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. Author manuscript; available in PMC: 2026 Jan 15.
Published before final editing as: J Stud Alcohol Drugs. 2025 Aug 6:10.15288/jsad.25-00003. doi: 10.15288/jsad.25-00003

Pandemic-related stressors linked to cannabis and nicotine use in a longitudinal study of Asian, Latinx, and White young adults

Griselda Martinez 1, Charles B Fleming 1, Isaac C Rhew 1, Jason R Kilmer 1,2, Mary E Larimer 1,2, Katarina Guttmannova 1
PMCID: PMC12802416  NIHMSID: NIHMS2115827  PMID: 40768379

Abstract

Objective:

Systemic inequities are associated with stressor experiences of racial and ethnic minoritized individuals and disparities in health and substance use. Recently, young adults (YAs) experienced pandemic-related stressors but the differences in exposure and their long-term implications for substance use are not well-understood. We examined associations of pandemic-related stressors with alcohol, cannabis, and nicotine use among non-Latinx (NL) Asian, Latinx, and NL White YAs in the context where the use of these substances is legal for those 21+.

Methods:

We used data from a statewide longitudinal (2019–2022) sample of YAs in Washington State (N=3,646; 13.8% NL Asian, 16.6% Latinx, and 69.6% NL White; 74.9%, 75.1%, and 74.2% female, respectively). Stressors in 2020 were regressed on race and ethnicity and 2019 background covariates. Substance use outcomes (modeled as latent variables of use in 2020–2022) were regressed on race and ethnicity, 2020 stressors, and background covariates.

Results:

Latinx YAs experienced more pandemic-related stressors than NL White YAs. Across 2020–2022 and adjusting for use in 2019, Latinx YAs reported more cannabis use days and NL Asian YAs reported fewer cannabis and alcohol use days than NL White YAs. Stressors were positively and significantly associated with cannabis, cigarette, and e-cigarette use in 2020–2022 but were not strongly associated with alcohol use. Associations between substance use and stressors were similar across groups.

Conclusions:

Pandemic-related stressors may have long-term implications for YAs’ substance use, and these stressors are an area of emphasis for preventive interventions.

Keywords: COVID-19 pandemic, stressors, alcohol use, cannabis use, nicotine use, young adults

Introduction

Long-standing systemic inequities impact the health and well-being of racial and ethnic minoritized people (Anderson et al., 2023; Romano et al., 2021; Sumibcay et al., 2024). Inequities include disparities in stressor experiences (Breslow et al., 2023; McKnight-Eily et al., 2021; Williams, 2018), which can lead to negative health and substance use outcomes (Tao et al., 2023; Williams, 2018). Recently, young adults experienced pandemic-related stressors, such as disruptions in employment, education, and living situation (Bakal et al., 2024; Cho et al., 2023; Graupensperger et al., 2023; Jaffe et al., 2023; Pokhrel et al., 2023). Differences in exposure to pandemic-related stressors and the long-term implication of stressors for substance use across ethnic and racial groups are not well understood.

Young adulthood is a period of heightened risk for substance use (Maggs & Schulenberg, 2004; Patrick et al., 2023), and substance use during this period is associated with short- and long-term negative social, emotional, and behavioral consequences (Hall et al., 2020; White & Hingson, 2013). Stressors are risk factors for substance use behaviors (Hyman & Sinha, 2009; Russell et al., 2017) and according to the self-medication model, young adults may engage in substance use to alleviate distress and negative emotions (Khantzian, 1997). Moreover, the negative affect model (Baker et al., 2004) suggests that stressors may be an antecedent to negative mood and emotions, which is in turn associated with substance use to reduce the impact of stressors. During the COVID-19 pandemic, direct and indirect positive associations of pandemic-related stressors with substance use and related negative consequences were observed among young adults (Cho et al., 2023; Graupensperger et al., 2023; Jaffe et al., 2023; Pokhrel et al., 2023). Although not specific to young adults, studies have shown that ethnic and racial minoritized individuals reported more pandemic-related stressors (Breslow et al., 2023; McKnight-Eily et al., 2021), which have been positively associated with more substance use among these groups (Tao et al., 2023).

Prior work with ethnic and racial minoritized populations, including young adults, have also highlighted the changing patterns of alcohol, cannabis, and tobacco use during the pandemic (Brotto et al., 2021; Fleming et al., 2025; Graupensperger et al., 2021; Hicks et al., 2022). A study examining substance use during the pandemic found that Asian young adults reported a steeper decrease in drinks per occasion relative to their non-Hispanic/Latinx White peers (Graupensperger et al., 2021). One study with individuals aged 18+ found that Latinx individuals were more likely to report increases or initiation of substance use to cope with stressors or emotions during the pandemic than other ethnic and racial groups (McKnight-Eily et al., 2021).

