ArticleTobacco prevention & cessation2026
Racism, discrimination, and distress: A cross-sectional examination of smoking behaviors among adults who smoke during the COVID-19 pandemic.
Article in Tobacco prevention & cessation, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionRacial and ethnic disparities in tobacco use and related health consequences persist. Experiences with racial discrimination have been associated with higher likelihood of smoking and worse cessation outcomes. The purpose of this study is to examine associations between perceived discrimination with serious quit attempts, smoking relapse, and changes in motivation to quit smoking, during the COVID-19 pandemic.
methodsData came from an October-November 2020 US nationally representative cross-sectional survey of adults who currently smoked cigarettes (n=1223). Participants reported changes in smoking frequency, motivation to quit, quit attempts, and relapse since February 2020. Perceived discrimination was assessed using a modified Everyday Discrimination Scale, the Complementary and Integrative Research Lab Pandemic Impact Questionnaire, and Domain-Specific Stress Scales. In addition to the associations between discrimination and smoking behaviors, we explored differences in smoking behaviors by race.
resultsApproximately 13-25% of participants reported having relapsed to smoking since the beginning of the COVID-19 pandemic. Black participants perceived higher levels of everyday discrimination and were more likely to report having been avoided or insulted because of their race or ethnicity. Participants who experienced racism and discrimination were more likely to have made a serious attempt to quit smoking since the beginning of COVID-19 (AOR=1.80; 95% CI: 1.08-3.03). Experiences with police brutality (AOR=1.61; 95% CI: 1.31-1.97), as well as being avoided or insulted because of their race or ethnicity (AOR=4.70; 95% CI: 2.75-8.04) was associated with higher likelihood of relapse.
conclusionsPerceived experiences with racism and discrimination among people who smoke were associated with making a serious smoking quit attempt but also predicted relapse. Further research can develop smoking cessation interventions that consider various social stressors, such as experiences with racism and discrimination.
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