Association between E-Cigarette Use Behaviors and Anxiety/Depression among Black/African American Adults Based on Sexual Identity

David Adzrago (), Melissa B. Harrell, Kayo Fujimoto, Antwan Jones and J. Michael Wilkerson
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David Adzrago: Center for Health Promotion and Prevention Research, School of Public Health, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX 77030, USA
Melissa B. Harrell: Department of Epidemiology, Human Genetics & Environmental Sciences, UTHealth Austin School of Public Health, Austin, TX 78701, USA
Kayo Fujimoto: Center for Health Promotion and Prevention Research, School of Public Health, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX 77030, USA
Antwan Jones: Department of Sociology, and Department of Epidemiology, The George Washington University, Washington, DC 20052, USA
J. Michael Wilkerson: Center for Health Promotion and Prevention Research, School of Public Health, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX 77030, USA

IJERPH, 2023, vol. 20, issue 3, 1-14

Abstract: Limited studies have examined disparities in e-cigarette use among Black/African American adults by sexual identity and whether the relationship between symptoms of anxiety/depression and e-cigarette use varies by sexual identity. We examined the association between e-cigarette use behaviors (never, former, and current use) and anxiety/depression among a nationally representative sample of Black/African American adults who identified as a sexual minority (lesbian/gay, bisexual, and others) or heterosexual individuals. We combined cross-sectional data from the 2011 to 2020 Health Information National Trends Survey (n = 6267), which is a nationally representative data set. We computed weighted e-cigarette use prevalence and multinomial logistic regression results (never use compared with former and current use, respectively). Among Blacks/African Americans, a larger percentage of sexual minority individuals compared with heterosexual individuals reported former and current e-cigarette use. Among sexual minorities, lesbian/gay individuals reported higher former e-cigarette use, whereas bisexual individuals reported higher current e-cigarette use. Among sexual minority individuals, moderate symptoms of anxiety/depression, compared with no symptoms of anxiety/depression, were associated with a higher likelihood of former e-cigarette use. Among heterosexuals, moderate symptoms of anxiety/depression were also associated with a higher likelihood of former e-cigarette use, while mild and severe symptoms of anxiety/depression were associated with current e-cigarette use compared with no symptoms of anxiety/depression. The intersection between sexual identity and anxiety/depression influenced e-cigarette use behaviors in different ways among Black/African Americans. The findings reinforce the heterogeneity within the Black/African American population, indicating the dangers of not considering subgroup differences as a standard part of public health research practice.

Keywords: electronic cigarettes; tobacco use; mental health; minority; identity (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2023
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