While studies on pandemic-related stressors, substance use, and their associations provide important information about the experiences of young adults, much of this work has been conducted during the early phases of the COVID-19 pandemic (e.g., 2020–2021). Given the rise of stressors during the pandemic, which were salient among ethnic and racial minoritized communities (Bakal et al., 2024; Breslow et al., 2023; McKnight-Eily et al., 2021; Tao et al., 2023), it is important to understand their long-term implications. However, it is not well understood whether pandemic-related stressors are associated with young adult substance use over the course of the early through late stages of the pandemic.

Legalization of nonmedical cannabis use has implications for young adult substance use (Fleming et al., 2022; Guttmannova et al., 2023; Kilmer et al., 2022). Following medical and recreational legalization of cannabis use, increases in cannabis use have been observed among ethnic and racial minoritized individuals nationally (Martins et al., 2021) and in Washington State (WA) (Johnson et al., 2019) with Latinx young adults reporting a similar or higher prevalence of past-month and past-year cannabis use than White young adults in the past decade (Patrick et al., 2023). WA legalized nonmedical cannabis use for those 21+ in 2012 (Cambron et al., 2016), and the legal age to purchase tobacco products changed to 21 in January 2020. As many closures of businesses occurred during the Spring 2020 related to the COVID-19 pandemic, cannabis retail stores and alcohol outlets were considered “essential businesses” and remained open (Kilmer et al., 2024). Thus, access to both cannabis and alcohol for offsite consumption was not diminished during the pandemic.

This study had three aims and focused on the developmental period of young adulthood to examine (1) ethnic and racial differences in pandemic-related stressors; (2) ethnic and racial differences in past-month alcohol use days, cannabis use days, any cigarette use, and any e-cigarette use during the early through late stages of the pandemic (2020–2022) adjusting for use in 2019; and (3) the extent to which pandemic-related stressors were associated with substance use and may account for racial and ethnic differences in substance use. We hypothesized that (1) NL Asian and Latinx young adults would report more pandemic-related stressors compared to NL White young adults and explored differences between NL Asian and Latinx young adults; (2) NL Asian and Latinx young adults would report less substance use than NL White young adults, except that Latinx young adults would report more cannabis use than NL White young adults and we explored differences between NL Asian and Latinx young adults; and (3) pandemic-related stressors would be associated with more substance use across all three groups with stressors accounting for ethnic and racial differences in cannabis use.

Method

Study Sample and Design

Data came from the Young Adult Health Survey (Kilmer et al., 2022), a cohort sequential longitudinal study that administered annual online surveys to young adults in WA. Beginning in 2014, cohorts of approximately 2,000 young adults aged 18–25 enrolled in the study each year, and then were followed annually. New cohorts were recruited every year. Participants were recruited by mail, using a list of eligible young adults provided by the WA Department of Licensing (DOL), or online through social media websites. The YAHS assessed substance use, related risk factors, and health behaviors and could be completed in approximately 20 minutes. Participants received $10 e-gift cards as compensation for completion (Kilmer et al., 2022). For the current study we used data collected in 2019–2022 from cohorts initially recruited in 2015–2019. Data collection periods in 2019–2022 were from June–December. The University of Washington Institutional Review Board approved all measures and procedures.

The analytic sample included 3,646 young adults who (1) provided data on past-month cannabis use and background sociodemographic covariates in 2019 and pandemic-related stressors in 2020, (2) provided data on cannabis use in at least one year between 2020 and 2022, and (3) identified as non-Latinx (NL) White, Latinx, or NL Asian. Limiting the sample to three racial and ethnic groups excluded 397 individuals who met the other eligibility criteria but belonged to racial and ethnic groups that comprised small portions of the sample. Among those 397 excluded, 43 (10.8%) were NL Black, 20 (5.0%) were NL Native American or Alaskan Native, 11 (2.8%) NL Pacific Islander or Native Hawaiian, and 323 (81.4%) NL of multiple races. Of the 2019 analytic sample, 61.6% had data in 2021 and 74.8% had data in 2022 and consisted of 2,538 (69.6%) NL White, 606 (16.6%) Latinx, and 502 (13.8%) NL Asian young adults. All young adults were living in WA at the time of recruitment and most continued to do so at the time of their follow-up surveys (ranging from 92.5% in 2019 to 82.4% in 2022). Table 1 shows descriptive information on sociodemographic characteristics by racial and ethnic group.

Table 1.

