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To 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. A 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. The 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. Young 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. • Approximately 14% of young adults used dual tobacco and cannabis. • Distress about most social problems were associated with exclusive cannabis use. • Distress about police brutality was associated with dual tobacco and cannabis use. [ABSTRACT FROM AUTHOR]

Little is known about the respiratory health effects of dual (two products) and polytobacco (three or more products) use among youth in the United States. Thus, we followed a longitudinal cohort of youth into adulthood using data from Waves 1–5 (2013–2019) of the Population Assessment of Tobacco and Health Study, examining incident asthma at each follow-up (Waves 2–5). We classified past 30-day tobacco use as 1) no products (never/former use), 2) exclusive cigarettes, 3) exclusive electronic nicotine delivery systems (ENDS), 4) exclusive other combustible (OC) tobacco products (cigars, hookah, pipe), 5) dual cigarettes/OC and ENDS, 6) dual cigarettes and OCs, and 7) polytobacco use (cigarettes, OCs, and ENDS). Using discrete time survival models, we analyzed the incidence of asthma across Waves 2–5, predicted by time-varying tobacco use lagged by one wave, and adjusted for potential baseline confounders. Asthma was reported by 574 of the 9141 respondents, with an average annual incidence of 1.44% (range 0.35% to 2.02%, Waves 2–5). In adjusted models, exclusive cigarette use (HR: 1.71, 95% CI: 1.11–2.64) and dual cigarette and OC use (HR: 2.78, 95% CI: 1.65–4.70) were associated with incident asthma compared to never/former use, while exclusive ENDS use (HR: 1.50, 95% CI: 0.92–2.44) and polytobacco use (HR: 1.95, 95% CI: 0.86–4.44) were not. To conclude, youth who use cigarettes with or without OCs had higher risk of incident asthma. Further longitudinal studies on the respiratory health effects of ENDS and dual/polytobacco use are needed as products continue to evolve. • Over five years, the average annual hazard of asthma was 1.44%. • Youth who exclusively used cigarettes (vs. never/former use) had higher risk for incident asthma. • Dual use of cigarettes and other combustibles (vs. never/former use) was associated with incident asthma. • Electronic nicotine delivery systems use (vs. never/former use) was not associated with incident asthma. [ABSTRACT FROM AUTHOR]