Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, 48109, USA.
Department of Behavioral Science, University of Kentucky College of Medicine, Lexington, KY, 40536, USA.
J Racial Ethn Health Disparities. 2024 Dec;11(6):3736-3747. doi: 10.1007/s40615-023-01822-z. Epub 2023 Oct 12.
Mental health problems in emerging adulthood are linked to tobacco and cannabis use, but whether race and ethnicity modifies these associations is unclear.
We used data from wave 4 of the Population Assessment of Tobacco and Health Study (youth n = 6898, young adult n = 10,304) to conduct latent class analysis (LCA) of six past 30-day tobacco and cannabis use indicators (i.e., cigarettes, electronic nicotine delivery systems (ENDS), cigars, blunts, cannabis vaping, other cannabis). We estimated associations between past 30-day internalizing and externalizing (i.e., low (referent), moderate, high) problems and latent classes of tobacco/cannabis use (vs. never/former use) using adjusted multinomial logistic regression. We explored whether associations varied by race and ethnicity through stratification.
We identified four exclusive use latent classes and two dual/poly use latent classes for both youth and young adult samples. Race/ethnicity-stratified models identified associations between internalizing/externalizing problems and most use classes for Hispanic and non-Hispanic White youth/young adults, with mixed results for non-Hispanic Black youth/young adults. For example, Hispanic (OR: 2.50, 95% CI: 1.09-5.74) and non-Hispanic White (OR: 1.90, 95% CI: 1.18-3.06) youth with high internalizing problems had higher odds of ENDS + cannabis vaping. Externalizing problems were not associated with use among non-Hispanic Black youth while internalizing problems were not associated with use among non-Hispanic Black young adults.
We observed racial/ethnic variation in mental health problems and tobacco and cannabis use. Understanding mental health problem and tobacco product and cannabis use comorbidity may better inform culturally relevant interventions aimed to prevent and reduce use.
成年初期的心理健康问题与烟草和大麻的使用有关，但种族和民族是否会改变这些关联尚不清楚。
我们使用来自人口烟草与健康评估研究（youth n = 6898，young adult n = 10304）第四波的数据，对六种过去 30 天的烟草和大麻使用指标（即香烟、电子烟、雪茄、blunts、大麻蒸气、其他大麻）进行潜在类别分析（LCA）。我们使用调整后的多项逻辑回归，估计过去 30 天的内化和外化问题（即低（参照）、中、高）与烟草/大麻使用的潜在类别（与从未/以前使用相比）之间的关联。我们通过分层来探讨这些关联是否因种族和民族而异。
我们为青年和成年样本分别确定了四个独用潜在类别和两个双用/多用潜在类别。按种族/民族分层的模型确定了内化/外化问题与西班牙裔和非西班牙裔白人群体中大多数使用类别的关联，而非西班牙裔黑人青年/成年群体的结果则较为复杂。例如，有高内化问题的西班牙裔（OR：2.50，95% CI：1.09-5.74）和非西班牙裔白人（OR：1.90，95% CI：1.18-3.06）青年使用电子烟和吸食大麻的可能性更高。外化问题与非西班牙裔黑人青年的使用无关，而内化问题与非西班牙裔黑人年轻成人的使用无关。
我们观察到心理健康问题与烟草和大麻使用在种族/民族方面的差异。了解心理健康问题与烟草产品和大麻使用的共病关系，可能会更好地为旨在预防和减少使用的具有文化相关性的干预措施提供信息。
