Social and Structural Determinants of Single and Polytobacco Use Among United States-Born and Foreign-Born Black Young Adults.

PurposeThis study examined nativity differences in social and structural correlates of single and polytobacco product use among United States (U.S.) Black young adults (YA).DesignOnline cross-sectional study.SettingUnited States.SampleU.S.-born and foreign-born Black YA ages 18-25 years (N = 484) living in the U.S.MeasuresSelf-reported past 30-day tobacco product use, safety concerns, and food and housing insecurity measured with the Accountable Health Communities Health-Related Social Needs Screening Tool; experience of racist events measured with the schedule of racist events scale.AnalysisStratified adjusted multinomial logistic regression analyses were conducted. Separate models were constructed for overall sample, U.S.-born YA, and foreign-born YA. All models adjusted for demographic characteristics. Models for foreign-born YA adjusted for length of stay in the U.S.ResultsOverall, 18.8% (CI = 15.6-22.5) and 17.4% (CI = 14.2-21.0) of participants reported single tobacco use and polytobacco use respectively. Among foreign-born participants, exposure to racist events (aOR = 1.06, 95%CI = 1.02-1.11) and housing insecurity (aOR = 1.95, 95%CI = 1.05-3.63) were associated with higher odds of polytobacco use. Among U.S.-born participants, exposure to racist events (aOR = 1.02, 95%CI = 1.001-1.05) and safety concerns (aOR = 3.19, 95%CI = 1.51-6.73) were associated with higher odds of polytobacco use.ConclusionExperience of racist events was associated with polytobacco use among both U.S.-born and foreign-born Black YA. However, different structural determinants were associated with polytobacco use among both groups. Results suggest need for tailored tobacco prevention efforts among Black young adults in the U.S.