Background sociodemographic covariates and substance use outcomes by race and ethnicity

Variables NL White Latinx NL Asian
Study Year N N N
 2019 2,538 606 502
 2020 2,538 606 502
 2021 1,545 386 314
 2022 1,896 432 399
N(%)/M(SD) N(%)/M(SD) N(%)/M(SD) Χ2/F p−value
Female 1,884 (74.2) 455 (75.1) 376 (74.9) 0.24 .885
Year in YAHS 21.14 .007
 2015 480 (18.9) 99 (16.3) 99 (19.7)
 2016 663 (26.1) 125 (20.6) 147 (29.3)
 2017 401 (15.8) 101 (16.7) 68 (13.5)
 2018 664 (26.2) 181 (29.9) 120 (23.9)
 2019 330 (13.0) 100 (16.5) 68 (13.5)
Age in 2019 24.54 (2.73) 23.68 (2.81) 24.15 (2.75) 25.55 <.001
College status 59.05 <.001
 Not in school 1644 (64.8) 354 (58.4) 254 (50.6)
 2-year college 456 (18) 146 (24.1) 127 (25.3)
 4-year college 196 (7.7) 60 (9.9) 39 (7.8)
 Grad or prof 242 (9.5) 46 (7.6) 82 (16.3)
Employ status 15.12 .004
 Not employed 489 (19.3) 135 (22.3) 129 (25.7)
 Part 731 (28.8) 189 (31.2) 140 (27.9)
 Full 1318 (51.9) 282 (46.5) 233 (46.4)
Live w parents 614 (24.2) 214 (35.3) 208 (41.4) 78.26 <.001
COVID stressors 2020 2.26 (1.86) 2.55 (1.96) 2.14 (1.83) 8.06 <.001
Mj daysa
 2019 3.91 (8.65) 3.84 (8.47) 1.76 (5.51) 14.50 <.001
 2020 4.38 (9.21) 4.38 (9.2) 2.06 (6.31) 14.76 <.001
 2021 4.40 (9.16) 4.53 (8.98) 2.24 (6.44) 8.25 <.001
 2022 4.12 (8.93) 5.14 (9.6) 2.05 (5.88) 13.66 <.001
Alc daysa
 2019 5.34 (6.38) 4.12 (5.83) 3.03 (4.26) 35.28 <.001
 2020 6.08 (7.2) 4.7 (6.53) 3.04 (4.85) 45.53 <.001
 2021 5.74 (6.86) 4.7 (6.3) 3.61 (5.11) 15.28 <.001
 2022 5.51 (6.45) 4.49 (6.11) 3.74 (5.32) 15.38 <.001
Any cig
 2019 198 (7.8) 19 (3.2) 16 (3.2) 27.62 <.001
 2020 174 (6.9) 32 (5.3) 13 (2.6) 14.16 <.001
 2021 88 (5.7) 12 (3.1) 9 (2.9) 7.59 .022
 2022 101 (5.3) 13 (3.0) 16 (4.0) 4.64 .098
Any e−cig
 2019 258 (10.2) 64 (10.6) 38 (7.6) 3.53 .172
 2020 219 (8.7) 55 (9.2) 26 (5.2) 7.32 .026
 2021 159 (10.3) 35 (9.1) 28 (9) 0.86 .649
 2022 185 (9.8) 44 (10.2) 29 (7.3) 2.61 .271
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Note. NL=non-Latinx. YAHS=Young Adult Health Survey. Grad or prof=graduate or professional school

a

Coded as missing if days=0. Bold typeface indicates p < .05.

Measures

Race and ethnicity.

Ethnic and racial identity were based on the 2019 survey. Latinx ethnicity was based on the item, “Are you Hispanic or Latino/a?” and racial identity was based on a “check all that apply” item offering seven categories including “More than one race” and “other”.

Substance use.

Annual surveys included questions about past-month days of cannabis, alcohol, cigarette, and e-cigarette use. Across years, 28–30% reported past-month cannabis use and 68–69% reported past-month alcohol use and their measures were operationalized as past-month days of use (ranging from 0–30). Any past-month use of cigarettes and e-cigarettes ranged from 5% to 7% and 8% to 10%, respectively, and measures were dichotomized to denote any past-month use.

Pandemic-related stressors.

In the 2020 survey, participants were asked about 12 stressors they might have experienced because of the novel coronavirus (COVID-19) pandemic (e.g., “Lost your job altogether”; “Had trouble paying bills (e.g., rent, food, medical, etc.)”). A full list of the pandemic-related stressors and percentage of participants who experienced each stressor can be found in Table 2. The measure of pandemic-related stressors for current analyses was based on the total number of items endorsed (ranging from 0 to 12).

Table 2.

