The contributions of everyday and major experiences of racial discrimination to current alcohol use and regular smoking in Black adults: Considering variation by demographic characteristics and family history

Abstract

Background: Racial discrimination has consistently been linked to elevated alcohol use and smoking in Black adults, but the independent contributions of everyday and major experiences of discrimination have rarely been investigated. The present study aimed to identify variation in magnitude of the links between each type of racial discrimination with current frequency of alcohol use and regular smoking by demographic characteristics and family history of problem drinking/regular smoking in Black adults in the U.S. Methods: Data were drawn from 4462 adults (29.40% Afro Caribbean, 70.60% African American; 63.20% female) in a nationally representative sample of Black Americans. Logistic regression analyses were conducted to predict current frequency of alcohol use and regular smoking using the Everyday Discrimination Scale (EDS) and Major Experiences of Discrimination Scale (MEDS), testing for interactions with demographic characteristics and family history. Results: In the alcohol model, an EDS by education level interaction was observed: OR = 1.04 (CI:1.02–1.07) for < high school; OR = 0.95 (CI:0.92–0.98) for ≥ high school. MEDS was independently associated with alcohol use (OR = 1.11, CI:1.04–1.18). In the smoking model, EDS was associated with elevated risk (OR = 1.03, CI:1.01–1.04) and a MEDS by age cohort interaction was observed: OR = 1.24 (CI:1.11–1.38) for <age 45; OR = 1.07 (CI:0.97–1.19) for ages 45–65. Conclusions: Everyday and major experiences of racial discrimination contribute independently to both alcohol use and regular smoking in Black adults, with some variation by education level and age. Differentiating everyday from major experiences of discrimination in studies of mechanisms linking racial discrimination to substance use will enhance their informativeness for intervention development.