Sex Differences in Cigarette Smoking Among Hispanic and Non-Hispanic Black All of Us Participants: The Relative Importance of Sociodemographic Characteristics and Social Determinants of Health.

Hispanic and Non-Hispanic (NH) Black adults, particularly men, disproportionately experience significant smoking-related health disparities, including cancer. Thus, identifying factors that explicate sex, racial, and ethnic differences in cigarette use is critical for developing tailored interventions to prevent smoking-related diseases among these groups. While sociodemographic characteristics and other social determinants of health (SDOH) are identified as key correlates of cigarette use, little is known about how these factors intersect with sex, race, and ethnicity to influence cigarette use. This study examined data from 15,695 Hispanic and Non-Hispanic (NH) Black participants of the National Institutes of Health All of Us Research Program to examine the role of sociodemographic characteristics and SDOH on cigarette use at the intersection of sex, race, and ethnicity. Using Horn's parallel analysis, we created a composite variable corresponding to cigarette use intensity and duration (CSID). Then, linear regressions and relative importance analyses identified the differential and relative associations among sociodemographic factors and SDOH on CSID across Hispanic men, Hispanic women, NH Black men, and NH Black women. Older age and lower educational level were the factors that were most strongly associated with higher CSID across the four groups. While housing insecurity was the third highest negative correlate for Hispanic men and women, religious service attendance, and being married ranked as third most important for NH Black women and men, respectively. These findings highlight specific factors to incorporate in smoking cessation and prevention programs uniquely designed for these populations.