Black men who have sex with men reported more cannabis use and lower ability to refuse cannabis than other Black men

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.

Chang, Kyle et al.·Substance use & misuse·2025·Moderate EvidenceCross-Sectional
RTHC-06183Cross SectionalModerate Evidence2025RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Cross-Sectional
Evidence
Moderate Evidence
Sample
N=202

What This Study 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.

Key Numbers

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 They Did This

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.

Why This Research 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 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.

What This Study Doesn't Tell Us

Cross-sectional design prevents causal claims; convenience sample may not represent all Black MSM; self-reported substance use; single geographic area.

Questions This Raises

  • ?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?

Trust & Context

Key Stat:
121 of 202 Black men reported cannabis use in the past 30 days
Evidence Grade:
Path analysis with theory-driven model, but cross-sectional design and convenience sample limit generalizability.
Study Age:
Published 2025
Original Title:
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.
Published In:
Substance use & misuse, 1-9 (2025)
Database ID:
RTHC-06183

Evidence Hierarchy

Meta-Analysis / Systematic Review
Randomized Controlled Trial
Cohort / Case-Control
Cross-Sectional / ObservationalSnapshot without intervening
This study
Case Report / Animal Study

A snapshot of a population at one point in time.

What do these levels mean? →

Frequently Asked Questions

Did sexual orientation affect cannabis use among Black men?

Yes. Black MSM reported higher rates of cannabis use, tobacco use, co-use, and lower cannabis refusal self-efficacy compared to Black non-MSM.

How were cannabis and tobacco use connected?

Path analysis found cannabis use mediated the relationship between MSM status and tobacco use, suggesting cannabis use may serve as a pathway to tobacco among Black MSM.

Read More on RethinkTHC

Cite This Study

RTHC-06183·https://rethinkthc.com/research/RTHC-06183

APA

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

MLA

Chang, Kyle, et al. "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, 2025. https://doi.org/10.1080/10826084.2025.2592877

RethinkTHC

RethinkTHC Research Database. "Tobacco and Cannabis Use and co-Use, and Cannabis Refusal Se..." RTHC-06183. Retrieved from https://rethinkthc.com/research/chang-2025-tobacco-and-cannabis-use

Access the Original Study

Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.

This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.