Abstract
Introduction: Sexual minority women (SMW) are more likely than heterosexual women to meet criteria for hazardous drinking (HD). Sober curiosity, which centres on non-pathologising approaches such as mindfulness and support for questioning norms that encourage heavy/hazardous alcohol use, may be a particularly salient non-stigmatising option for SMW to reduce alcohol consumption. However, SMW's perceptions of sober curiosity as a strategy for changing drinking behaviours have not been explored. Methods: We conducted in-depth individual interviews with a purposive sample of 17 SMW from the United States who self-reported moderate to heavy alcohol consumption or a desire to reduce their drinking. Questions explored the socio-cultural contexts of SMW's drinking, their desire to examine and/or to reduce their drinking and perceived supports and barriers for doing so. Results: SMW described heavy drinking norms, the centrality of alcohol in social spaces and events (both queer and non-queer) and alcohol use as a way to reduce stress, as factors that contribute to HD. Although some participants had mixed opinions about the term ‘sober curiosity’, they described feeling motivated to evaluate their alcohol consumption. Barriers to reducing alcohol use included fear of social rejection and loss of social connections. Discussion and Conclusion: Overall, findings suggest sexual identity-specific online support and resources reflecting the sober curious philosophy have the potential to be useful for SMW seeking to reduce alcohol consumption. Key facilitators may include access to opportunities for connection in alcohol-free settings, social support and educational resources regarding alcohol and its impact on health.
| Original language | English |
|---|---|
| Pages (from-to) | 723-734 |
| Number of pages | 12 |
| Journal | Drug and Alcohol Review |
| Volume | 44 |
| Issue number | 3 |
| DOIs | |
| State | Published - Mar 2025 |
Bibliographical note
Publisher Copyright:© 2025 Australasian Professional Society on Alcohol and other Drugs.
Funding
This study was funded by an intramural grant provided by the Center for Sexual and Gender Minority Health Research at Columbia University School of Nursing (principal investigators: Hughes and Bochicchio). Dr. Lauren Bochicchio's work was supported by the National Institutes of Health/National Institute on Alcohol Abuse and Alcoholism (NIAAA) under Grant F32AA029957 (principal investigator: Bochicchio). The authors would also like to acknowledge funding from NIAAA to Dr. Hughes (R01AA027252, R01AA013328, principal investigator: Hughes) from which the participants were recruited. We conducted in-depth individual interviews with a diverse sample of SMW recruited from the participant pool enrolled in the Chicago Health and Life Experiences of Women studies [29, 30]. Women were originally recruited to the Chicago Health and Life Experiences of Women if they were 18 years of age or older, able to speak and understand English and self-identified as a SMW (e.g., lesbian, bisexual, queer) [29, 30]. We purposively sampled SMW from the parent studies who met the following criteria: moderate to heavy drinkers (i.e., light drinking was defined as 0.01–0.21 oz. ethanol/day or 1–3 standard drinks per week, moderate drinking as 0.22–0.99 oz. ethanol/day or 4–13 drinks/week and heavy drinking as 1.00 or more oz. ethanol/day or 14 or more drinks/week). We also included SMW who reported that they had tried and were unable to cut down on their drinking in the 30 days prior. From those eligible (N = 104), we selected a diverse sample varying in age, race/ethnicity and education levels. Interested SMW were contacted via email and/or text message and provided a summary of participation requirements. Participants received a $50 Amazon gift card in appreciation of their contribution. All study procedures were approved by Columbia University Irving Medical Center Institutional Review Board. The final sample (N = 17) ranged in age from 28 to 73 (mean = 43.4; SD = 12.1) (see Table 1). Almost half (47.0%) identified as White, 17.7% as Black, 17.7% as Hispanic/Latinx, 11.7% as multi-racial/Hispanic/Latinx and 5.9% as multi-racial/non-Hispanic. About one-third of the sample had completed at least some college or a technical degree (29.4%), a bachelor's degree (29.4%) or graduate degree (29.4%). Over half (58.9%) reported heavy drinking and 29.4% were moderate drinkers. Two participants were light drinkers, but indicated a desire to reduce alcohol consumption. We conducted in-depth individual interviews with a diverse sample of SMW recruited from the participant pool enrolled in the Chicago Health and Life Experiences of Women studies [29, 30]. Women were originally recruited to the Chicago Health and Life Experiences of Women if they were 18 years of age or older, able to speak and understand English and self-identified as a SMW (e.g., lesbian, bisexual, queer) [29, 30]. We purposively sampled SMW from the parent studies who met the following criteria: moderate to heavy drinkers (i.e., light drinking was defined as 0.01–0.21 oz. ethanol/day or 1–3 standard drinks per week, moderate drinking as 0.22–0.99 oz. ethanol/day or 4–13 drinks/week and heavy drinking as 1.00 or more oz. ethanol/day or 14 or more drinks/week). We also included SMW who reported that they had tried and were unable to cut down on their drinking in the 30 days prior. From those eligible (N = 104), we selected a diverse sample varying in age, race/ethnicity and education levels. Interested SMW were contacted