{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T03:12:26Z","timestamp":1788491546628,"version":"build-2803163510"},"reference-count":51,"publisher":"BMJ","issue":"10","funder":[{"DOI":"10.13039\/501100000272","name":"National Institute for Health Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000289","name":"Cancer Research UK","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000289","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2017,6,30]]},"published-print":{"date-parts":[[2017,10]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To assess the association between tobacco and hazardous alcohol use and sexual orientation and whether such an association could be explained by other sociodemographic characteristics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Cross-sectional household survey conducted in 2014\u20132016.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>England, UK.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Representative English population sample (pooled n=43\u2009866).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main outcomes<\/jats:title>\n                    <jats:p>Sexual orientation identity (lesbian\/gay, bisexual, heterosexual, prefer-not-to-say); current tobacco and hazardous alcohol use (defined as Alcohol Use Disorders Identification Test Score \u22658). All outcomes were self-reported.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Due to interactions between sexual orientation and gender for substance use, analyses were stratified by gender. Tobacco use prevalence was significantly higher among lesbian\/gay (women: 24.9%, 95% CI 19.2% to 32.6%; men: 25.9%, 95%\u2009CI 21.3% to 31.0%) and bisexual participants (women: 32.4%, 95%\u2009CI 25.9% to 39.6%; men: 30.7%, 95%\u2009CI 23.7% to 30.7%) and significantly lower for prefer-not-to-say participants in women (15.5%, 95%\u2009CI 13.5% to 17.8%) but not men (22.7%, 95%\u2009CI 20.3% to 25.3%) compared with heterosexual participants (women: 17.5%, 95%\u2009CI 17.0% to 18.0%; men: 20.4%, 95%\u2009CI 19.9% to 21.0%; p&lt;0.001 for omnibus test). Similarly, hazardous alcohol use was significantly more prevalent for lesbian\/gay (women: 19.0%, 95%\u2009CI 14.0% to 25.3%; men: 30.0%, 25.2%\u201335.3%) and bisexual participants (women: 24.4%, 95%\u2009CI 18.7% to 31.3%; men: 24.3%, 95%\u2009CI 17.9% to 32.1%) and lower for prefer-not-to-say participants (women: 4.1%, 95%\u2009CI 3.0% to 5.4%; men: 13.7%; 95%\u2009CI 11.8% to 16.0%) compared with heterosexuals (women: 8.3%, 95%\u2009CI 7.9% to 8.7%; men: 18.4%, 95%\u2009CI 17.9% to 18.9%; p&lt;0.001 for omnibus test). However, after adjusting for sociodemographic confounders, tobacco use was similar across all sexual orientation groups among both women and men. By contrast, sexual orientation differences in hazardous alcohol use remained even after adjustment among women but not for bisexual and gay men.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In England, higher rates of tobacco use among sexual minority men and women appear to be attributable to other sociodemographic factors. Higher rates of hazardous alcohol use among sexual minority men may also be attributable to these factors, whereas this is not the case for sexual minority women.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2016-015058","type":"journal-article","created":{"date-parts":[[2017,10,26]],"date-time":"2017-10-26T00:40:14Z","timestamp":1508978414000},"page":"e015058","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":37,"title":["Sexual orientation identity and tobacco and hazardous alcohol use: findings from a cross-sectional English population survey"],"prefix":"10.1136","volume":"7","author":[{"given":"Lion","family":"Shahab","sequence":"first","affiliation":[{"name":"Department of Behavioural Science and Health, University College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jamie","family":"Brown","sequence":"additional","affiliation":[{"name":"Department of Behavioural Science and Health, University College London, London, UK"},{"name":"Department of Clinical, Educational and Health Psychology, University College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gareth","family":"Hagger-Johnson","sequence":"additional","affiliation":[{"name":"Administrative Data Research Centre for England (ADRC-E), Farr Institute, University College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan","family":"Michie","sequence":"additional","affiliation":[{"name":"Department of Clinical, Educational and Health Psychology, University College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanna","family":"Semlyen","sequence":"additional","affiliation":[{"name":"Norwich Medical School, University of East Anglia, Norwich, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"West","sequence":"additional","affiliation":[{"name":"Department of Behavioural Science and Health, University College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine","family":"Meads","sequence":"additional","affiliation":[{"name":"Faculty of Health, Social Care and Education, Anglia Ruskin University, Cambridge, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2017,10,25]]},"reference":[{"key":"2025121602564589000_7.10.e015058.1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2007.130336"},{"key":"2025121602564589000_7.10.e015058.2","doi-asserted-by":"publisher","DOI":"10.1007\/s10508-011-9768-7"},{"key":"2025121602564589000_7.10.e015058.3","unstructured":"Haseldon L , Joloza T . 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