Mental health stressors have different impacts on the likelihood of nicotine or cannabis use among young adults

The use of nicotine and cannabis products in various forms, including smoking and vaping, by young adults is increasing at a time of increasing reports of mental health stressors – anxiety, depression and discrimination – among this age group.

In one of the first studies to examine the impact of these common stressors on diverse young adults, researchers including Arthur Owora, Ph.D., MPH, of the Regenstrief Institute and Indiana University and Wura Jacobs, Ph.D., MSc , from the IU School of Public Health-Bloomington, have found that these stressors have different impacts on the likelihood of substance use depending on the race or ethnicity of the young adult.

Among the findings of the study:

• Higher depression and discrimination increased the likelihood of nicotine or cannabis use among Hispanic young adults.
• Higher anxiety was associated with greater odds of dual nicotine and cannabis use among Hispanic young adults.
• Higher discrimination, with or without depression and anxiety, was a risk factor for both nicotine and cannabis use among Latin American and Asian young adults.
• Higher anxiety was associated with a greater likelihood of nicotine use among black young adults.
• Conversely, higher depression among black young adults was associated with a decreased likelihood of using nicotine products.
• Conversely, for black young adults, discrimination was also associated with a decreased likelihood of dual vaping of nicotine and cannabis.

“By tracking the behavioral determinants and trends of diverse young Los Angeles adults as they grew older, we made nuanced findings indicating that stressors differentially impact substance use by race and ethnicity at a critical age when behavior changes as they approach leaving high school and being in transition. towards post-secondary education, training or employment and face the challenges of becoming independent,” says research scientist Dr. Owora of the Regenstrief Institute, a quantitative epidemiologist and applied biostatistician.

“Our work can help inform program design and outreach efforts aimed at reducing nicotine and cannabis use among marginalized young adults.

“There is a need for better coordination of services that address a broader scope or greater diversity of races and ethnicities,” he added. “For example, we see that people who are Hispanic and Asian have increased use of nicotine products compared to people who are black, where we see a decrease. There is a missed opportunity to educate the Hispanic and possibly Asian young adult populations around some of the harmful effects of substance use.”

A total of 2,478 young adults ages 18 to 29 from Los Angeles were surveyed:

• 57% identified as Hispanic.
• 19% identified as Asian.
• 15% identified as white.
• 4% identified as black.
• 3% identified as multiracial.

At the start of the study in 2019, anxiety was not significantly different among young adults across racial/ethnic groups. However, depression and discrimination scores were significantly different. Depression scores were highest among Asian young adults, followed by multiracial young adults, with white young adults reporting the lowest levels of depression. Discrimination was highest among black young adults, followed by Asians, with white young adults reporting the lowest discrimination.

Over the course of the three-year follow-up, not all of these stressors showed a similar pattern:

• There was a significant increase in depression, anxiety and discrimination among Hispanic young adults.
• Depression did not increase among black young adults.
• Only discrimination, but not depression or anxiety, increased significantly among Asian young adults.
• Only depression, but not anxiety or discrimination, increased among white young adults.

“Everyone knows that children and adolescents are considered vulnerable because of their age. And we all know that we need to better guide them in their formative years. But young adults are a group that people don’t often think about, because they are not children or adolescents.

“They are technically adults because they are 18 years or older, but technically they are also not fully adults because they do not have the cognitive development that you expect in adulthood. In reality, they are a vulnerable group that is usually classified as non-adults.” is considered vulnerable,” says the study’s first author, behavioral epidemiologist Dr. Jacobs.

“Young adults are in a transition period – they are still growing and trying to figure out how to cope with these social and mental health stressors. We now know that the causes of substance use risk for these different groups are not all the same.

“We expected that higher experiences of anxiety, discrimination and depression would lead to substance use as a way of coping, but what we saw in the data was that actually only the experience of everyday discrimination was associated with a greater chance of use. of almost all product forms examined,” she noted.

“We also saw that minority groups experience many more mental health stressors than non-minority groups.”

One of the screening tools used to assess mental health stress levels was the Generalized Anxiety Disorders Scale (GAD-7), co-developed by Regenstrief Institute research scientist Kurt Kroenke, MD, and used by researchers and clinicians across the around the world, as well as by the Centers for Medicare. and Medicaid Services, the U.S. Department of Veterans Affairs and others.

“Race/Ethnic Differences in the Association of Anxiety, Depression, and Discrimination with Subsequent Nicotine and Cannabis Use Among Young Adults: A Prospective Longitudinal Study” is published in the news Addictive behavior.