Alcohol, tobacco and other drug use among sexual minority women

Sexual minority women (lesbian, bisexual, and women who have sex with women but do not use labels) are at higher risk for substance use and abuse than women who identify as heterosexual. Nearly every study in the past twenty years, whether using convenience samples or representative probability sampling, and whether conducted in rural or urban areas, confirms this, but there has been less research about potential subsets of sexual minority female populations by sexual identity category, age, race/ethnicity, income level or other characteristics. This presentation reviews the complex literature on the relationships between sexual identity categories and substance use data, and suggests that bisexual women and women who have sex with women without adopting labels are a higher risk than those who identify as lesbians. Possible explanations for this finding will be explored, along with discussion of underlying reasons for higher substance use, and exploration of some of the barriers to accessing treatment services for substance abuse and smoking cessation treatments. The presentation ends with a theoretical framework for developing interventions for substance abuse among sexual minority women that addresses individual, community, and larger societal levels influences.