Tobacco and Cannabis Use and co-Use, and Cannabis Refusal Self-Efficacy Among Black Men: A Cross-Sectional Study Examining Differences Between Men Who Have Sex with Men (MSM) and Non-MSM.
| Journal | Substance use & misuse |
| Study Type | Clinical Study |
| Population | Human participants |
This cross-sectional study identifies higher cannabis and tobacco co-use rates among Black MSM compared to Black non-MSM, with lower cannabis refusal self-efficacy as a mediating factor. Understanding these substance use patterns is clinically relevant for addressing health disparities and developing targeted interventions for vulnerable populations.
This study examined 202 Black men aged 18-34, comparing substance use patterns between MSM (n=94) and non-MSM (n=108). Over 30 days, 68 reported tobacco use, 121 reported cannabis use, and 62 reported co-use. Black MSM demonstrated significantly higher rates of both tobacco and cannabis use, along with lower cannabis refusal self-efficacy compared to non-MSM participants. Path analysis revealed indirect effects of MSM status on tobacco use mediated through cannabis refusal self-efficacy and cannabis use patterns. The findings support minority stress theory as a framework for understanding elevated substance use in multiply marginalized populations.
“While this study highlights important health disparities, the cross-sectional design limits our ability to establish causation or predict clinical outcomes. The focus on self-efficacy as a predictor provides a potentially actionable target for clinical interventions, though we need longitudinal data to understand how these patterns evolve over time.”
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FAQ
Are Black men who have sex with men (MSM) at higher risk for cannabis and tobacco co-use?
Yes, this study found that Black MSM reported significantly higher rates of both cannabis and tobacco use compared to Black non-MSM. Among the 202 participants, Black MSM demonstrated higher co-use patterns, with minority stress theory helping explain these disparities through multiple social stressors.
How common is cannabis and tobacco co-use among young Black men?
In this study of Black men aged 18-34, approximately 31% (62 out of 202) reported co-using both cannabis and tobacco in the past 30 days. Overall, 60% reported cannabis use and 34% reported tobacco use, indicating substantial overlap between substances.
What role does cannabis refusal self-efficacy play in substance use patterns?
Black MSM showed lower cannabis refusal self-efficacy compared to non-MSM, meaning they felt less confident in their ability to refuse cannabis in various situations. The study identified that MSM status indirectly affects tobacco use through reduced cannabis refusal self-efficacy and increased cannabis use.
Why might Black MSM be particularly vulnerable to cannabis and tobacco co-use?
The study suggests that Black MSM face multiple minority stressors (racial and sexual minority status) that may increase substance use as a coping mechanism. This “multiple minority status” creates unique psychological pressures that can lead to higher rates of both cannabis and tobacco use.
What are the clinical implications for healthcare providers treating Black MSM patients?
Providers should screen Black MSM patients more thoroughly for both cannabis and tobacco use, recognizing the high likelihood of co-use patterns. Interventions should address minority stress factors and focus on building cannabis refusal self-efficacy, as this appears to be a key pathway to reducing overall substance use in this population.
