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

Abstract

IntroductionFinancial strain and discrimination are consistent predictors of negative health outcomes and maladaptive coping behaviors, including tobacco use. Although there is considerable information exploring stress and smoking, limited research has examined the relationship between patterns of stress domains and specific tobacco/nicotine product use. Even fewer studies have assessed ethnic variations in these relationships.MethodsThis study investigated the relationship between discrimination and financial strain and current tobacco/nicotine product use and explored the ethnic variation in these relationships among diverse sample of US adults (N = 1068). Separate logistic regression models assessed associations between stress domains and tobacco/nicotine product use, adjusting for covariates (e.g., age, gender, race/ethnicity, and household income). Due to statistically significant differences, the final set of models was stratified by race/ethnicity.ResultsHigher levels of discrimination were associated with higher odds of all three tobacco/nicotine product categories. Financial strain was positively associated with combustible tobacco and combined tobacco/nicotine product use. Financial strain was especially risky for Non-Hispanic Whites (AOR:1.191, 95%CI:1.083–1.309) and Blacks/African Americans (AOR:1.542, 95%CI:1.106–2.148), as compared to other groups, whereas discrimination was most detrimental for Asians/Pacific Islanders (AOR:3.827, 95%CI:1.832–7.997) and Hispanics/Latinas/Latinos (AOR:2.517, 95%CI:1.603–3.952).ConclusionsFindings suggest discrimination and financial stressors are risk factors for use of multiple tobacco/nicotine products, highlighting the importance of prevention research that accounts for these stressors. Because ethnic groups may respond differently to stress/strain, prevention research needs to identify cultural values, beliefs, and coping strategies that can buffer the negative consequences of discrimination and financial stressors.

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

“…Considering that health insurance is the gateway to healthcare and these demographic and SES factors are commonly correlated with health status (18,43,(65)(66)(67), these variables were selected in order to analyze the unique relationship between financial difficulties and continuous mental and physical health variables. While much of the previous research would suggest that binge drinking is positively associated with financial difficulties, especially for AA samples (8,9,11), the findings did not indicate an association between financial difficulties and binge drinking. This may be due to the high percentage of participants who did not drink at all in our sample (65.1%).…”

“…A systematic review of the literature by Richardson and colleagues revealed a number of findings indicating a relationship between financial concerns and the likelihood to smoke (8). Recent findings indicate financial difficulties increase the risk of tobacco/nicotine use, and this relationship is especially strong for AA populations (11). Furthermore, financial difficulties can influence smoking cessation such that pre-quit financial difficulties are associated with more severe withdrawal symptoms which in turn reduces the likelihood of smoking abstinence (12,13).…”

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

“…The present study is also one of the first to examine the relationship between discrimination and e-cigarette. A recent study found that more frequent discrimination was directly associated with higher odds of combustible tobacco use in the overall sample and among Black Americans, but higher odds of e-cigarette use in the overall sample and among White Americans (Rogers et al, 2018). Moreover, we previously found that persons with PD and lifetime mental health conditions were more likely to be current or daily e-cigarette users (Spears et al, 2017, 2018, 2019).…”

Interpersonal ethnic–racial discrimination and tobacco products: The moderating role of critical action.

“…Although much of the research has focused mainly on racially minoritized individuals’ coping with interpersonal ethnic–racial discrimination through alcohol, cannabis, opiates, and other illicit drug use (Pascoe et al, 2022), some research associates increased incidences of licit substances such as tobacco and other nicotine products has also been established (Kendzor, Businelle, Reitzel, Rios, et al, 2014; Rogers et al, 2018). Rogers et al (2018) discovered significant dose–response relationships between increased experiences of IERD and increased usage of combustible and electronic tobacco/nicotine products among a sample of racially diverse adults. Moreover, increased IERD reduced the likelihood of achieving 7-day abstinence among tobacco users attempting tobacco cessation (Kendzor, Businelle, Reitzel, Castro, et al, 2014).…”