Racial and ethnic discrimination (RED) & tobacco use and cannabis co-use behaviors among young adults
In 2021, racism was declared a public health crisis in the US. The declaration came with the COVID-19 pandemic, which disproportionately impacted minority communities and exacerbated existing systemic inequities that contribute to health disparities. One manifestation of systemic racism is targeted tobacco marketing that exploits vulnerable populations and perpetuates tobacco-related health disparities. Racial and ethnic discrimination (RED) has been shown to have harmful effects on the physical and mental well being among communities of color. The experience of RED has also been shown to contribute to the use of cigarettes and use/co-use of cannabis, particularly among Black/African American and Hispanic/Latinx populations across the lifespan. Notably, the experience of RED and subsequent use of tobacco and/or cannabis has been noted to be modified by exposure to targeted marketing, highlighting the importance of considering both when evaluating key exposures leading to tobacco use and cannabis co-use. Despite the known relationship between RED and cigarette use, the relationship with other tobacco products, particularly little cigars and cigarillos (LCCs), remains understudied. The relationship between RED and tobacco and/or cannabis co-use may be explained by the psychological distress brought on by oppressive experiences and how individuals may cope with distress.
This study by Faculty Associate Craig Fryer and colleagues was done to understand the “intersection between RED and coping by taking steps to disentangle mechanisms that may be pertinent specifically to the use of LCCs as a distinct form of tobacco use and/or cannabis co-use.” Fryer and colleagues hypothesized that “1) RED both at the systemic and interpersonal level may contribute to greater odds of use of LCCs with just tobacco (as-sold) as well as those co-administered with cannabis as a blunt and 2) emotion-focused strategies to cope with interpersonal RED may contribute to greater use of LCCs.”
Data from a cross-sectional survey conducted among a nationally representative sample of US young adults in May 2022 was used for this study. The respondents of the survey were asked about their exposure to LCC marketing, interpersonal experiences of RED, coping strategies, and use of LCC as-sold, or as a blunt with marijuana. For analysis, multivariable logistic regression was employed to examine the odds of LCC use examining systemic and interpersonal RED and the relationship between emotion-focused and problem-focused coping strategies among those who have experienced RED.
Fryer and colleagues found that exposure to systemic RED was associated with increased odds of blunt use. Increased odds of LCC use as-sold and as blunts were associated with interpersonal experiences of RED. “Among individuals who experienced any RED, the impact of problem-focused and emotion-focused coping was differential across racial and ethnic identities in the impact on LCC use modality.”
The findings from this research highlight the variability across racial and ethnic identities reflecting differences in how young adults experience systemic and interpersonal RED and subsequently cope with their lived experiences. In addition, the findings emphasize the importance of examining RED with greater granularity across multiple levels to “more broadly encapsulate and contextualize the influence of various personal, interpersonal, cultural, environmental characteristics that may shape product use.”
Moore, S.P., Fryer, C.S., Lee, E., Sterling, K.L. (2025). “Unpacking the complexities in racial and ethnic discrimination and tobacco use and cannabis co-use behaviors among young adults in the U.S.” Addictive Behavior Reports. https://doi.org/10.1016/j.abrep.2025.100593