COVID-19 pandemic-related stressors in 2020 (N=3,646)

Total Sample (N=3,646) NL White (N=2,538) Latinx (N=606) NL Asian (N=502)
Stressor n % n % n % n % Χ2 p
Laid off or furloughed from a prior job (i.e., with communication that they intend to bring you back when circumstances improve)? 709 19.4 480 18.9 137 22.6 92 18.3 4.73 .094
Had your work hours reduced? 1,775 30.7 763 30.1 195 32.2 161 32.1 1.55 .461
Lost your job altogether? 404 11.1 275 10.8 83 13.7 43 9.2 6.24 .044
Had your work hours increased? 553 15.2 381 15.0 97 16.0 75 14.9 0.40 .819
Gotten a job when you were previously unemployed? 281 7.7 201 7.9 52 8.6 28 5.6 4.01 .135
Taken an additional job? 311 8.5 208 8.2 58 9.6 45 9.0 1.33 .515
Had an important life event canceled or postponed? 1469 40.3 1042 41.1 248 40.9 179 35.7 5.20 .074
Altered plans for college? 658 18.0 417 16.4 146 24.1 95 18.9 19.72 <.001
Lost a loved one due to the virus? 126 3.5 73 2.9 34 5.6 19 3.8 11.15 .004
Had a change in living situation? 765 21.0 515 20.3 127 21.0 123 24.5 4.48 .106
Had trouble paying bills (e.g., rent, food, medical, etc.)? 770 21.1 518 20.4 170 28.1 82 16.3 25.15 <.001
Had difficulty maintaining health care, both mental and/or physical? 1182 32.4 855 33.7 200 33.0 127 25.3 13.58 .001
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Note. NL=non-Latinx. p=p-value. Bold typeface indicates p < .05.

Covariates.

Covariates included variables we found, in prior analyses of data from this project (Fleming et al., 2022; Gilson et al., 2022; Kilmer et al., 2022), to be associated with substance use or social role statuses plausibly related to pandemic-related stressors, substance use, and race and ethnicity. Demographic covariates included sex assigned at birth (0=male, 1=female) and age in years at the time of the 2019 survey. Variables denoting social role status in 2019 included education (indicator coded into four categories: not in school [reference], community college or vocational school, four-year college, professional or graduate school), employment (coded into three categories: not employed [reference], parttime, fulltime), and living situation (whether living with parents).

Analyses

After considering sample descriptive statistics and bivariate associations of background covariates and substance use with race and ethnicity, we estimated a multiple linear regression model predicting pandemic-related stressors in 2020 (skewness=0.92, Kurtosis=0.66; 21%=zero stressors) to assess stressor experiences across racial and ethnic groups (Aim 1, Figure 1 and Appendix Figure A) adjusting for both sociodemographic covariates and each type of substance use in 2019. To address Aim 2, we examined models assessing race and ethnicity as a predictor of each type of substance use in 2020–2022 adjusting for both sociodemographic covariates and each type of substance use in 2019. These models used a latent variable specification for each substance use in that period with use in each of the years as indicators of the latent variable and factor loadings fixed to 1 (Figure 1). This is equivalent to a one factor latent growth model, with the intercept growth factor capturing level of use across the three years. Alternative models with an additional growth factor capturing rate of change across 2020–2022 were tested, but means and variances for the additional growth factor were not significantly different from zero in all four cases; thus, we modeled the intercept growth factor for each substance use outcome. We used a negative binomial distributional model with outcomes specified as counts for days of cannabis and alcohol use and a logistic model with outcomes specified as dichotomous for any cigarette and e-cigarette use. Results of models without (Model 1) and with (Model 2) 2020 stressors are presented. The combination of the model predicting 2020 pandemic stressors and models predicting each type of substance use, with 2020 stressors as one of the covariates, provides the basis of a joint significant test (Leth-Steensen & Gallitto, 2016; MacKinnon, 2012) of indirect effects of race and ethnicity on pandemic-period substance use through stressors (Aim 3). To address Aim 3, we also tested stressors-by-race and ethnicity interaction terms to assess differences in associations between stressors and substance use outcomes by race and ethnicity, and then ran stratified models to see how stressors and other model covariates were related to outcomes for each group. For all models we present both unstandardized and standardized regression coefficients. For effects of race and ethnicity, based on model estimates, we also report standardized effect sizes (ds) for standard deviation unit differences in the given outcome (i.e., 2020 stressors or intercept growth factor for 2020–2022 substance use) associated with Latinx or NL Asian versus NL White. We also estimated regression models for differences between Latinx and NL Asian .

Figure 1. Schematic Model Predicting Latent Variable of Substance Use (Aim 2).

Figure 1.

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Note. Models conducted separately for each type of substance use. We used a negative binomial distributional model for days of cannabis and alcohol use and a logistic model for any cigarettes and e-cigarette use. Background covariates were biological sex, age, education status, work status, and whether living with parents assessed in 2019.

Robust maximum likelihood estimation of regression models allowed for inclusion of cases with partially missing data (i.e., individuals missing substance use data in one or two of the 2020–2022 years), under the assumption that data were missing at random after taking nonmissing values on other model variables into account (Graham, 2012). A statistical significance criterion of p<.05 was used to help organize the presentation of the findings. We used Mplus 8.8 (Muthén & Muthén, 1998–2017) to run all analyses.

