Abstract B015: Examining the role of psychosocial stressors in concurrent smoking and alcohol consumption among African American adults

Abstract Introduction: Cigarette smoking and alcohol consumption remain leading causes of preventable cancers and mortality in the United States, and there is growing evidence that their effect could be additive. African Americans experience a disproportionate burden of psychosocial stress, driven in part by interpersonal inequities and structural racism. However, limited research has explored how everyday stressors may influence concurrent smoking and alcohol consumption behaviors within this population. This study examines the role of various personal, interpersonal, and occupational everyday stressors on smoking status and alcohol use among African Americans. Methods: This study analyzed data from a national probability survey of African Americans (AA) conducted in 2008. The analytic sample included 1,956 AA aged 21 and older with complete survey responses to smoking status, alcohol use, psychosocial stressors, and covariates. The dependent variable categorized participants into four groups: neither use (reference), smoking only, alcohol only, and both smoking and drinking (‘dual use’). Smoking was defined as smoking ≥100 cigarettes in one’s lifetime, and alcohol use was defined as consumption within the past 30 days (yes/no). Adapted from the Hassles and Uplifts Scale (Kanner et al., 1981), the independent binary variables for everyday psychosocial stressors included interpersonal conflict, daily hassles, loneliness, dissatisfaction with physical abilities, and work-related challenges. Covariates included age, gender, educational attainment, and median household income. A multinomial logistic regression model was used to examine associations between stressors and the categorical outcome, adjusting for covariates. Results: Of the participants, 35.4% reported neither smoking nor drinking, 21.3% reported smoking only, 21.1% reported alcohol use only, and 22.2% reported dual use. The adjusted logistic regression model revealed that several interpersonal stressors were significantly associated with increased odds of dual use. Feeling let down by friends (Adjusted odds ratio [AOR] = 1.60, 95% confidence interval [CI]: 1.21–2.13, p = .001), experiencing separation from loved ones (AOR=1.40, 95% CI: 1.06–1.84, p = .017), and having conflict with a romantic partner (AOR = 1.38, 95% CI: 1.03–1.84, p = .029) were all significantly associated with dual use compared to neither use. In contrast, stressors tied to occupational dissatisfaction, daily hassles, sleep deprivation, physical health concerns, and loneliness did not show significant associations with concurrent substance use behaviors. Additional models examined smoking-only and alcohol-only groups. Conclusions: These findings indicate that interpersonal stressors may play a more central role than those at individual or occupational levels in influencing concurrent smoking and alcohol consumption behaviors within the AA population. Future studies should explore how interpersonal stressors may interact with structural factors (e.g., housing instability, racism) to shape smoking and alcohol use behaviors. Citation Format: Tiffany F. Saavedra, Cheryl L. Knott. Examining the role of psychosocial stressors in concurrent smoking and alcohol consumption among African American adults [abstract]. In: Proceedings of the 18th AACR Conference on the Science of Cancer Health Disparities; 2025 Sep 18-21; Baltimore, MD. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2025;34(9 Suppl):Abstract nr B015.