Racial/ethnic discrimination and tobacco and cannabis use outcomes among US adults

Delvon T. Mattingly; Harold W. Neighbors; Briana Mezuk; Michael R. Elliott; Nancy L. Fleischer

doi:10.1016/j.josat.2023.208958

Racial/ethnic discrimination and tobacco and cannabis use outcomes among US adults

Delvon T. Mattingly, Harold W. Neighbors, Briana Mezuk, Michael R. Elliott, Nancy L. Fleischer

Research output: Contribution to journal › Article › peer-review

12 Scopus citations

Abstract

Introduction: Racial/ethnic discrimination (hereafter, discrimination) is associated with use of individual tobacco and cannabis products. However, we know little about how discrimination affects dual/polytobacco and cannabis use and associated use disorders. Methods: We used cross-sectional data on adults (18+) from the 2012–2013 National Epidemiologic Survey on Alcohol and Related Conditions-III (n = 35,744). We defined past-year discrimination as a summary scale (range: 0–24) based on six scenarios. We created a mutually exclusive six-category use variable: noncurrent, individual tobacco and noncannabis, individual tobacco and cannabis, individual cannabis and nontobacco, dual/polytobacco and noncannabis, and dual/polytobacco and cannabis based on past 30-day tobacco use of four products (i.e., cigarettes, electronic nicotine delivery systems, other combustibles (cigars, pipe), smokeless tobacco) and cannabis use. We also examined past-year tobacco use disorder (TUD) and cannabis use disorder (CUD) as a four-level variable: no disorders, TUD only, CUD only, and TUD and CUD. We estimated associations between discrimination and each outcome using adjusted multinomial logistic regression and assessed effect modification by stratifying adjusted models by race/ethnicity (i.e., Hispanic, non-Hispanic (NH) White, NH Black, and another race/ethnicity). Results: Experiencing more discrimination was associated with each outcome but was most strongly associated with dual/polytobacco and cannabis use (OR: 1.13, 95 % CI: 1.07–1.19) and joint TUD and CUD (OR: 1.16, 95 % CI: 1.12–1.20). Models stratified by race/ethnicity showed that discrimination was associated with dual/polytobacco and cannabis only among NH White adults, and with joint TUD and CUD only among NH Black and NH White adults. Conclusions: Discrimination was associated with tobacco and cannabis use outcomes among multiple adult racial/ethnic populations, but associations were more profound for NH White and NH Black adults than adults from other racial/ethnic populations.

Original language	English
Article number	208958
Journal	Journal of substance use and addiction treatment
Volume	148
DOIs	https://doi.org/10.1016/j.josat.2023.208958
State	Published - May 2023

Bibliographical note

Publisher Copyright:
© 2023 Elsevier Inc.

Funding

This work was supported by the National Cancer Institute of the National Institutes of Health and the Food and Drug Administration's Center for Tobacco Products [grant number U54CA229974]. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. This work was supported by the National Cancer Institute of the National Institutes of Health [grant number U54CA229974 ]. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Funders	Funder number
National Childhood Cancer Registry – National Cancer Institute
Food and Drug Administration's Center for Tobacco Products	U54CA229974
National Institutes of Health (NIH)	U54CA229974
National Institutes of Health (NIH)

Keywords

Cannabis
Health disparities
Polytobacco
Racial discrimination
Substance use disorder
Tobacco

ASJC Scopus subject areas

Medicine (miscellaneous)
Psychiatry and Mental health
Psychiatric Mental Health

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.josat.2023.208958

Cite this

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title = "Racial/ethnic discrimination and tobacco and cannabis use outcomes among US adults",

abstract = "Introduction: Racial/ethnic discrimination (hereafter, discrimination) is associated with use of individual tobacco and cannabis products. However, we know little about how discrimination affects dual/polytobacco and cannabis use and associated use disorders. Methods: We used cross-sectional data on adults (18+) from the 2012–2013 National Epidemiologic Survey on Alcohol and Related Conditions-III (n = 35,744). We defined past-year discrimination as a summary scale (range: 0–24) based on six scenarios. We created a mutually exclusive six-category use variable: noncurrent, individual tobacco and noncannabis, individual tobacco and cannabis, individual cannabis and nontobacco, dual/polytobacco and noncannabis, and dual/polytobacco and cannabis based on past 30-day tobacco use of four products (i.e., cigarettes, electronic nicotine delivery systems, other combustibles (cigars, pipe), smokeless tobacco) and cannabis use. We also examined past-year tobacco use disorder (TUD) and cannabis use disorder (CUD) as a four-level variable: no disorders, TUD only, CUD only, and TUD and CUD. We estimated associations between discrimination and each outcome using adjusted multinomial logistic regression and assessed effect modification by stratifying adjusted models by race/ethnicity (i.e., Hispanic, non-Hispanic (NH) White, NH Black, and another race/ethnicity). Results: Experiencing more discrimination was associated with each outcome but was most strongly associated with dual/polytobacco and cannabis use (OR: 1.13, 95 \% CI: 1.07–1.19) and joint TUD and CUD (OR: 1.16, 95 \% CI: 1.12–1.20). Models stratified by race/ethnicity showed that discrimination was associated with dual/polytobacco and cannabis only among NH White adults, and with joint TUD and CUD only among NH Black and NH White adults. Conclusions: Discrimination was associated with tobacco and cannabis use outcomes among multiple adult racial/ethnic populations, but associations were more profound for NH White and NH Black adults than adults from other racial/ethnic populations.",

