Australian Institute of Health and Welfare 2021. Alcohol, tobacco & other drugs in Australia. Cat. no. PHE 221. Canberra: AIHW. Viewed 28 October 2021, https://www.aihw.gov.au/reports/alcohol/alcohol-tobacco-other-drugs-australia
Australian Institute of Health and Welfare. (2021). Alcohol, tobacco & other drugs in Australia. Retrieved from https://www.aihw.gov.au/reports/alcohol/alcohol-tobacco-other-drugs-australia
Alcohol, tobacco & other drugs in Australia. Australian Institute of Health and Welfare, 24 September 2021, https://www.aihw.gov.au/reports/alcohol/alcohol-tobacco-other-drugs-australia
Australian Institute of Health and Welfare. Alcohol, tobacco & other drugs in Australia [Internet]. Canberra: Australian Institute of Health and Welfare, 2021 [cited 2021 Oct. 28]. Available from: https://www.aihw.gov.au/reports/alcohol/alcohol-tobacco-other-drugs-australia
Australian Institute of Health and Welfare (AIHW) 2021, Alcohol, tobacco & other drugs in Australia, viewed 28 October 2021, https://www.aihw.gov.au/reports/alcohol/alcohol-tobacco-other-drugs-australia
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According to the 2016 Census, there are approximately 47,000 same-sex couples in Australia, an increase of 42% since 2011 (ABS 2017). This may be an underrepresentation as it is known that people identifying as lesbian, gay, bisexual, transgender, intersex or queer (LGBTIQ+) may hide their sexuality or gender identity due to discrimination, harassment or hostility (Australian Human Rights Commission 2014).
There is a lack of publicly available and comprehensive data examining the use of alcohol and other drugs by people identifying as LGBTIQ+. The AIHW’s National Drug Strategy Household Survey (NDSHS) is the only national data source that specifically disaggregates by sexual identity and provides comprehensive estimates. However, the NDSHS does not include estimates for people identifying as transgender, intersex or queer.
Since 2010, the NDSHS has consistently shown high rates of substance use among people who identify as gay, lesbian or bisexual relative to the heterosexual Australian population (Table S3.60). These proportions have declined for smoking and alcohol use, but remain relatively stable for illicit drug use. After adjusting for differences in age, people who were homosexual or bisexual were still far more likely than others to smoke daily, consume alcohol in risky quantities, use illicit drugs and use pharmaceuticals non-medically in 2019 (AIHW 2020).
From 2010 to 2019, the proportion of people who identify as homosexual or bisexual who smoke daily declined from 28% to 16.0%
Risky alcohol consumption for people identifying as homosexual or bisexual declined between 2010 and 2019
40% of people identifying as homosexual or bisexual recently used any illicit drug in 2019. This has remained relatively stable since 2010 (36%)
View the People identifying as LGBTIQ+ fact sheet >
Estimates from the 2019 NDSHS indicate that daily smoking among people who identify as homosexual or bisexual has steadily declined from 28% in 2010 to 16.0% in 2019 (AIHW 2020). However, after adjusting for age differences, people who identify as homosexual or bisexual (16.7%) were still 1.5 times as likely to smoke daily as people who identify as heterosexual (10.8%) (AIHW 2020; Figure LGBTIQ1).
Figure LGBTIQ1: Recent tobacco, alcohol and other drug use, by sexuality and drug type/risk behaviour, people aged 14 and over, 2010 to 2019 (age standardised per cent)
The figure shows that, in 2019, people who identified as homosexual or bisexual were more likely than were heterosexual people to be daily smokers (16.7% compared with 10.8%). Homosexual/bisexual people were also more likely to exceed alcohol guidelines for single occasion (35.4% compared with 26.1% for heterosexual people) and lifetime risk (24.6% compared with 16.9%). Recent use of any illicit drug was also more common among homosexual/bisexual people (36%) than heterosexual people (16.1%).
New Australian guidelines to reduce health risks from drinking alcohol were released in December 2020. Data for alcohol risk in this report are measured against the 2009 guidelines (see Box ALCOHOL1). National Drug Strategy Household Survey data relating to the updated guidelines are available in the Measuring risky drinking according to the Australian alcohol guidelines report.
Risky drinking has been declining among people who identify as homosexual or bisexual since 2010 (Figure LGBTIQ1). Estimates from the NDSHS showed that from 2010 to 2019, there has been a decline in the proportion of homosexual and bisexual people who exceed the guidelines for lifetime (from 30% to 22%) and single occasion risk (from 45% to 38%) for alcohol consumption (AIHW 2020).
However, after adjusting for age differences, people who identify as homosexual or bisexual are still more likely than heterosexual people to drink at risky levels (AIHW 2020). In 2019, compared with people who identified as heterosexual, people who identified as homosexual or bisexual were:
Unlike smoking and drinking alcohol at risky levels, recent use of illicit drugs has not declined among people who identify as homosexual or bisexual between 2010 and 2019. In 2019, 2 in 5 (40%) people identifying as homosexual or bisexual had recently used any illicit drug, compared with 36% in 2010 (AIHW 2020).
When adjusted for age, stability in recent drug use is relatively consistent across drug types between 2016 and 2019, with the exception of:
Estimates from the NDSHS show that homosexual and bisexual people continue to be more likely than heterosexual people to use a range of illicit drugs (AIHW 2020). In 2019, after adjusting for age differences, 36% of people who identified as homosexual or bisexual had recently used any illicit drug, compared with 16.1% of heterosexual people (Table S3.60). Compared with people who identified as heterosexual, people identifying as homosexual or bisexual were:
For related content on injecting drug use, see also:
Responses from the 2020 Australian Needle Syringe Program Survey (ANSPS) show that 4% of respondents identified as homosexual and 10% as bisexual. Three per cent of respondents identified their sexuality as ‘Other’ (Heard et al. 2021).
Data collection for the 2020 ANSPS was impacted by COVID-19 restrictions. The survey took place in several phases from September to December 2020, instead of the usual October timeframe. South Australia required participants complete the survey offsite due to a snap lockdown and Victoria were unable to participate due to public health restrictions (Heard et al. 2021). This should be taken into account when comparing data from 2020 with previous years.
Australian Bureau of Statistics (ABS) 2017. Census of Population and Housing: Reflecting Australia - Stories from the Census, 2016. ABS cat. no. 2071.0. Canberra: ABS, Viewed 9 May 2018.
Australian Human Rights Commission 2014. Face the facts: lesbian, gay, bisexual, trans and intersex people. Sydney: AHRC, Viewed 3 November 2017.
AIHW (Australian Institute of Health and Welfare) 2020. National Drug Strategy Household Survey 2019. Drug statistics series no. 32. Cat. no. PHE 270. Canberra: AIHW. Viewed 16 July 2020.
Heard S, Iversen J & Maher L 2021. Australian Needle Syringe Program Survey National Data Report 2016–2020: Prevalence of HIV, HCV and injecting and sexual behaviour among NSP attendees. Sydney: Kirby Institute, UNSW Sydney
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