Results

Descriptives

Table 1 provides descriptive information on study variables by race and ethnicity. The three groups were similar with respect to proportion female and mean age. Higher proportions of NL Asian participants were in graduate or professional school and not employed in 2019 compared to the other two groups. A smaller proportion of NL White participants were living with parents in 2019 compared to the other groups. Latinx participants reported the most pandemic-related stressors in 2020 on average, followed by NL White and NL Asian participants. Across years, average number of cannabis use days in the past month were similar for NL White and Latinx young adults, while lower for NL Asian participants. More days of alcohol use were reported by NL White participants than either of the other two groups. Any cigarette use prevalence was also higher among NL White participants, although decreasing across years. Smaller proportions of Latinx and NL Asian individuals reported any cigarette use than NL White participants. E-cigarette use prevalence was similar across groups, except for 2020 when prevalence was lower for NL Asian participants than the other groups.

Table 2 provides descriptive information on ethnic and racial differences in 2020 pandemic-related stressors. Higher proportions of Latinx than NL Asian and NL White young adults reported losing their job altogether, altering plans for college, losing a loved one due to the virus, and having trouble paying bills. A similar proportion of Latinx and NL White young adults reported having difficulty maintaining health care.

Multiple regression model predicting pandemic-related stressors.

Estimates for the model predicting stressors in 2020 are consistent with the results of bivariate analyses (Table 3 and Figure 2). Of primary interest, the model showed a significant differences between racial and ethnic groups. Latinx young adults reported more stressors than both NL White (β = .04, d = .10, p = .023) and NL Asian (β = .07, d = .18, p = .002) participants, adjusting for other model covariates.

Table 3.

Covariates predicting pandemic-related stressors in 2020 among the whole sample, with race and ethnicity indicator coded

Predictor B SE β P
Race/ethnicity (ref.=NL White)
 Latinx 0.189 0.083 0.04 .023
 NL Asian −0.150 0.087 −0.03 .084
 Latinx vs. NL Asian 0.338 0.108 0.07 .002
Days of cannabis use in 2019 0.026 0.004 0.12 <.001
Days of alcohol use in 2019 0.001 0.005 0.00 .841
Any cigarette use in 2019 0.325 0.148 0.04 .029
Any e−cigarette use in 2019 0.263 0.120 0.04 .028
Female 0.466 0.065 0.11 <.001
Age −0.107 0.028 −0.16 <.001
Age x age 0.004 0.003 0.04 .238
Education status 2019 (ref=not in school)
 community coll or votech 0.678 0.098 0.15 <.001
 4-year coll 0.441 0.120 0.06 <.001
 grad or prof school 0.284 0.102 0.05 .005
Work status 2019 (ref=not working)
 work parttime 0.698 0.086 0.17 <.001
 work fulltime 0.014 0.083 0.00 .869
Live w parents 2019 −0.038 0.070 −0.01 .585
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Note. Ref=Reference. NL=non-Latinx. Votech=vocational or tech school. Grad or prof=graduate or professional school. B=beta coefficient. SE=Standard Error. β=Standardized beta coefficient. p=p-value. Bold typeface indicates p < .05.

Figure 2. Pandemic-related stressors in 2020 across NL Asian, Latinx, and NL White young adults.

Figure 2.

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Note. Model expected stressors at the mean level of other covariates (i.e., sex assigned at birth, age, education level, employment status, and whether living with parent) are presented. NL=Non-Latinx.

Whole sample multiple regression models predicting substance use

Table 4 shows the results of models in which substance use across 2020–2022 was regressed on race and ethnicity, substance use in 2019, background covariates, and pandemic-related stressors. In both models adjusting and not adjusting for pandemic stressors, Latinx participants reported more days of cannabis use (d = .10 in both Model 1 and 2) and NL Asian participants reported fewer days of cannabis use (d = −.15 in both Model 1 and 2) compared to NL White young adults. Adjusted racial and ethnic differences in days of alcohol use indicated less use by both Latinx (d = −.07 in both Model 1 and 2) and NL Asian (d = −.21 in both Model 1 and 2) participants compared to NL White young adults, although only the later difference was statistically significant. There were no statistically significant differences by racial and ethnic groups for any cigarette or e-cigarette use. When comparing substance use between Latinx and NL Asian young adults, Latinx young adults reported more days of alcohol and cannabis use and there were no statistically significant differences for any cigarette and e-cigarette use. Number of 2020 pandemic-related stressors were positively and significantly associated with cannabis, cigarette, and e-cigarette use (βs = .08–.13), while the association with days of alcohol use was positive but small and not significant (β = .03). The statistically significant unique associations of race and ethnicity with 2020 stressors (Table 3) and of stressors with 2020–2022 cannabis, cigarette, and e-cigarette use (Table 4) suggest indirect effects of race and ethnicity variables on cannabis, cigarette, and e-cigarette use but not alcohol use (since the effect of stressors on alcohol use was not significant). These indirect effects are small, however, as indicated by how little the coefficients for race and ethnicity indicators change from Model 1 to Model 2.

Table 4.

