• Hongying Daisy Dai, Grace Thiel, and Dylan Hafer.
• College of Public Health University of Nebraska Medical Center, Omaha, NE, United States. Electronic address: daisy.dai@unmc.edu.
• Prev Med. 2024 Jan 1; 178: 107811107811.

ObjectivesThis study sought to examine associations between U.S. adolescents' perceived racism and discrimination (PRD) at school and current substance use.MethodsData were drawn from the Adolescent Behaviors and Experiences Survey (ABES), a probability sample of U.S. high school students in 2021 (n = 7705). Multivariable regression models were conducted to examine associations of PRD with current (past 30-day) use of tobacco products, marijuana, alcohol, and prescription opioid misuse. Interaction effects of PRD and demographic factors were tested.ResultsAmong participants in the 2021 ABES, PRD was associated with higher odds of current use of tobacco (AOR = 1.3, p = 0.03), marijuana (AOR = 1.3, p = 0.03), alcohol (AOR = 1.2, p = 0.03), and misuse of prescription opioids (AOR = 1.6, p = 0.004). The effects of PRD on current tobacco and alcohol use differed by Hispanic and non-Hispanic adolescents (interaction effect = 0.007 and 0.01, respectively) with higher odds among Hispanic youth than among non-Hispanic counterparts. The associations of PRD and current tobacco use, marijuana use, alcohol use, and misuse of prescription opioids were moderated by sex with more pronounced effects on males than females.ConclusionsEfforts to promote awareness and create support environments that value diversity and inclusivity at school are needed to mitigate adolescent exposure to racism and discrimination.Copyright © 2023 Elsevier Inc. All rights reserved.

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