Psychosocial and Structural Correlates of Tobacco Use Among Black Young Adults.

Abstract

Introduction: U.S.- and foreign-born Black young adults often have different cultural backgrounds and experiences that can an affect the types of, extent of, and response to the psychosocial stressors encountered. This study examined whether psychosocial and structural stressors are similarly related to any and polytobacco (i.e., 2 or more tobacco products) use among subgroups of Black young adults in the U.S.

Methods: Cross sectional data were collected in 2023 from 445 Black young adults (aged 18-25 years) in the U.S. Stratified regression models were used to examine the association of psychosocial (mental health adversity, race-related adversity, concerns about societal issues) and structural (food insecurity and housing insecurity) stressors with past 6-month any and polytobacco use among U.S.- and foreign-born Black young adults.

Results: Race-related adversity was associated with higher odds of polytobacco use (than odds of nonuse) among both U.S.- (AOR=1.36, 95% CI=1.06, 1.74) and foreign- (AOR=2.18, 95% CI=1.18, 4.03) born Black young adults. Food insecurity was associated with higher odds of polytobacco use among foreign-born Black young adults (AOR=1.92, 95% CI=1.13, 3.27) and any tobacco use among both U.S.- (AOR=1.36, 95% CI=1.04, 1.79) and foreign- (AOR=1.47, 95% CI=1.01, 2.17) born Black young adults. However, concern about societal issues was associated with reduced odds of polytobacco use in both groups.

Conclusions: In all models, experiences of racism and discrimination (race-related adversity) were linked to higher odds of polytobacco use, whereas concern about societal issues was protective. However, there were nativity differences in the association of food insecurity with any and polytobacco use. Findings support the need for culturally/ethnically conscious tobacco prevention strategies that address the underlying psychosocial and structural drivers of tobacco use among Black young adult subgroups.