained even after adjustment among women but not for bisexual and gay men.

Conclusions In England, higher rates of tobacco use among sexual minority men and women appear to be attributable to other sociodemographic factors. Higher rates of hazardous alcohol use among sexual minority men may also be attributable to these factors, whereas this is not the case for sexual minority women.

  • Tobacco use
  • hazardous alcohol use
  • sexual orientation identity
  • LGB
  • epidemiology

[This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0/]

Item Type:Evidence resource
Drug Type:Alcohol, Tobacco
Intervention Type:AOD disorder, AOD prevention, AOD disorder harm reduction
Source:BMJ Open
Date:October 2017
Volume:7
Number:10
EndNote:View
Subjects:A Substance use, abuse, and dependence > Prevalence > Substance use behaviour > Alcohol consumption
B Substances > Alcohol
B Substances > Tobacco (cigarette smoking)
F Concepts in psychology > Motivation
F Concepts in psychology > Specific attitude and behaviour
J Health care, prevention and rehabilitation > Risk and protective factors
T Demographic characteristics > Homosexual, gay, bisexual or lesbian, LGBTI
VA Geographic area > Europe > United Kingdom > England

Repository Staff Only: item control page