Understanding smoking behaviour in LGB populations across Great Britain: Quantitative analyses using secondary data

This thesis is the first to examine the associations between sexuality and smoking behaviour in Great Britain, using quantitative analyses of secondary data sources. Drawing on previous literature from geography, psychology and epidemiology, the thesis aims to understand the factors associated with greater smoking prevalence in lesbian, gay and bisexual (LGB) populations, how LGB smoking has changed over time, and whether different measures of sexuality impact smoking and co-behaviour likelihood. Whilst recent calls to reduce smoking prevalence in Great Britain have acknowledged inequalities between LGB and heterosexual populations, few studies in Great Britain have examined smoking trends and patterns in this population beyond prevalence rates. Much of the previous research looking at sexuality and smoking behaviour has been carried out in the United States, where contextual differences mean findings cannot be generalised. This thesis uses multilevel modelling to examine individual and environmental factors in smoking behaviour and patterns to draw comparisons across Great Britain between LGB and heterosexual populations. Findings suggest that, in Great Britain, inequalities in smoking persist between LGB people and heterosexual populations, and also within LGB groups. Across Great Britain, LGB people in certain areas may be more affected by smoking inequalities, and sexual minority women are amongst the most affected. Anti-smoking policies should address these inequalities by taking into account variations by place and recognising that sexual minority populations are more vulnerable