Do sexual minority women have higher tobacco use rates than heterosexual women?

Studies confirm that sexual minority women, including lesbian, bisexual, and other non-heterosexual women, use tobacco more frequently than heterosexual women. This difference is linked to factors like minority stress, stigma, and discrimination. Bisexual women are frequently identified as the subgroup with the highest risk for substance use, including smoking.

What the research says

A structured review of multiple studies found that sexual minority women show elevated prevalence of tobacco use compared with heterosexual women. This pattern holds across different types of research and populations ¹. The review notes that bisexual women are often the highest-risk subgroup within this group ¹.

Specific data from Australia supports this finding, showing that sexual minority women consume tobacco at higher rates than heterosexual women. In one study, 16.9% of sexual minority women were currently smoking, a rate significantly higher than that of heterosexual women ⁴. Another study found that sexual minority women reported a greater proportion of smoking days and smoked more cigarettes on those days than heterosexual women ⁵.

Research also highlights that these higher rates are connected to specific stressors. Factors like internalized stigma, discrimination, victimization, and adverse childhood experiences contribute to the increased likelihood of tobacco use in this population ¹. For trans women specifically, stressors such as homelessness and intimate partner violence are strongly associated with tobacco use ⁶.

What to ask your doctor

• What specific stressors or life events might be contributing to my tobacco use?
• Are there LGBTQ+-affirming smoking cessation programs available in my area?
• How can we address stigma or discrimination that might be affecting my ability to quit?
• What support systems, like peer groups or family, can help me stay smoke-free?