keywords = "Cannabis, Health disparities, Polytobacco, Racial discrimination, Substance use disorder, Tobacco",

author = "Mattingly, \{Delvon T.\} and Neighbors, \{Harold W.\} and Briana Mezuk and Elliott, \{Michael R.\} and Fleischer, \{Nancy L.\}",

note = "Publisher Copyright: {\textcopyright} 2023 Elsevier Inc.",

year = "2023",

month = may,

doi = "10.1016/j.josat.2023.208958",

language = "English",

volume = "148",

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T1 - Racial/ethnic discrimination and tobacco and cannabis use outcomes among US adults

AU - Mattingly, Delvon T.

AU - Neighbors, Harold W.

AU - Mezuk, Briana

AU - Elliott, Michael R.

AU - Fleischer, Nancy L.

PY - 2023/5

Y1 - 2023/5

N2 - Introduction: Racial/ethnic discrimination (hereafter, discrimination) is associated with use of individual tobacco and cannabis products. However, we know little about how discrimination affects dual/polytobacco and cannabis use and associated use disorders. Methods: We used cross-sectional data on adults (18+) from the 2012–2013 National Epidemiologic Survey on Alcohol and Related Conditions-III (n = 35,744). We defined past-year discrimination as a summary scale (range: 0–24) based on six scenarios. We created a mutually exclusive six-category use variable: noncurrent, individual tobacco and noncannabis, individual tobacco and cannabis, individual cannabis and nontobacco, dual/polytobacco and noncannabis, and dual/polytobacco and cannabis based on past 30-day tobacco use of four products (i.e., cigarettes, electronic nicotine delivery systems, other combustibles (cigars, pipe), smokeless tobacco) and cannabis use. We also examined past-year tobacco use disorder (TUD) and cannabis use disorder (CUD) as a four-level variable: no disorders, TUD only, CUD only, and TUD and CUD. We estimated associations between discrimination and each outcome using adjusted multinomial logistic regression and assessed effect modification by stratifying adjusted models by race/ethnicity (i.e., Hispanic, non-Hispanic (NH) White, NH Black, and another race/ethnicity). Results: Experiencing more discrimination was associated with each outcome but was most strongly associated with dual/polytobacco and cannabis use (OR: 1.13, 95 % CI: 1.07–1.19) and joint TUD and CUD (OR: 1.16, 95 % CI: 1.12–1.20). Models stratified by race/ethnicity showed that discrimination was associated with dual/polytobacco and cannabis only among NH White adults, and with joint TUD and CUD only among NH Black and NH White adults. Conclusions: Discrimination was associated with tobacco and cannabis use outcomes among multiple adult racial/ethnic populations, but associations were more profound for NH White and NH Black adults than adults from other racial/ethnic populations.

AB - Introduction: Racial/ethnic discrimination (hereafter, discrimination) is associated with use of individual tobacco and cannabis products. However, we know little about how discrimination affects dual/polytobacco and cannabis use and associated use disorders. Methods: We used cross-sectional data on adults (18+) from the 2012–2013 National Epidemiologic Survey on Alcohol and Related Conditions-III (n = 35,744). We defined past-year discrimination as a summary scale (range: 0–24) based on six scenarios. We created a mutually exclusive six-category use variable: noncurrent, individual tobacco and noncannabis, individual tobacco and cannabis, individual cannabis and nontobacco, dual/polytobacco and noncannabis, and dual/polytobacco and cannabis based on past 30-day tobacco use of four products (i.e., cigarettes, electronic nicotine delivery systems, other combustibles (cigars, pipe), smokeless tobacco) and cannabis use. We also examined past-year tobacco use disorder (TUD) and cannabis use disorder (CUD) as a four-level variable: no disorders, TUD only, CUD only, and TUD and CUD. We estimated associations between discrimination and each outcome using adjusted multinomial logistic regression and assessed effect modification by stratifying adjusted models by race/ethnicity (i.e., Hispanic, non-Hispanic (NH) White, NH Black, and another race/ethnicity). Results: Experiencing more discrimination was associated with each outcome but was most strongly associated with dual/polytobacco and cannabis use (OR: 1.13, 95 % CI: 1.07–1.19) and joint TUD and CUD (OR: 1.16, 95 % CI: 1.12–1.20). Models stratified by race/ethnicity showed that discrimination was associated with dual/polytobacco and cannabis only among NH White adults, and with joint TUD and CUD only among NH Black and NH White adults. Conclusions: Discrimination was associated with tobacco and cannabis use outcomes among multiple adult racial/ethnic populations, but associations were more profound for NH White and NH Black adults than adults from other racial/ethnic populations.

KW - Cannabis

KW - Health disparities

KW - Polytobacco

KW - Racial discrimination

KW - Substance use disorder

KW - Tobacco

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JO - Journal of substance use and addiction treatment

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Racial/ethnic discrimination and tobacco and cannabis use outcomes among US adults

Abstract

Bibliographical note

Funding

Keywords

ASJC Scopus subject areas

UN SDGs

Access to Document

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