The prevalence and factors associated with smoking among lesbian and bisexual women: Analysis of the Australian National Drug Strategy Household Survey

Background: In many countries, sexual minority women smoke at higher rates than their heterosexual counterparts. Analyses tend to combine lesbian and bisexual women, preventing an understanding of relevant factors associated with smoking for each group. This analysis used a representative sample of the Australian population to compare tobacco use between heterosexual, lesbian and bisexual women, and examine factors associated with smoking among these groups. Methods: In a secondary analysis of data from the National Drug Strategy Household Survey (N = 23,855), descriptive statistics were produced for heterosexual (n = 11,776), lesbian (n = 135) and bisexual (n = 167) women. Multivariate logistic regression modelling was undertaken to assess which factors were associated with current smoking among the different groups. Results: Compared to heterosexual women, lesbian and bisexual women were more likely to be current smokers (OR 2.9(1.8,4.5) and OR 3.6(2.4, 5.4) respectively). Employment, income and psychological distress were significant factors associated with smoking for lesbian women. Recent illicit drug use was the only significant factor associated with smoking for bisexual women. Conclusions: We need to better understand the psychological, social and cultural factors that influence initiation, and sustain smoking among lesbian and bisexual women. Our findings demonstrate that sexual minority women in Australia warrant specific policy attention in a national framework.