Psychological, Social and Cultural Influences on Smoking among Lesbian, Bisexual and Queer Women

Grant R, Mooney-Somers J, McNair R, Pennay A, Segan C, Power J, Bourne A.
Psychological, Social and Cultural Influences on Smoking among Lesbian, Bisexual and Queer Women Tob Control. 2025 Jan 27:tc-2024-059039. doi: 10.1136/tc-2024-059039. Epub ahead of print. PMID: 39870519.

Background: Smoking rates have declined markedly in Australia over time; however, lesbian, bisexual and queer (LBQ) women continue to smoke at higher rates than heterosexual women. Understanding the factors influencing smoking in this population is crucial for developing targeted cessation interventions and other supports.

Methods: Experiences of and motivations for smoking among 42 LBQ cisgender and transgender women and non-binary people in Australia who currently or previously smoked were explored through semi-structured interviews. Participants were primarily white Australian cisgender women in their 30s-40s. Thematic analysis was used to identify common psychological, social and cultural influences on smoking.

Results: While coping with minority stress was a common factor influencing some participants' smoking behaviours, participants also described how smoking offered pleasurable opportunities for gender expression, affirmation and rebellion. Smoking also enabled participants to experience 'marginalised connectivity', a form of social solidarity fostered through the sharing of a stigmatised practice by an oppressed or stigmatised community.

Conclusion: This article identifies factors contributing to the ongoing socio-cultural relevance of smoking for some LBQ women in Australia. These specific psychological, social and cultural contexts remain salient for LBQ women's smoking and must be factored into smoking cessation campaigns and programme designs for this population. Tailored messaging that emphasises alternative self-care strategies and the benefits of quitting in the context of supportive communities may be more effective in engaging LBQ women than long-term health risk messages.