Adverse Childhood Experiences, Discrimination, Nativity, and Associations with Tobacco and Cannabis Use Among Black Young Adults in the U.S.

Objective: Adverse experiences during childhood (ACEs) and other adversities, such as experiences of discrimination are important risk factors for substance use, particularly among Black individuals in the United States (U.S.). Given the ethnic diversity of Black people in the U.S., it is important to examine how nativity influences the impact of these stressors on substance use risk.

Methods: Participants were 484 Black young adults (YA) recruited through opt-in panels and online platforms. Nativity differences in the association between ACEs, everyday discrimination, and count of tobacco/nicotine and cannabis products used were examined with descriptive statistics, zero-inflated negative binomial (ZINB), and logistic regression models.

Results: Participants' average age was 21.96 years; 53.1% females and 37.6% foreign-born. There were nativity differences ( < 0.05) in education, ACEs, everyday discrimination and lifetime count of tobacco/nicotine and cannabis product types used. Each additional ACE and experience of everyday discrimination was associated with higher lifetime tobacco/nicotine product count by 5% (IRR = 1.05, 95% CI 1.01-1.09) and 2% (IRR = 1.02, 95% CI 1.01-1.04), respectively. ACEs were associated with lower odds of abstaining from tobacco/nicotine and cannabis products in the lifetime (aOR = 0.87, 95% CI 0.76-0.99 and aOR = 0.83 95% CI 0.73-0.95, respectively) and higher odds of co-occurring product exposure (aOR = 1.17, 95% CI 1.05-1.31). Foreign-born YA had 40% lower cannabis product count (IRR = 0.60, 95% CI 0.41-0.88) relative to U.S.-born YA.

Conclusion: Findings emphasize the role of early life (ACEs) and societal stressors (everyday discrimination) on tobacco/nicotine and cannabis product count (i.e., exposure) among U.S.- and foreign-born Black YA.