Unpacking the complexities in racial and ethnic discrimination and tobacco use and cannabis co-use behaviors among young adults in the U.S.

Introduction: There is a general paucity of research describing the relationship between racial and ethnic discrimination (RED) and coping strategies on use of little filtered cigars and cigarillos (LCCs) across racial and ethnic identities. This research sought to unravel some of the complex, multilayered experiences of RED and subsequent coping strategies to examine the impact on LCC use. Methods: Data come from a cross-sectional survey conducted among a nationally representative sample of U.S. young adults (n = 1,178) in May 2022. Respondents were asked about their exposure to LCC marketing (systemic RED), interpersonal experiences of RED, coping strategies, and use of LCCs as-sold (tobacco only) or as a blunt (with marijuana). Multivariable logistic regression was used to examine 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. Results: Exposure to systemic RED was associated with increased odds of blunt use. Interpersonal experiences of RED were associated with increased odds of LCC use as-sold and as blunts. Among those 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. Conclusion: Systemic and interpersonal RED are independently associated with LCC use. There are considerable differences in how young adults cope with RED which necessitates additional research to further elucidate the complex pathways between RED and product use to more effectively inform strategies to address the undeniable racial and ethnic inequities in tobacco-related health outcomes.