Gay/Lesbian sexual orientation increases risk for cigarette smoking and heavy drinking among members of a large Northern California health plan

Data from random sample general health surveys of adult members of a large Northern California Health Plan conducted in 1999 and 2002 were analyzed using gender-based multivariate logistic regression models to assess whether lesbians (n = 210) and gay men (n = 331) aged 20–65 were more likely than similarly aged heterosexual women (n = 12,188) and men (n = 9342) to be smokers and heavy drinkers.After adjusting for age, race/ethnicity, education, and survey year, lesbians were significantly more likely than heterosexual women to be heavy drinkers (OR 2.14, 95% CI 1.08, 4.23) and current smokers (OR 1.60, 95% CI 1.02, 2.51). Among men, gays were significantly more likely than heterosexuals to be current smokers (OR 2.40, 95% CI 1.75, 3.30), with borderline significant increased risk for heavy drinking (OR 1.54, 95% CI 0.96, 2.45).Lesbians and gay men may be at increased risk for morbidity and mortality due to higher levels of cigarette and alcohol use. More population-based research is needed to understand the nature of substance use in these communities so that appropriate interventions can be developed.Tobacco-related diseases are the most preventable health problems in the United States. Although tobacco use is declining, it is responsible for nearly 20% of the deaths in the U.S., and kills approximately 50% of continuous smokers. Smoking-related diseases include many types of cancer, chronic obstructive pulmonary disease, coronary heart disease, stroke, peripheral vascular disease and peptic ulcer disease [1]. Lung cancer is the leading cause of cancer-related death among women and men in the United States [2].Similarly, alcohol misuse may contribute to morbidity and mortality resulting in acid-related disorder, arthritis, asthma, cirrhoses of the liver, diseases of the pancreas, hepatitis C, chronic obstructive pulmonary disease, diabetes, hypertension, injuries and overdoses, depression, anxiety, and major psychosis [3,4]. If, as many studies indicate, lesbians