Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Oct 25;7(10):e015058.
doi: 10.1136/bmjopen-2016-015058.

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

Lion Shahab  1 , Jamie Brown  1   2 , Gareth Hagger-Johnson  3 , Susan Michie  2 , Joanna Semlyen  4 , Robert West  1 , Catherine Meads  5
Affiliations

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

Lion Shahab et al. BMJ Open. .

Abstract

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.

Setting: England, UK.

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.

Keywords: LGB; Tobacco use; epidemiology; hazardous alcohol use; sexual orientation identity.

PubMed Disclaimer

Conflict of interest statement

Competing interests: LS has received a research grant and honoraria for a talk and travel expenses from a Pfizer, manufacturer of smoking cessation medications. JB has received unrestricted research funding from Pfizer to study smoking cessation. RW has received travel funds and hospitality from, and undertaken research and consultancy for, pharmaceutical companies that manufacture or research products aimed at helping smokers to stop. GHJ receives royalties from ‘Introduction to Research Methods and Data Analysis in Psychology’ (2013) and ‘Psychometric Assessment, Statistics and Report Writing’ (2013), both published by Pearson and ‘Introduction to Research Methods and Data Analysis in the Health Sciences’. He has also worked as a consultant for various universities and Public Health England. His substantive contribution to the manuscript was prior to June 2016. CM, SM and JS have no competing interests.

Figures

Figure 1
Figure 1
Prevalance of (A) tobacco use (B) hazarddous alcohol use by gender and sexual orientation identity. PNTS, prefer-not-to-say; Error bars are 95% CIs; All data are unadjusted.
See this image and copyright information in PMC

References

    1. Dilley JA, Simmons KW, Boysun MJ, et al. . Demonstrating the importance and feasibility of including sexual orientation in public health surveys: health disparities in the Pacific Northwest. Am J Public Health 2010;100:460–7. 10.2105/AJPH.2007.130336 - DOI - PMC - PubMed
    1. McCabe SE, Hughes TL, Bostwick W, et al. . Measurement of sexual identity in surveys: implications for substance abuse research. Arch Sex Behav 2012;41:649–57. 10.1007/s10508-011-9768-7 - DOI - PMC - PubMed
    1. Haseldon L, Joloza T. Measuring sexual identity: a guide for researchers. Newport, Wales: Office for National Statistics; 2009.
    1. Laumann EO, Gagnon JH, Michael RT, et al. . The social organization of sexuality: Sexual practices in the United States. Chicago: University of Chicago Press, 1994.
    1. Semlyen J, King M, Varney J, et al. . Sexual orientation and symptoms of common mental disorder or low wellbeing: combined meta-analysis of 12 UK population health surveys. BMC Psychiatry 2016;16:67 10.1186/s12888-016-0767-z - DOI - PMC - PubMed

LinkOut - more resources