• Delvon T Mattingly, Briana Mezuk, Michael R Elliott, Harold W Neighbors, Adam M Leventhal, and Nancy L Fleischer.
• Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI 48109, USA; Department of Behavioral Science, University of Kentucky College of Medicine, Lexington, KY 40536, USA; Center for Health Equity Transformation, University of Kentucky College of Medicine, Lexington, KY 40536, USA. Electronic address: delvonmattingly@uky.edu.
• Prev Med. 2024 Feb 1; 179: 107850107850.

ObjectiveTo examine associations of concern, worry, and stress about discrimination, shootings/violence, and police brutality and exclusive and dual tobacco and cannabis use among young adults.MethodsA prospective, racially/ethnically diverse cohort of young adults (n = 1960) living in Los Angeles, California completed a baseline survey in 2020 (age range: 19-23) and a follow-up survey in 2021. Exploratory factor analysis (EFA) was employed on nine variables assessing levels of concern, worry, and stress about societal discrimination, societal shootings/violence, and community police brutality at baseline. Past 30-day tobacco and cannabis use at follow-up was categorized as current exclusive tobacco, exclusive cannabis, and dual tobacco and cannabis (vs never/former) use based on eleven use variables. Multinomial logistic regressions estimated adjusted associations between each factor score (translated to standard deviation units) with exclusive and dual tobacco and cannabis use.ResultsThe EFA produced four factor scores representing concern/worry/stress (i.e., distress) about community police brutality (F1), distress about societal shootings/violence (F2), and distress about societal discrimination (F3), as well as generalized stress about police brutality, shootings/violence, and discrimination (F4). F1, F2, and F3 were associated with subsequent exclusive current cannabis use, with F1 having the strongest association (OR: 1.35, 95% CI: 1.18-1.55), while only F1 (OR: 1.51, 95% CI: 1.27-1.78) was associated with dual tobacco and cannabis use. None of the factors were associated with exclusive tobacco use.ConclusionsYoung adult concern, worry, and/or stress about social problems may increase risk of cannabis use with or without concurrent tobacco use 6-12 months later.Copyright © 2024 Elsevier Inc. All rights reserved.

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