Concurrent Daily Alcohol and Tobacco Use among Sexual Minority and Heterosexual Women

Abstract

Background: Studies show that sexual minority women (SMW) report more hazardous alcohol use patterns and higher rates of tobacco use than exclusively heterosexual women. Despite the public health implications of drinking and smoking, especially when they co-occur, little is known about SMW’s daily use patterns or the factors that may facilitate concurrent use. Objectives: The present study seeks to identify patterns of daily concurrent alcohol and tobacco use among SMW and heterosexual women, including socio-environmental drinking contexts of concurrent use. Methods: Data come from a community sample of lesbian, bisexual, and heterosexual women (N = 246) who completed up to 84 consecutive days of web-based reports about substance use. Results: Participants reported 4,012 drinking days (24%), 2,019 smoking days (12%), and 769 concurrent drinking and smoking days (5%). No differences were found between SMW and heterosexual women in the proportion of drinking days; however, SMW consumed more drinks on drinking days. SMW also reported a greater proportion of smoking days, more cigarettes smoked on smoking days, and a greater proportion of concurrent drinking and smoking days. Reciprocal daily relationships between alcohol and tobacco use were identified, and these relationships were strongest for bisexual women. Socio-environmental factors—including certain locations, situations, and companions—increased the likelihood of concurrent use for all women; however, few sexual identity differences were found in concurrent use contexts. Importance: Results expand our understanding about daily concurrent alcohol and tobacco use risk among SMW, and potentially inform treatment research to better address the unique experiences of this vulnerable group.

Keywords:

• Alcohol
• cigarette smoking
• daily diary
• sexual minority women
• bisexual women
• lesbian women
• concurrent smoking and drinking

Declaration of interest

The authors declare that they have no conflicts of interest to report.

Notes

1 Participants (n = 15) who selected “other” sexual identity on the phone screen, but recategorized their sexual identity as lesbian or bisexual on the forced choice item were also compared on demographics as well as smoking and drinking behaviors. Significant group differences were found in demographics (ps < 0.001), but not smoking or drinking (ps = 0.120–0.776). This group was older than bisexual women (p = .002), but not lesbian and heterosexual women (ps = 0.332–0.879), F (3, 245) = 9.76, p <.001. This group also reported lower incomes than lesbian and heterosexual women (ps = 0.021–0.039), but not bisexual women (p = .996), F (3, 244) = 12.44, p < .001. Given the lack of differences in smoking and drinking, these participants were retained in the present study, but because of the insufficient sample size to examine this group separately, these participants were analyzed as lesbian or bisexual (based on their forced choice selection).

Additional information

Funding

This work was supported by the National Institute of Justice, Office of Justice Programs, U.S. Department of Justice under Award No. 2014-VA-CX-0067 (PI Hequembourg). The opinions, findings, and conclusions or recommendations expressed in this publication are those of the authors and do not necessarily reflect those of the funding agency.