Covariates predicting substance use in 2020–2022 among the whole sample, with race and ethnicity indicator coded

Cannabis (N=3646)
Model 1 Model 2
Predictor Variables B SE β p B SE β p
Race/ethnicity (ref.=NL White)
 Latinx 0.313 0.139 0.04 0.024 0.291 0.138 0.04 .036
 NL Asian −0.451 0.168 −0.05 0.007 −0.433 0.168 −0.05 .010
 Latinx vs. NL Asian 0.764 0.198 0.09 <.001 0.724 0.198 0.09 <.001
Any use 2019 0.213 0.004 0.59 <.001 0.209 0.004 0.58 <.001
Female 0.212 0.122 0.03 0.081 0.157 0.122 0.02 .197
Age −0.129 0.050 −0.12 0.010 −0.113 0.051 −0.10 .026
Age x age 0.004 0.006 0.03 0.497 0.004 0.006 0.03 .557
Education status (ref=not in school)
 community coll or votech −0.087 0.162 −0.01 0.591 −0.170 0.162 −0.02 .294
 4-year coll 0.007 0.209 0.00 0.972 −0.056 0.207 −0.01 .788
 grad or prof school −0.195 0.193 −0.02 0.312 −0.228 0.193 −0.02 .238
Work status (ref=not working)
 work parttime 0.240 0.156 0.04 0.123 0.152 0.157 0.02 .335
 work fulltime 0.114 0.157 0.02 0.467 0.111 0.155 0.02 .473
Live w parents 2019 −0.426 0.131 −0.06 0.001 −0.417 0.130 −0.06 .001
Pandemic stressors in 2020 0.130 0.027 0.08 <.001
Alcohol (N=3621)
Model 1 Model 2
Predictor Variables B SE β p B SE β p
Race/ethnicity (ref.=NL White)
 Latinx −0.085 0.058 −0.02 0.138 −0.089 0.058 −0.02 .123
 NL Asian −0.284 0.064 −0.07 <.001 −0.281 0.064 −0.07 <.001
 Latinx vs. NL Asian 0.199 0.078 0.05 .010 0.192 0.078 0.05 .013
Any use 2019 0.136 0.004 0.60 <.001 0.135 0.004 0.60 <.001
Female 0.012 0.049 0.00 0.800 0.003 0.049 0.00 .946
Age −0.027 0.021 −0.05 0.202 −0.024 0.021 −0.05 .245
Age x age 0.002 0.003 0.02 0.551 0.001 0.003 0.02 .570
Education status (ref=not in school)
 community coll or votech 0.114 0.067 0.03 0.089 0.101 0.068 0.03 .135
 4-year coll −0.125 0.089 −0.03 0.159 −0.136 0.089 −0.03 .127
 grad or prof school 0.267 0.067 0.06 <.001 0.263 0.067 0.06 <.001
Work status (ref=not working)
 work parttime 0.358 0.065 0.12 <.001 0.343 0.066 0.11 <.001
 work fulltime 0.431 0.064 0.16 <.001 0.432 0.064 0.16 <.001
Live w parents 2019 −0.245 0.053 −0.08 <.001 −0.243 0.052 −0.08 <.001
Pandemic stressors in 2020 0.021 0.012 0.03 .074
Cigarettes (N=3625)
Model 1 Model 2
Predictor Variables B SE β p B SE β p
Race/ethnicity (ref.=nl white)
 Latinx 0.059 0.298 0.01 0.842 0.021 0.299 0.00 .945
 NL Asian −0.513 0.359 −0.06 0.153 −0.490 0.358 −0.05 .171
 Latinx vs. NL Asian 0.572 0.431 0.07 0.184 0.510 0.432 0.06 .237
Any use 2019 6.422 0.415 0.50 <.001 6.309 0.412 0.49 <.001
Female −0.366 0.239 −0.05 0.125 −0.449 0.241 −0.06 .063
Age −0.139 0.100 −0.12 0.167 −0.108 0.100 −0.10 .280
Age x age 0.011 0.013 0.07 0.375 0.010 0.013 0.06 .436
Education status (ref=not in school)
 community coll or votech 0.064 0.338 0.01 0.850 −0.039 0.341 −0.01 .908
 4-year coll −0.020 0.440 0.00 0.964 −0.103 0.424 −0.01 .807
 grad or prof school −0.933 0.473 −0.09 0.048 −0.985 0.478 −0.09 .039
Work status (ref=not working)
 work parttime 0.206 0.301 0.03 0.494 0.026 0.306 0.00 .931
 work fulltime −0.067 0.317 −0.01 0.833 −0.086 0.313 −0.01 .783
Live w parents 2019 −0.517 0.257 −0.07 0.045 −0.515 0.256 −0.07 .044
Pandemic stressors in 2020 0.214 0.059 0.13 <.001
E−cigarettes (N=3636)
Model 1 Model 2
Predictor Variables B SE β p B SE β p
Race/ethnicity (ref.=NL White)
 Latinx −0.007 0.281 0.00 0.981 −0.058 0.281 −0.01 .836
 NL Asian −0.269 0.328 −0.02 0.411 −0.219 0.325 −0.02 .501
 Latinx vs. NL Asian 0.263 0.392 0.02 0.503 0.161 0.390 0.02 .680
Any use 2019 6.554 0.378 0.51 <.001 6.450 0.374 0.50 <.001
Female −0.279 0.232 −0.03 0.229 −0.410 0.233 −0.05 .079
Age −0.109 0.097 −0.08 0.262 −0.081 0.096 −0.06 .402
Agexage −0.007 0.013 −0.04 0.574 −0.008 0.013 −0.04 .544
Education status (ref=not in school)
 community coll or votech −0.386 0.339 −0.04 0.256 −0.503 0.341 −0.05 .140
 4-year coll −0.005 0.401 0.00 0.991 −0.123 0.397 −0.01 .756
 grad or prof school −1.433 0.449 −0.11 0.001 −1.471 0.445 −0.12 .001
Work status (ref=not working)
 work parttime 0.355 0.310 0.04 0.252 0.150 0.308 0.02 .626
 work fulltime −0.103 0.320 −0.01 0.748 −0.132 0.317 −0.02 .676
Live w parents 2019 −0.116 0.251 −0.01 0.643 −0.095 0.249 −0.01 .703
Pandemic stressors in 2020 0.247 0.057 0.12 <.001
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Note. Ref=Reference. NL=non-Latinx. Coll=college. Votech=vocational or tech school. Grad or prof=graduate or professional school. B=beta coefficient. SE=Standard Error. β=Standardized beta coefficient. p=p-value. Bold typeface indicates p < .05.

