Ethnic variations in the relationship between multiple stress domains and use of several types of tobacco/nicotine products among a diverse sample of adults

Race, Concern About COVID-19 Discrimination, and Cigarette Smoking Behavior: Comparison Between US Asian and White Adults Who Use Commercial Tobacco

Anti-Asian discrimination incidents in the USA have resurged during the COVID-19 pandemic. It is unclear how concern about being discriminatorily treated due to the COVID-19 pandemic varies between Asian and Asian American (A&AsA) and White adults. We examined A&AsA vs. White differences in concern about COVID-19 discrimination and associations of this concern with changes in cigarette smoking behaviors before and during the pandemic. Data were from a US representative sample of A&AsA and White adults (≥ 21 years) who currently and formerly used commercial tobacco (n = 1052), collected through an online panel oversampling A&AsA adults in January-February 2021. Participants reported their concern, worry, and stress about COVID-19 discrimination and past-30-day cigarette consumption before and during the pandemic. We examined the association between race and overall concern about COVID-19 discrimination, and this concern's associations with changes in past-30-day cigarette smoking consumption, smoking continuation, and return to smoking using weighted multivariable logistic and linear regression models. Overall concern about COVID-19 discrimination was higher (adjusted mean = 1.7, standard error = 0.16) among A&AsA adults who currently and formerly used commercial tobacco than their White counterparts (adjusted mean = 0.60, standard error = 0.04; p < 0.01). Overall concern about COVID-19 discrimination was associated with increased past-30-day cigarette consumption by 26.5 cigarettes (95% confidence interval [CI] = 1.2-51.9) and 4.4 times (95% CI = 2.3-8.5) greater odds of return to smoking among adults who smoke cigarettes. A&AsA adults who currently and formerly used commercial tobacco disproportionately bore higher concern about COVID-19 discrimination, and in turn could lead to increased smoking behavior and related morbidity and mortality among A&AsA adults.

Discrimination, psychological functioning, and substance use among U.S. young adults aged 18-28, 2017

This study aimed to test whether (a) discrimination is associated with past 30-day/current alcohol, cigarette, e-cigarette, alcohol, marijuana, and other illicit drug use among Black and White U.S. adults aged 18-28, (b) psychological distress (PD) and positive well-being (PW) are mediators of the discrimination-substance use relationships, and (c) the associations are moderated by race and sex. Using data from a 2017 U.S. nationally representative survey we conducted multiple-group moderated mediation analyses among 2,192 young adults aged 18-28 (508 Black males, 594 Black females, 533 White males, 557 White females). Black males had higher discrimination, Whites had higher PW, and females had higher PD scores. Discrimination was positively associated with PD and negatively associated with PW. Among all groups, discrimination was positively associated with other illicit drug (direct and indirect), and marijuana use through PD. Indirect effects were stronger among White males for other illicit drugs and Black males for marijuana. The indirect effect of discrimination and alcohol use through PW was positive for Black females and negative for all other groups examined. Among Black males only, discrimination was positively associated with cigarette and alcohol use through PD (positive) and cigarette smoking through PW (negative). This study highlights the negative influence of perceived discrimination on current licit and illicit substance use among Black and White young adults. Our results suggest that this relationship may be partially mediated by PD and PW, especially among Black male young adults. Future discrimination and substance use studies should consider potential mediation effects of poor mental health and differences by race and sex. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Association between Perceived Discrimination and Vaping among College Students

