Sexual Orientation and Smoking: Results From a Multisite Women's Health Study

Abstract

Although lesbians are believed to be at disproportionately high risk for smoking, few published studies have focused on smoking rates in this population. We examined and compared rates and demographic correlates of smoking among 550 lesbians and 279 heterosexual women in Chicago, Minneapolis/St. Paul, and in New York City in 1994-1996 using a self-administered survey questionnaire. African-American lesbians were more likely than African-American heterosexual women or White lesbians to be current smokers. For the sample as a whole, education was the most robust predictor of both current and lifetime smoking. Racial/ethnic minority lesbians with high school education or less were most likely to report both current and lifetime cigarette smoking. The study's limitations are noted.Keywords sexual orientation; sexual minority; lesbian; sexual identity; sexual attraction; cigarette smoking Over the past several decades, cigarette smoking has become recognized as a health risk of major proportions and the single most preventable cause of premature death in the United States. Nearly one in five deaths in the United States result from the use of tobacco-more each year than AIDS, alcohol, cocaine, heroin, homicide, suicide, motor vehicle crashes, and fires combined (United States Department of Health and Human Services [USDHHS], 2000). In addition, smoking is associated with increased risk for health problems specific to women, including cervical cancer, early onset of menopause, infertility, and osteoporosis (USDHHS, 2001). In 1987 lung cancer surpassed breast cancer as the leading cause of cancer mortality in women (Jemal et al., 2003). Given the seriousness of the problem as well as research indicating that smoking rates are declining more slowly for women than for men (Carpenter,Wayne, and Connolly, 2005;Fiore et al., 1989;Molarius et al., 2001), it is important to learn as much as possible about groups of women who may be at heightened risk for smoking.Smoking rates among women are known to differ by socioeconomic status, education, age, and race/ethnicity (USDHHS, 2001). Women with less than a high school (12 years) education are three times as likely to smoke as those with 16 or more years of education. Racial/ethnic differences in smoking rates among woman also vary substantially, with the highest rates among Native Americans and lowest among Hispanics and Asian/Pacific Islanders. Despite , 2003;Ryan, Wortley, Easton, Pederson, and Greenwood, 2001; USDHHS, 2000 USDHHS, , 2001; several recent studies report substantially higher rates of smoking among lesbians and gay men (Burgard, Cochran, and Mays, 2005;Case et al., 2004;Cochran et al., 2001;Greenwood et al., 2005;Mays, Yancey, Cochran, Weber, and Fielding, 2002;Tang et al., 2004;Valanis et al., 2000) than among their heterosexual counterparts. Nevertheless, an Institute of Medicine (IOM) report on lesbian health notes large gaps in current knowledge about smoking among lesbians (Solarz, 1999). In our review of the literature we found only three studie...

Racial/ethnic differences in identity and mental health outcomes among young sexual minority women.

“…There were no racial/ethnic differences in rates of tobacco use. Given that our study was unique in our focus on Emerging Adulthood, it is possible that the differences found in previous studies do not emerge until later in adulthood (Hughes et al, 2008; Mays et al, 2002), or that they represent cohort effects. However, our sample overall had relatively high rates of current smoking as compared with general studies of young heterosexual women (Burgard, Cochran, and Mays, 2005; Case et al, 2004; Greenwood et al, 2005; Tang et al, 2004).…”

Sex steroid signaling: Implications for lung diseases

“…For example, asthma is more common in pre-pubescent males, but becomes more common in females after puberty (Becklake & Kauffmann, 1999; Bjornson & Mitchell, 2000; Caracta, 2003; Carey et al, 2007b; Jensen-Jarolim & Untersmayr, 2008; Melgert et al, 2007) such that the incidence, frequency and severity of asthma is greater among adult women, compared to men (Bjornson & Mitchell, 2000; Caracta, 2003; Carey et al, 2007b; Jensen-Jarolim & Untersmayr, 2008; Melgert et al, 2007). Similarly, differences between men and women in the incidence/frequency of and morbidity/mortality associated with smoking-induced lung disease have also been noted, not all of which can be explained by differences in smoking rates between the sexes (Hughes & Jacobson, 2003; Hughes et al, 2008; Mannino et al, 2002; Troisi et al, 1995a). What is less clear from epidemiological data such as these is the relative contributions of intrinsic sex differences in lung structure and/or function vs. sex steroids: a topic of considerable interest and ongoing research.…”

Addressing Health Disparities of Lesbian and Bisexual Women: A Grounded Theory Study

“…They are at increased risk for cardiovascular disease (Farmer, Jabson, Bucholz, & Bowen, 2013), are more likely to smoke and use alcohol or drugs (Cochran, Ackerman, Mays, & Ross, 2004;Farmer et al, 2013;Hughes, Johnson, & Matthews, 2008;Lee, Griffin, & Melvin, 2009;Marshal et al, 2012;Parsons, Kelly, & Wells, 2006), and be obese or overweight (Boehmer, Bowen, & Bauer, 2007;Boehmer et al, 2011;Jun et al, 2012). Additionally, they are more likely to report a mood or anxiety disorder (Burgess, Lee, Tran, & Van Ryn, 2008;King et al, 2008).…”