Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, 48109, USA.
Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI, 48109, USA.
J Racial Ethn Health Disparities. 2024 Feb;11(1):395-405. doi: 10.1007/s40615-023-01527-3. Epub 2023 Jan 25.
Racial/ethnic discrimination (hereafter, discrimination) is associated with tobacco use. However, little is known about the relationship between discrimination and dual/polytobacco use and tobacco use disorder (TUD), including how these relationships vary by race/ethnicity.
Data on adults 18 and older come from the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions-III (n = 35,881). Past-year discrimination was measured using the Experiences of Discrimination scale. Past 30-day exclusive, dual, and polytobacco use was measured as the mutually exclusive use of any combination of four types of tobacco products: cigarettes, electronic nicotine delivery systems, other combustibles (i.e., cigars and pipe), and smokeless tobacco. Past-year TUD was defined according to DSM-5 criteria. Associations between discrimination and exclusive, dual, and polytobacco use and discrimination and TUD were estimated using multinomial logistic regression and logistic regression, respectively. Models were stratified by race/ethnicity (i.e., Hispanic, non-Hispanic (NH) White, NH Black, another race/ethnicity) to assess effect modification.
Adults who used tobacco and who had TUD was 24.2% and 19.2%, respectively. More discrimination was associated with higher odds of exclusive, dual, and polytobacco use as well as TUD. Models stratified by race/ethnicity suggest that discrimination was associated with dual/polytobacco use among NH Black adults (OR: 1.05, 95% CI: 1.002-1.11) and NH White adults (OR: 1.18, 95% CI: 1.13-1.22). While more discrimination was associated with TUD among all racial/ethnic groups, the relationship was the strongest for NH White adults.
Discrimination was associated with more severe tobacco use outcomes among multiple racial/ethnic groups, but associations were the strongest for NH White adults.
种族/民族歧视（以下简称歧视）与烟草使用有关。然而，人们对歧视与双重/多种烟草使用和烟草使用障碍（TUD）之间的关系知之甚少，包括这些关系如何因种族/民族而异。
本研究的数据来自 2012-2013 年国家酒精流行病学调查与相关条件 III（N = 35881）。使用歧视经历量表来衡量过去一年的歧视情况。过去 30 天的独家、双重和多种烟草使用情况，通过四种类型烟草产品的组合使用来衡量，包括香烟、电子烟、其他可燃产品（如雪茄和烟斗）和无烟烟草。过去一年的 TUD 根据 DSM-5 标准定义。使用多项逻辑回归和逻辑回归分别估计歧视与独家、双重和多种烟草使用以及歧视与 TUD 之间的关联。模型按种族/民族（即西班牙裔、非西班牙裔白人、非西班牙裔黑人、其他种族/民族）分层，以评估效应修饰。
使用烟草且患有 TUD 的成年人分别占 24.2%和 19.2%。更多的歧视与更高的独家、双重和多种烟草使用以及 TUD 的几率相关。按种族/民族分层的模型表明，歧视与非西班牙裔黑人成年人（OR：1.05，95%CI：1.002-1.11）和非西班牙裔白人成年人（OR：1.18，95%CI：1.13-1.22）的双重/多种烟草使用相关。虽然在所有种族/民族群体中，更多的歧视与 TUD 相关，但与非西班牙裔白人成年人的关系最强。
歧视与多种种族/民族群体中更严重的烟草使用结果有关，但与非西班牙裔白人成年人的关系最强。
