Black MSM reported higher rates of tobacco and cannabis use and lower cannabis refusal self-efficacy than Black non-MSM, with cannabis use mediating the pathway from sexual minority status to tobacco use.
Substance use researchers, LGBTQ+ health providers, harm reduction specialists
121 of 202 Black men reported cannabis use in the past 30 days
What the researchers found
MSM reported more tobacco and cannabis use and lower cannabis refusal self-efficacy; path analysis showed indirect effects linking MSM status to tobacco use through cannabis refusal self-efficacy and cannabis use.
Why it matters
Cannabis and tobacco co-use patterns differ across populations, and understanding how minority stress drives substance use among Black MSM can inform targeted harm reduction.
The numbers in context
202 participants; 68 reported tobacco use, 121 reported cannabis use, 62 reported co-use in past 30 days; MSM had higher rates across all measures.
How the study worked
Cross-sectional study of 202 Black men ages 18-34 (94 MSM, 108 non-MSM); measured past-30-day substance use and cannabis refusal self-efficacy; path analysis guided by minority stress theory.
What this study cannot tell us
Cross-sectional design prevents causal claims; convenience sample may not represent all Black MSM; self-reported substance use; single geographic area.
How to read the evidence
Path analysis with theory-driven model, but cross-sectional design and convenience sample limit generalizability.
When this study was published
Published 2025
The bigger picture
Minority stress theory suggests intersecting identities (Black, male, sexual minority) compound substance use risk, with cannabis refusal self-efficacy as a potential intervention target.
Questions still open
- Would strengthening cannabis refusal self-efficacy reduce both cannabis and tobacco use in Black MSM? Do these patterns hold across different age groups and regions?
Common questions
Did sexual orientation affect cannabis use among Black men?
How were cannabis and tobacco use connected?
Read the original research
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.
Substance use & misuse, 1-9
Citation
Chang, Kyle; D'Anna, Laura Hoyt; Owens, Jaelen; Wood, Jefferson L. (2025). 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.. Substance use & misuse, 1-9. https://doi.org/10.1080/10826084.2025.2592877
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