Lesbian and bisexual women more likely to smoke while drinking alcohol than heterosexual women

BUFFALO, N.Y. — Sexual minority women are more likely to smoke cigarettes when drinking alcohol than heterosexual women, according to new University at Buffalo research.

The study, published recently in Substance Use & Misuse, sought to identify patterns of same-day alcohol and tobacco use, and the settings in which concurrent use is more likely to occur for lesbian, bisexual and heterosexual women.

“Our research is important because sexual minority women, particularly bisexual women, report significantly greater health disparities than the general population, including higher rates of drinking and smoking,” said Amy Hequembourg, PhD, lead investigator and associate professor in the UB School of Nursing. “Understanding the nature of substance use among this vulnerable population is critical for informing ways that we might reduce these disparities.”

Funded by the National Institute of Justice, the study included 84 days of online surveys collected from nearly 250 young adult lesbian, bisexual and heterosexual women.

The women reported their alcohol and tobacco use each day, including the number of cigarettes smoked and the number of alcoholic drinks consumed, and the settings where the substances were used.

The most popular places to drink were at home, another person’s home, bars and restaurants. Women tended to drink with friends, romantic partners or family. Occasionally, women drank by themselves.

Although sexual minority and heterosexual women did not differ in the proportion of drinking days across the study, lesbian and bisexual women consumed more alcohol on the days they drank compared to heterosexual women. Sexual minority women also smoked more days and had more cigarettes.  

Concurrent alcohol and tobacco use, which increases the risk of illness and disease, was greater among sexual minority women. Reciprocal patterns between alcohol and tobacco use were strongest for bisexual women.

Women of all sexual identities were more likely to concurrently use alcohol and tobacco when in bars or at another person’s home, when with friends, or around other people who were drinking or intoxicated. However, sexual minority women were most likely to drink with friends.

“Despite recent social, cultural and legal changes that have improved the lives of sexual minorities, health disparities continue to be a big concern,” said Hequembourg. “Unlike past research, which shows that sexual minority women largely socialize in bars, the current study suggests that smoking and drinking contexts may be changing and, in some ways, becoming more similar to heterosexual women.

“Yet, greater substance use and poor health outcomes persist for this vulnerable population, underscoring the need to examine risky health behaviors as they occur in the everyday lives of lesbian and bisexual women.”

Additional investigators include Jessica A. Blayney, PhD, postdoctoral fellow in psychiatry and behavioral sciences at the University of Washington School of Medicine; Wendy Bostwick, PhD, associate professor of nursing at the University of Illinois at Chicago; and Mark Van Ryzin, PhD, research scientist at the Oregon Research Institute.