Background: Sexual minorities, including lesbian, gay, and bisexual individuals, often face higher substance use rates due to societal stressors. Recent societal changes, including the COVID-19 pandemic and rising hate crimes in the UK, may have impacted these disparities across sexual orientations. This study aims to examine changes in vaping, smoking, and alcohol use disparities across sexual orientations in the UK from 2014 to 2021.

Method: Data from the UK Longitudinal Household Survey (2014-2021) were analyzed, covering 42,052 participants aged 16+. Sexual orientation categories included heterosexual, gay/lesbian, bisexual, and other sexual minorities. The outcomes were smoking, vaping, and harmful alcohol drinking. Longitudinal logit models with generalized estimating equations were used, adjusting for demographic factors. Predictive prevalences were calculated and used to examine the disparities between each sexual minority group and heterosexual group over time.

Results: Bisexual individuals had around 10% increased predicted prevalence of harmful alcohol drinking (in 2019-20) relative to their heterosexual counterparts, while gay/lesbian individuals had 5% increased predicted prevalence in vaping (in 2020-21). Smoking risk was higher in the lesbian group in 2015 and 2017, but the disparities disappeared post-2017.

Conclusion: Our study highlights vaping among gay and lesbian individuals and harmful drinking among bisexual individuals as emerging public health concerns. Further research is needed for research on how evolving marketing strategies targeting the LGBTQ+ community influence substance use behaviors and highlights the importance of developing alcohol-free spaces.

Co-authors

Yihong Bai; Chungah Kim; Kristine Ienciu; Dr Antony Chum, York University, Canada