Perceived discrimination has been associated with a higher prevalence of e-cigarette use among adult samples. However, little is understood about the relationship between discrimination and various vaping behaviors among college students. Methods: College students completed an online survey about e-cigarette use (N = 488; 73.2% women; 52.7% White, 30.5% Black/African American, 6.1% Asian, 5.3% other races, 3.9% Multiracial). Participants completed the Everyday Discrimination Scale and identified which of their identities discrimination was most directed toward. Regressions, controlling for significant covariates of outcomes, examined discrimination in relation to e-cigarette ever use, current use, and frequency of use. Results: A higher discrimination score predicted greater odds of ever vaping compared with never use (OR = 1.21, p=.03). Controlling for race (p=.003), greater discrimination was related to increased likelihood of established vaping (100+ times) versus lighter levels of use (AOR = 1.22, p=.04). Discrimination was not associated with likelihood of current vaping (p>.05). Among e-cigarette users, greater perceived discrimination was related to an increased time spent vaping per day (β =1.69, SE = 0.204, p=.05). Conclusions/Importance: Greater perceived discrimination was associated with more frequent vaping among college students. Current results extend previous findings by suggesting that among college e-cigarette users, those who experience discrimination are more likely to use these products frequently rather than experimentally. Findings can inform the identification and development of resources for students experiencing discrimination to prevent the uptake of e-cigarette use.

E-cigarette use among Asian Americans: a systematic review

The use of electronic cigarettes (e-cigarettes) has been rising among adolescents and adults in the United States, including among Asian Americans. However, despite being one of the largest racial/ethnic minority groups, the specific trends and patterns of e-cigarette use among Asian Americans are understudied and unclear. This review aimed to summarize relevant information in the last two decades. This systematic review followed the a priori guide outlined by the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement. Articles were gathered from PsycINFO, PubMed, Sage Journals Online, ScienceDirect, and SpringerLink. Forty articles were reviewed and analyzed. Most articles reviewed only reported on the prevalence rate of e-cigarettes among Asian Americans and indicated regional differences. Results noted between- and within-group differences among racial/ethnic groups that warrant further examination. There is a dearth of information regarding health outcomes and correlates or predictors of e-cigarette use among Asian Americans. Despite its popularity and prevalence among Asian Americans, the use of e-cigarettes and related factors or outcomes deserves more nuanced studies and analyses. It is important to delineate subgroup differences by adjusting study designs and data analytic methods to glean meaningful information regarding Asian American's e-cigarette use in the future.

Stressful Life Events and Racial Disparities in Cognition Among Middle-Aged and Older Adults

BACKGROUND

It is well-documented that African Americans have elevated risk for cognitive impairment and dementia in late life, but reasons for the racial disparities remain unknown. Stress processes have been linked to premature age-related morbidity, including Alzheimer's and related dementias (ADRD), and plausibly contribute to social disparities in cognitive aging.

OBJECTIVE

We examined the relationship between stressful life events and cognitive decline among African American and White participants enrolled in the Wisconsin Registry for Alzheimer's Prevention (WRAP).

METHODS

Linear mixed models including demographic, literacy, and health-related covariates were used to estimate (1) relationships between a life event index score and decline in cognitive test performance in two domains of executive function (Speed & Flexibility, Working Memory) and one domain of episodic memory (Verbal Learning & Memory) among 1,241 WRAP enrollees, stratified by race, and (2) contributions of stressful life events to racial differences in cognition within the full sample.

RESULTS

African Americans (N = 50) reported more stressful life events than Whites (N = 1,191). Higher stress scores associated with poorer Speed & Flexibility performance in both groups, though not with declines across time, and partially explained racial differentials in this domain. Among African Americans only, stressor exposure also associated with age-related decline in Verbal Learning & Memory. Stressor-cognition relationships were independent of literacy and health-related variables.

CONCLUSIONS

Greater lifetime stress predicted poorer later-life cognition, and, in a small sample of African Americans, faster declines in a key domain of episodic memory. These preliminary findings suggest that future work in large minority aging cohorts should explore stress as an important source of modifiable, socially-rooted risk for impairment and ADRD in African Americans, who are disproportionately exposed to adverse experiences across the life course.

The role of perceived discrimination in substance use trajectories in Hispanic young adults: A longitudinal cohort study from high school through emerging adulthood

PURPOSE

Associations between discrimination and substance use have been identified cross-sectionally in multiple populations including Hispanics. However, there is limited research exploring this phenomenon longitudinally in Hispanic youth over the transition from adolescence through emerging adulthood (EA).

