# Ecological momentary assessment of daily minority stressors and cannabis and tobacco co-use among sexual minority young adults

> **NIH NIH R21** · UNIVERSITY OF OKLAHOMA HLTH SCIENCES CTR · 2024 · $216,772

## Abstract

PROJECT SUMMARY
Past-month cannabis use and tobacco use, independently, is 2 times higher in sexual minority young adults (SMYAs)
(defined here as lesbian, gay, queer, bisexual/bisexual+3) compared to their heterosexual peers.4 Young adulthood is
a vulnerable period for substance use initiation and progression5-7, coming out8, 9, and experiencing sexual orientation
discrimination.10 In fact, nearly 1 in 6 young adults (YAs) identifies as a sexual minority (SM). Bisexual and bisexual+
(bi/bi+) identity is the most common and fastest growing group of all SM identities,11 and individuals who identify as
bi/bi+ are at greatest risk for tobacco and cannabis use, independently, relative to both heterosexual and gay/lesbian
individuals.12,13 Cannabis and tobacco co-use (referred to as CAN-TOB co-use) has become increasingly popular in the
general population14-20, particularly among young adults (YAs), yet little is known about CAN-TOB co-use in SMYAs.21
This is concerning, as CAN-TOB co-use is correlated with greater cannabis and nicotine dependence,22, 23 poorer
tobacco and cannabis cessation outcomes,24, 25 as well as substance use and mental health problems,6, 26-31 relative to
single use of either. The popularity of non-cigarette tobacco products (e-cigarettes, cigars, etc.) among SMYAs is also
concerning, as these can be used as vehicles to consume cannabis.32-35 Minority Stress Theory36 indicates that coping
with sexual minority stressors (e.g., experiences of discrimination) is an important reason for substance use among SM
individuals.36, 37 Cannabis use has been associated with mood enhancement and tension-reduction, and may be
particularly appealing to SMYAs as a means to cope with minority stress experiences. Certain patterns of CAN-TOB
co-use, like blunt smoking, which result in an intense high38, 39, may appreciably temper or mitigate the negative mental
and emotional impacts of daily and “in the moment” minority stressors, and encourage future use of cannabis or other
substances, placing SM individuals at greater risk for negative consequences.40 Little data exist on day-to-day and “in
the moment” minority stressors and how they are correlated with different patterns of CAN-TOB co-use and single use
among SMYAs. This proposal addresses this gap by seeking to characterize different minority stressors among SMYAs
and examine their associations to daily patterns of CAN-TOB co-use and single use, in a sample of 150 SMYAs (ages
18-25) who are current tobacco users and consume cannabis > 2 a week. It is responsive to NOT-OD-22-166 (Research
on the Health of Bisexual and Bisexual+ People). Participants will track CAN-TOB single use and co-use as well as “in
the moment” minority stressors (e.g., daily experiences of discrimination) twice daily for 28 days via ecological
momentary assessment (EMA). We will characterize patterns of CAN-TOB single use and co-use and assess the
indirect association of daily minority stressors on the association of sex...

## Key facts

- **NIH application ID:** 11057000
- **Project number:** 1R21MD019345-01A1
- **Recipient organization:** UNIVERSITY OF OKLAHOMA HLTH SCIENCES CTR
- **Principal Investigator:** Amy M Cohn
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $216,772
- **Award type:** 1
- **Project period:** 2024-09-21 → 2026-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/11057000

## Citation

> US National Institutes of Health, RePORTER application 11057000, Ecological momentary assessment of daily minority stressors and cannabis and tobacco co-use among sexual minority young adults (1R21MD019345-01A1). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/11057000. Licensed CC0.

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