via email and/or text message and provided a summary of participation requirements. Participants received a $50 Amazon gift card in appreciation of their contribution. All study procedures were approved by Columbia University Irving Medical Center Institutional Review Board. The final sample (N = 17) ranged in age from 28 to 73 (mean = 43.4; SD = 12.1) (see Table 1). Almost half (47.0%) identified as White, 17.7% as Black, 17.7% as Hispanic/Latinx, 11.7% as multi-racial/Hispanic/Latinx and 5.9% as multi-racial/non-Hispanic. About one-third of the sample had completed at least some college or a technical degree (29.4%), a bachelor's degree (29.4%) or graduate degree (29.4%). Over half (58.9%) reported heavy drinking and 29.4% were moderate drinkers. Two participants were light drinkers, but indicated a desire to reduce alcohol consumption. Interviews were conducted by the first and third author via phone or Zoom, based on participant preference, using a semi-structured interview guide [31]. We developed the interview guide in consultation with experts in sober curiosity, then piloted tested it with two SMW (who were not participants in the Chicago Health and Life Experiences of Women study) and refined it prior to commencing study interviews. Participants were invited to comment on their views about alcohol use in LGBTQ+ communities and their own experiences and perceptions related to sober curiosity or other approaches or motivations to reducing alcohol consumption. Although our primary focus was on participant perceptions and experiences related to sober curiosity, the interview guide was intentionally designed to be inclusive of other approaches to reducing alcohol use (such as temporary alcohol abstinence challenges). We used this broader lens to maximise participant comfort and engagement in the interviews because awareness of sober curiosity is generally low in the US population [21] and pilot interviews suggested potential mixed reactions to the term ‘sober curious’. Sample questions include, ‘Over the past few years there has been greater discussion, especially in online platforms, about reducing alcohol consumption or taking a voluntary break from drinking alcohol (such as sober curiosity or Dry January). Have you ever actively tried to reduce your alcohol consumption?’; and ‘What do you perceive as some of the barriers to reducing alcohol consumption for yourself or other women like you?’ Participants were also invited to discuss potential messaging or ways to communicate about the concept of sober curiosity that might resonate with them or others in the SMW community. Interviews averaged 56 min were audio recorded and transcribed by a professional transcription service compliant with US national guidelines for the Health Insurance Portability and Accountability Act. Recruitment ended when data saturation relative to the research aim was reached. We followed the Braun and Clarke [32] six-step method for reflective thematic analysis (RTA): (i) becoming familiar with the data; (ii) coding response units; (iii) drafting themes; (iv) reviewing and adjusting potential themes; (v) naming and creating definition summaries for themes; and (vi) presenting results. Data analysis occurred concurrently with data collection. An iterative process was used across the first six transcripts to refine the analysis process (e.g., semantic analysis to list barriers; construction of meanings underlying social interactions, such as need to belong). All authors reviewed thematic coding of the first six transcripts to identify response units and draft initial themes. The first author then coded the first six transcripts, identified statements that aided our interpretations according to the research aim and shared these preliminary findings with the team. Refinements were made based on interpretative discussion, and the first author repeated this process with the remaining 11 transcripts, with feedback from the other authors. RTA does not involve a numerical count of instances of thematic content. However, patterns in the data were observable and we use descriptive language to communicate the general prevalence of a sub-theme across interviews (e.g., referring to a majority or many participants when a subtheme was reflected in the narratives of more than half, and ‘some’ or ‘a few’ when referring to less than half). This study was funded by an intramural grant provided by the Center for Sexual and Gender Minority Health Research at Columbia University School of Nursing (principal investigators: Hughes and Bochicchio). Dr. Lauren Bochicchio's work was supported by the National Institutes of Health/National Institute on Alcohol Abuse and Alcoholism (NIAAA) under Grant F32AA029957 (principal investigator: Bochicchio). The authors would also like to acknowledge funding from NIAAA to Dr. Hughes (R01AA027252, R01AA013328, principal investigator: Hughes) from which the participants were recruited.
| Funders | Funder number |
|---|---|
| National Institutes of Health (NIH) | |
| National Institute on Alcohol Abuse and Alcoholism | F32AA029957, R01AA027252, R01AA013328 |
| National Institute on Alcohol Abuse and Alcoholism |
UN SDGs
This output contributes to the following UN Sustainable Development Goals (SDGs)
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SDG 3 Good Health and Well-being
Keywords
- alcohol use
- hazardous drinking
- sexual minority women
- sober curiosity
ASJC Scopus subject areas
- Medicine (miscellaneous)
- Health(social science)
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