Why do bisexual women smoke so much?

Several hypotheses: double stress (homophobia + biphobia, sometimes rejection by the lesbian community), erasure, younger on average (smoking falls with age in all populations). But no single cause.

I am on feminising hormone therapy. Is tobacco more dangerous for me?

Yes, more than for the average: thromboembolic risk strongly increased. It is one of the most important risk factors to discuss with your endocrinologist. Many recommend quitting before or very early in the journey.

My LGBTQ+ circle smokes all the time. How do I quit without isolating myself?

You do not have to choose between quitting and keeping your community. A few ideas: leave parties earlier, stand away from smokers, find an ally who quits with you, frequent smoke-free venues too (cafés, daytime cultural events).

Do clinicians ask about sexual orientation?

Not always. You have the right not to mention it, but mentioning it can help you get more adapted care (minority stress, drug interactions if on transition…).

Is vaping more common in the LGBTQ+ community?

Yes, slightly, as a quit-smoking tool. In the US and UK, LGBTQ+ vaping prevalence is somewhat higher. Consistent with a community more exposed to tobacco to begin with.

LGBTQ+ community and smoking: why prevalence is higher and how to close the gap

LGBTQ+ people smoke more than average — around 1 in 6 vs 1 in 9. Minority stress, targeted marketing, nightlife: the picture and tailored resources.

June 17, 2026 Aria

The scientific basis on quitting smoking was reviewed on a voluntary basis by Pr. Bertrand Dautzenberg , a tobacco specialist, in order to rule out gross, potentially dangerous errors. It reflects positions commonly shared by health professionals and health agencies, without always corresponding exactly to his thinking or his practice. He is not the author of this text; he has only carried out a vigilance review of it.

A little-covered but well-documented fact: LGBTQ+ people smoke more than the general population, start younger, and smoke longer. Why the gap? And above all, what works to close it? Here is the picture and the concrete levers.

The gap is documented, globally

~ 1 in 6 lesbian, gay or bisexual adults smoke cigarettes — vs 1 in 9 heterosexual adults. And smoking is even higher among transgender adults than cisgender ones.

CDC (Centers for Disease Control and Prevention) United States

A landmark Canadian study (Toronto Rainbow Tobacco Survey) on 3,140 LGBTBA people found 36% current smokers — with peaks at 45% among bisexual men and women. More recently, UK data from Stonewall and ASH confirms a similar gap.

Why this higher prevalence?

1. "Minority stress"

Discrimination, family rejection, social stigma and the pressure of coming out generate chronic stress. Tobacco is often used as a coping mechanism to manage that stress.

International public-health research on LGBTQ+ health

Synthesis on 'minority stress'

The concept of minority stress is central: living in a society that rejects or erases you is a chronic stress that weighs on mental health and favours addictive behaviour.

2. Targeted tobacco industry marketing

This marketing built a sense of belonging around brands (Marlboro, Camel, Parliament) — a sense particularly effective in communities seeking recognition.

3. Nightlife culture

Bars, clubs, parties: LGBTQ+ sociability long built itself around night venues where tobacco (and alcohol) were historically very present. That is changing, but the cultural inheritance persists.

4. Mental-health co-morbidities

5. Tobacco as gender expression

An Australian study (Tobacco Control) shows that for some lesbian women or trans people, smoking is also a form of identity expression: defying heteronormative norms, asserting a masculinity, marking belonging. A point prevention programmes often miss.

Why "general" programmes work less well

Classic programme limit	LGBTQ+ reality
Assumes family support	Sometimes rejecting family
Assumes non-smoking social setting	Historically smoky nightlife
Ignores minority stress	Chronic stress ignored → quick relapse
Poorly trained clinicians	Fear of judgement, under-disclosure
Non-inclusive tools	No one to identify with in communications

What works: inclusive LGBTQ+ programmes

1. Acknowledge minority stress

Before tackling the cigarette, treat what it masks: stress, anxiety, isolation. Pairing with mental-health follow-up adapted to the community.

2. Inclusive communication

Visuals, testimonies, language that represent LGBTQ+ people. In the US, campaigns like "This Free Life" (FDA) showed greater impact than general campaigns.

3. Specialist resources

4. Reorganise nightlife strategies

Instead of avoiding bars and clubs (unrealistic), reorganise: plan strategies for nights out (a smoke-free pause, chewing gum, going with a non-smoking friend, moderate alcohol).

Particular case: trans people in transition

In United Kingdom

Your questions

Why do bisexual women smoke so much?

Several hypotheses: double stress (homophobia + biphobia, sometimes rejection by the lesbian community), erasure, younger on average (smoking falls with age in all populations). But no single cause.
I am on feminising hormone therapy. Is tobacco more dangerous for me?

Yes, more than for the average: thromboembolic risk strongly increased. It is one of the most important risk factors to discuss with your endocrinologist. Many recommend quitting before or very early in the journey.
My LGBTQ+ circle smokes all the time. How do I quit without isolating myself?

You do not have to choose between quitting and keeping your community. A few ideas: leave parties earlier, stand away from smokers, find an ally who quits with you, frequent smoke-free venues too (cafés, daytime cultural events).
Do clinicians ask about sexual orientation?

Not always. You have the right not to mention it, but mentioning it can help you get more adapted care (minority stress, drug interactions if on transition…).
Is vaping more common in the LGBTQ+ community?

Yes, slightly, as a quit-smoking tool. In the US and UK, LGBTQ+ vaping prevalence is somewhat higher. Consistent with a community more exposed to tobacco to begin with.

sources

CDC (Centers for Disease Control), Smoking and tobacco use among LGBTQ+ adults, 2023.
Prevalence of smoking among the LGBTTQ subpopulations in Toronto — Toronto Rainbow Tobacco Survey, PubMed, 2012.
LGBT Foundation, Smoking in the LGBT community, briefing.
Tobacco use and LGBT women (Tobacco Control), February 2025.
Stonewall / ASH UK, LGBT and tobacco data sheet.