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Publication Detail
Smoking and quitting behaviour by sexual orientation: a cross-sectional survey of adults in England
Abstract Objective To assess associations between sexual orientation and smoking and quitting behaviour among adults in England. Methods Data were collected from 112,537 adults (≥16y) participating in a nationally-representative monthly cross-sectional survey between 07/2013 and 02/2019. Sexual orientation was self-reported as heterosexual, bisexual, lesbian/gay, or prefer-not-to-say. Main outcomes were smoking status, e-cigarette use, cigarettes per day, time to first cigarette, motivation to stop smoking, motives for quitting, use of cessation support, and past-year quit attempts. Associations were analysed separately for men and women using multivariable regression models adjusted for relevant covariates. Results Smoking prevalence is now similar between gay (21.6%), prefer-not-to-say (20.5%) and heterosexual men (20.0%), and lesbian (18.3%) and heterosexual women (16.9%), but remains higher among bisexual men (28.2%, ORadj 1.41, 95%CI 1.11; 1.79) and bisexual women (29.8%, ORadj 1.64, 95%CI 1.33; 2.03) and lower among prefer-not-to-say women (14.5%, ORadj 0.85, 95%CI 0.72; 0.99). Among smokers, bisexuals were less addicted than heterosexuals, with bisexual men smoking fewer cigarettes per day (Badj -2.41, 95%CI -4.06; -0.75) and bisexual women less likely to start smoking within 30 minutes of waking (ORadj 0.66, 95% CI0.45; 0.95) than heterosexuals. However, motivation to stop smoking and quit attempts did not differ significantly. Conclusions In England, differences in smoking prevalence among people with different sexual orientations have narrowed, primarily driven by a larger decline in smoking rates among sexual minority groups than heterosexuals. Bisexual men and women remain more likely to smoke but have lower levels of addiction while being no less likely to try to quit.
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