METHODS

Hispanic youth in Southern California (n = 1457) completed surveys over 11 years, from 2006 to 2017, including three high school collection waves and five EA collection waves. Multinomial logistic regression models were used to explore the associations between perceived discrimination during high school and cigarette and marijuana use in both high school and EA, controlling for gender, socioeconomic status, acculturation, and EA discrimination.

RESULTS

Compared with those who never used cigarettes or marijuana in high school and EA, perceived discrimination in high school was a significant predictor of two patterns of use: high school initiators who discontinued use of smoking (RRR = 1.677, 95%CI = 1.292-2.176) and/or marijuana (RRR = 1.464, 95%CI = 1.162-1.844), and high school initiators who continued smoking (RRR = 1.492, 95%CI = 1.196-1.861) and/or marijuana use (RRR = 1.249, 95%CI = 1.052-1.482) into EA. For late initiators who did not use in high school but started in EA, perceived high school discrimination was a significant predictor for cigarette smoking (RRR = 1.193, 95%CI = 1.036-1.373) but not for marijuana use.

CONCLUSIONS

Perceived discrimination during adolescence is associated with substance use trajectories across both adolescence and EA. Culturally tailored prevention programs that provide training in skills to cope with psychosocial stressors could improve Hispanic adolescent health.

Mental and Physical Health Correlates of Financial Difficulties Among African-American Older Adults in Low-Income Areas of Los Angeles

Background: While financial difficulties correlate with mental and physical health status, less is known about these associations among economically disadvantaged African-American (AA) older adults. Objective: This study explored mental and physical health correlates of financial difficulties among AA older adults in low-income areas of south Los Angeles. Methods: A cross-sectional study on 740 AA older adults (age ≥ 55 years) conducted in South Los Angeles between 2015 and 2018. Independent variable was financial difficulties. Outcomes were depressive symptoms, chronic pain, chronic medical conditions, self-reported health, and sick days. Age, gender, educational attainment, living alone, marital status, smoking, and drinking were also measured. Zero order (unadjusted) and partial (adjusted) correlates of financial difficulties were calculated for data analysis. Adjusted (partial) bivariate correlations controlled for age, gender, education, marital status, living alone, and health insurance. Results: In adjusted analyses, financial difficulties were positively associated with chronic pain, chronic medical conditions, self-rated health, sick days, and depressive symptoms. Conclusion: Financial difficulties seem to be linked to chronic pain, chronic medical conditions, self-rated health, sick days, and depressive symptoms. The results advocate for evaluation of social determinants of health in providing health care of AA older adults. Addressing financial difficulties may help with the health promotion of low-income AA older adults in urban areas.

Adverse Childhood Experiences, Ethnicity, and Substance Use among College Students: Findings from a Two-State Sample

Objectives: Despite college students reporting high rates of substance use and adverse childhood experiences (ACE), few studies have examined ACE-related substance use patterns with diverse student samples. We estimated the prevalence of ACE and substance use and investigated ethnic differences in the relationship between ACE and substance use among college students from two states. Design: Data are responses (N = 7,148) on the National College Health Assessment (in California) and the College Student Health Survey (in Minnesota). Multivariable regression models assessed the associations between individual and accumulated ACE and alcohol, tobacco, marijuana, and illicit substance use and binge drinking (adjusting for age, gender, depression, and state) among non-Hispanic White, Hispanic, African American/Black, Asian Pacific Islanders, multiracial, and other students. Interaction terms were calculated to test for ethnic differences. Results: In the month preceding the survey, 22% of students used marijuana, 28% used tobacco, 75% drank alcohol; 6% used an illicit drug in the past year and 30% acknowledged past 2-week binge drinking. Although ACE were associated with all substance use behaviors (AORs ranged from 1.19 to 1.54, p < .001), there was significant ethnic variation in ACE exposure (40-52%) and the dose-response relationship between ACE and marijuana and tobacco use and binge drinking. Conclusions: The variability in ACE-related substance use patterns across ethnic groups highlights the need for research that advances our understanding of sociocultural influences in trauma response and the role that campus communities could have in the development of culturally sensitive services that address this issue.