LGB (lesbian, gay, and bisexual) state policy protections and substance use disparities.

LGB (lesbian, gay, and bisexual) individuals have higher rates of tobacco and alcohol use than the general population. While protective social policies have been found to reduce these disparities, their long-term impact remains largely unknown. In this study, we used data from waves 3 (2001-2002) and 4 (2008-2009) of the National Longitudinal Study of Adolescent to Adult Health to assess the impact of exposure to LGB state policy protections during emerging adulthood on substance use in young adulthood. Using multivariable Poisson models, we evaluated whether emerging adulthood was a critical period of exposure and quantified the relative reduction in substance use disparities between LGB and heterosexual individuals living in more protective states. Findings suggest that LGB individuals living in states with more policy protections during emerging adulthood had a significantly lower prevalence of tobacco use and binge drinking in young adulthood compared with those in less protective states. These findings were not observed among heterosexual individuals, indicating that policy effects were specific to LGB individuals. Furthermore, these protections appeared to reduce overall substance use disparities, especially among female participants. It is critical to continue evaluating policy protections to safeguard the health of the LGB community, especially considering the potential erosion of these vital protections.