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

Purpose This study examined nativity differences in social and structural correlates of single and polytobacco product use among United States (U.S.) Black young adults (YA). Design Online cross-sectional study. Setting United States. Sample U.S.-born and foreign-born Black YA ages 18-25 years (N = 484) living in the U.S. Measures Self-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. Analysis Stratified 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. Results Overall, 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. Conclusion Experience 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.