Objectives. We examined the association between perceived discrimination and smoking status and whether psychological distress mediated this relationship in a large, multiethnic sample.
Methods. We used 2004 through 2008 data from the Behavioral Risk Factor Surveillance System Reactions to Race module to conduct multivariate logistic regression analyses and tests of mediation examining associations between perceived discrimination in health care and workplace settings, psychological distress, and current smoking status.
Results. Regardless of race/ethnicity, perceived discrimination was associated with increased odds of current smoking. Psychological distress was also a significant mediator of the discrimination–smoking association.
Conclusions. Our results indicate that individuals who report discriminatory treatment in multiple domains may be more likely to smoke, in part, because of the psychological distress associated with such treatment.
- Jason Q. Purnell and Kassandra Alcaraz are with the George Warren Brown School of Social Work, Washington University in St. Louis, St. Louis, MO. Luke J. Peppone and Gary R. Morrow are with the Department of Radiation Oncology, University of Rochester School of Medicine & Dentistry, Rochester, NY. Amy McQueen is with the Department of Medicine, School of Medicine, Washington University in St. Louis. Joseph J. Guido is with the Department of Community & Preventive Medicine, University of Rochester School of Medicine & Dentistry. Jennifer K. Carroll is with the Department of Family Medicine, University of Rochester School of Medicine & Dentistry. Enbal Shacham is with the Department of Behavioral Science & Health Education, Saint Louis University School of Public Health.