Stratified models

Tests of stressors-by-race and ethnicity interactions were not statistically significant in any of the cases (Appendix Table A). Appendix Table B reports results of stratified models that provide estimates for covariate effects for each racial and ethnic group. For cannabis, stressors had a positive effect for all three groups (βs =.08–.09), although not statistically significant for the NL Asian group. For alcohol, effects of stressors were not statistically significant for any of the three groups (βs =.02–.03). For cigarettes and e-cigarettes, effects of stressors were statistically significant for NL White and NL Asian participants. The standardized effect sizes were larger in magnitude for the Latinx group than the NL White group, although uncertainty in estimates was also greater for the Latinx group due to its smaller sample size. For all three groups, effects of stressors were positive for both cigarettes (βs = .11–.22) and e-cigarettes (.11–.17).

Discussion

The current study examined differences in pandemic-related stressors, substance use, and their associations among NL Asian, Latinx, and NL White young adults in 2020–2022 while adjusting for 2019 substance use and background covariates. Research on stressor experiences highlights the importance of examining stressors as they relate to the changing social context (Williams, 2018). A recent example of changing context is the COVID-19 pandemic, which disrupted many areas of young adults’ lives.

The current study findings add to our understanding of pandemic-related stressors among young adults. Prior work with adult healthcare workers has shown that Latinx and NL Asian individuals compared to NL White individuals experienced more pandemic-related stressors (Breslow et al., 2023). A different study with adults aged 18 and older found that Latinx compared to White individuals were more likely to report pandemic-related stressors, such as not having enough food or stable housing (McKnight-Eily et al., 2021). Here, we examined ethnic and racial differences in stressor experiences among a statewide sample of young adults in the context of cannabis legalization. Findings showed that Latinx young adults reported more pandemic-related stressors than NL Asian and NL White young adults. Findings also showed that a higher proportion of Latinx young adults reported experiencing stressors across various domains, such as losing a job or altering plans for college.

We also examined whether there were ethnic and racial differences in substance use during the early and late stages of the pandemic (2020–2022). Nationally representative data suggests differences in cannabis use are narrowing between NL White and Latinx young adults (Patrick et al., 2023). Our findings are consistent with and extend prior work by showing that Latinx young adults compared to NL White young adults reported more cannabis use days during the early to late stages of the pandemic. Although the standardized effect size was relatively small, this finding may have important population-level implications given the sizeable (and growing) percentage of young adults who identify as Latinx in WA. More days of alcohol use were reported by NL White compared to NL Asian young adults, which is consistent with developmental studies showing an escalation in alcohol use during young adulthood, particularly among NL White individuals (Banks & Zapolski, 2018; Chen & Jacobson, 2012). We also found that Latinx young adults compared to NL Asian young adults reported more alcohol use days. While this finding is in line with other work examining differences in alcohol use outcomes between NL Asian and Latinx young adults (Cook & Caetano, 2014), this work is limited, and more studies examining alcohol use differences between ethnic and racial minoritized groups are needed to better understand the heterogeneity in drinking patterns. When adjusting for substance use in 2019, there were no significant differences in nicotine (cigarette and e-cigarette) use across groups, which may be due to the low prevalence in both forms of nicotine use among young adults in this sample. It is possible that heightened risk of worse outcomes of the pandemic (e.g., COVID-19 infection and disease progression) found to be associated with smoking (Gaiha et al., 2020; Patanavanich & Glantz, 2021) deterred young adults from engaging in cigarette and e-cigarette use.

