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
. 2022 Dec;63(6):987-996.
doi: 10.1016/j.amepre.2022.07.003. Epub 2022 Sep 15.

Perceived Substance Use Risks Among Never Users: Sexual Identity Differences in a Sample of U.S. Young Adults

Megan S Schuler  1 , Rebecca J Evans-Polce  2
Affiliations

Perceived Substance Use Risks Among Never Users: Sexual Identity Differences in a Sample of U.S. Young Adults

Megan S Schuler et al. Am J Prev Med. 2022 Dec.

Abstract

Introduction: Lower perceived risk is a well-established risk factor for initiating substance use behaviors and an integral component of many health behavior theories. Established literature has shown that many substance use behaviors are more prevalent among individuals who identify as lesbian, gay, or bisexual than among those who identify as heterosexual. However, potential differences in perceived risk by sexual identity among individuals with no lifetime use have not been well characterized to date.

Methods: Data on 111,785 adults aged 18-34 years (including 11,377 lesbian, gay, and bisexual adults) were from the 2015-2019 National Survey on Drug Use and Health. Perceived risks (classified as great risk versus less than great risk) were assessed with 11 National Survey on Drug Use and Health survey items regarding 6 different substances (alcohol, cigarettes, marijuana, cocaine, lysergic acid diethylamide, and heroin). Survey-weighted and sex-stratified logistic regression models were used to estimate sexual identity differences regarding perceived great risk among those reporting no lifetime use. Analyses were conducted in 2021-2022.

Results: Gay men, bisexual men, lesbian/gay women, and bisexual women were all significantly less likely than heterosexual peers to perceive great risk associated with specific marijuana, cocaine, lysergic acid diethylamide, and heroin use behaviors. Bisexual men and women were also significantly less likely than heterosexual peers to perceive great risk associated with binge drinking behaviors and smoking ≥1 packs of cigarettes daily.

Conclusions: This novel investigation among never users provides evidence that lesbian, gay, and bisexual adults perceive significantly lower risks associated with multiple substance use behaviors than heterosexual adults, which may indicate important sexual identity differences in susceptibility to substance use initiation.

PubMed Disclaimer

Conflict of interest statement

REP was supported by award R21DA051388. The content is solely the responsibility of the authors and does not necessarily represent the official views of NIMH, the NIH or the US Government. The sponsor did not have any role in study design; collection, analysis, and interpretation of data; writing the report; or the decision to submit the report for publication.

Figures

Figure 1.
Figure 1.
Perceived risk associated with alcohol, cigarette, and marijuana behaviors by sexual identity and sex among never-using NSDUH respondents ages 18–34
Figure 2.
Figure 2.
Perceived risk associated with cocaine, LSD, and heroin behaviors by sexual identity and sex among never-using NSDUH respondents ages 18–34
See this image and copyright information in PMC

References

    1. Evans-Polce RJ, Veliz P, Kcomt L, Boyd CJ, McCabe SE. Nicotine and tobacco product use and dependence symptoms among US adolescents and adults: Differences by age, sex, and sexual identity. Nicotine Tob Res. 2021;23(12):2065–2074. - PMC - PubMed
    1. Schuler MS, Rice CE, Evans-Polce RJ, Collins RL. Disparities in substance use behaviors and disorders among adult sexual minorities by age, gender, and sexual identity. Drug Alcohol Depend. 2018;189:139–146. - PMC - PubMed
    1. Rice CE, Vasilenko SA, Fish JN, Lanza ST. Sexual minority health disparities: an examination of age-related trends across adulthood in a national cross-sectional sample. Ann Epidemiol. 2019;31:20–25. - PMC - PubMed
    1. Fish JN, Pasley K. Sexual (minority) trajectories, mental health, and alcohol use: A longitudinal study of youth as they transition to adulthood. J Youth Adolesc. 2015;44(8):1508–1527. - PMC - PubMed
    1. McCabe SE, Engstrom CW, Kcomt L, Evans-Polce R, West BT. Trends in binge drinking, marijuana use, illicit drug use, and polysubstance use by sexual identity in the United States (2006–2017). Subst Abus. 2022;43(1):194–203. - PMC - PubMed

Publication types

LinkOut - more resources