Use of alcohol among lesbians: Research and clinical implications.

Abstract

A review of the literature on the prevalence of alcohol use and problems among lesbians reveals that the few studies yielding information on this population are beset by design and methodological problems. Those factors possibly associated with higher risk status of lesbians are identified, as are gaps in the literature, and implications for clinical practice and research are discussed.

Alcohol and tobacco use patterns among heterosexually and homosexually experienced California women

“…For some time, it has been thought that lesbians and bisexual women do not show normative age-related declines in their alcohol use, though the actual evidence for this perspective is sparse (Hughes and Wilsnack, 1997). Gruskin et al (2001), using a much smaller sample than the California Women's Health Survey, was able to show tentatively that lesbian and bisexual women between 20 and 34 years of age were at greater risk for more frequent and heavy alcohol use when compared to heterosexual women, but that this difference between the two groups attenuated among older women.…”

“…Accumulating evidence suggests that lesbians and bisexual women may represent a subpopulation at especially elevated risk for the harmful health effects from alcohol and tobacco use (Bradford et al, 1994;Cochran, 2001;Cochran et al, 2000;Diamant et al, 2000;Fifield et al, 1975;Gruskin et al, 2001;Hughes and Eliason, 2002;Israelstam and Lambert, 1983;Peterson, 1989a, 1989b;Nardi, 1982;Roberts and Sorensen, 1999;Skinner, 1994;Skinner and Otis, 1996). Although findings observed across surveys of lesbians and bisexual women have not been entirely consistent (Bloomfield, 1993;Cochran et al, 2003;Roberts and Sorensen, 1999), typically women classified as lesbian or bisexual, as compared to heterosexual women, more commonly report being a current or former tobacco smoker (Bradford and Ryan, 1988;Cochran et al, 2001;Diamant and Wold, 2003;Diamant et al, 2000;Gruskin et al, 2001), appear less likely to abstain from alcohol consumption (Cochran et al, 2000;Diamant et al, 2000;Roberts and Sorensen, 1999), evidence a pattern of alcohol use that includes more frequent consumption as well as greater amounts drunk, though typically still within a moderate range (Diamant et al, 2000;Hughes and Eliason, 2002;Roberts and Sorensen, 1999), and perhaps fail to show normative age-related declines in alcohol use (Abbott, 1998;Bradford et al, 1994;Gruskin et al, 2001;Hughes and Wilsnack, 1997;Peterson, 1989a, 1989b). Although only a minority of lesbians and bisexual women in these surveys evidence problematic drinking behavior, the prevalences observed are generally higher than those reported by heterosexual women.…”

“…Another emphasizes that social stigmatization of homosexuality generates stress that may then contribute to higher rates of substance use (Bux Jr., 1996;Cochran, 2001;Hughes and Eliason, 2002;Mays and Cochran, 2001;Peterson, 1989a, 1989b;Meyer, 2003). A third highlights the structural differences in women's lives associated with minority sexual orientation including the importance of the gay bar as a focus of socialization, the absence of heterosexual marriage, and alternative family structures that are less likely to include parenting responsibilities but more likely to involve full-time employment, which is a known risk factor for higher alcohol consumption among women (Alm et al, 2000;Cochran, 2001;Cochran et al, 2000;Fifield et al, 1975;Hughes and Wilsnack, 1997;Peterson, 1989a, 1989b;Rothblum and Factor, 2001). In addition, some recent work suggests that the highest risk for substance use may be somewhat concentrated among women who can be labeled by either identity or sexual behavior patterns as being bisexual (Diamant et al, 2000;Russell et al, 2002;Scheer et al, 2002).…”

Patterns of cigarette smoking and alcohol use among lesbians and bisexual women enrolled in a large health maintenance organization

“…8,14,15 One potential factor is that younger lesbians and bisexual women may be more likely than older lesbians and bisexual women to participate in the lesbian "bar culture" as a primary means of socialization. 15 Furthermore, younger lesbians and bisexual women might be more likely than their elders to cope with the stress resulting directly from homophobia and heterosexism by smoking, drinking heavily, or both.…”

“…[7][8][9][10][11][12][13] Research published before 2000 on the prevalence of alcohol consumption and cigarette smoking among lesbians and bisexual women was based primarily on small, homogeneous convenience samples recruited from the lesbian and bisexual communities, and the findings therefore have had limited generalizability. In 2000, 4 published population-based studies investigating alcohol use and smoking indicated that lesbians and bisexual women were more likely to drink heavily and smoke cigarettes than were heterosexual women.…”