The current study findings are consistent with the self-medication (Khantzian, 1997) and negative affect models (Baker et al., 2004), such that young adults who experienced more pandemic-related stressors engaged in more cannabis and nicotine use during the early and late phases of the pandemic. Studies have shown a positive association between pandemic-related stressors and substance use (Brotto et al., 2021; Tao et al., 2023), though less work has examined these associations longitudinally among young adults. It is possible that associations of pandemic-related stressors and substance use may be shaped by young adults’ forms of coping and the type or level of resources or support available to them during a time of pandemic-related disruptions (e.g., school closure, decline in labor market) that may have created and exacerbated stressors. Moreover, in WA, cannabis retail stores and alcohol outlets remained open, even in the early stages of the pandemic, creating an environment where alcohol and cannabis remained accessible. Other work has found a positive association between stressors and alcohol use (Graupensperger et al., 2023), but the current study did not find support for that association. Young adults tend to engage in alcohol use in social settings with peers (Schulenberg & Maggs, 2002), which was limited during COVID-19 pandemic and may explain the null findings. Future studies could expand on the measures of substance use assessed in the current study and examine the association of stressors with other margins/measures of substance use, such as quantity, substance use disorders, and related negative consequences. Another important area for future studies is to examine protective factors for substance use, such as access to health services, resources, and support, in the context of large-scale sociohistorical disruptions.

Limitations and Future Directions

The current study is not without limitations. Although we used a statewide sample, a majority of the sample was female (~74%); however, there was variability on key variables of interest. Further, it is possible that unmeasured substance use behaviors during the pandemic period may be related to attrition. Although attrition occurs in many longitudinal studies, it is important to note that the pandemic may have created unique context that could be associated with study participation. In addition, we focus on pandemic-related stressors in 2020, but it is possible these experiences varied in later years. Although we controlled for social role status variables in 2019, future studies could consider accounting for the time-varying nature of young adult social roles. The current study also did not allow us to asses within-group variability (Niño et al., 2017) to capture ethnic or cultural heterogeneity. This is an important area for future research. Relatedly, the current study included a relatively small sample of young adults who identified as Black, Native American or Alaskan Native, Pacific Islander or Native Hawaiian, and multiple races; thus, future research with larger sample sizes are needed to examine patterns and differences in stressors and substance use among these groups.

Conclusion

Young adults navigate the transition into adulthood in the context of macro-level sociohistorical events. The COVID-19 pandemic was a recent example of such an event. The present study found ethnic and racial differences in pandemic-related stressors and use of alcohol and cannabis in the increasingly common context where the purchase and use of these substances is legal for those 21+. Positive associations of stressors with cannabis and nicotine use were found across all ethnic and racial groups. Although the national public health emergency for the COVID-19 pandemic ended on May 11, 2023 (COVID-19 Public Health Emergency, 2023), many people continue to experience stressors that may be in part due to the long-lasting consequences of the COVID-19 pandemic (American Psychological Association, 2023). Continued monitoring of antecedents and correlates of substance use behaviors are needed.

Supplementary Material

Supplemental Materials
Public Health Significance Statement

Public Health Significance Statement.

Latinx young adults experienced more pandemic-related stressors than non-Latinx Asian or White young adults. For young adults with different ethnic and racial identities, associations between pandemic-related stressors and substance use were similar. Prevention and intervention approaches that emphasize both stressor experiences and substance use behaviors are needed.

Acknowledgments

The authors thank participants of the Washington State Young Adult Health Survey. An earlier version of this paper was presented at the Society for Prevention Research annual meeting held in Seattle, WA in May 2025. This research was supported by the National Institute on Drug Abuse (NIDA) grant (R01DA057705, principal investigator [PI]: Dr. Guttmannova), NIDA Diversity Supplement grant (3R01DA048827–03S1, PI: Dr. Guttmannova), and a National Institute on Alcohol Abuse and Alcoholism (NIAAA) grant (T32AA007455; PI: Dr. Larimer). The data were collected with support from the Washington State Health Care Authority’s Division of Behavioral Health and Recovery (PI: Dr. Kilmer). Partial support for this research also came from a Eunice Kennedy Shriver National Institute of Child Health and Human Development research infrastructure grant, P2C HD042828, to the Center for Studies in Demography & Ecology at the University of Washington. The content of this manuscript is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health, NIDA, NIAAA, the Washington State Health Care Authority, or the University of Washington.

Footnotes

No conflicts of interest and financial disclosures were reported by the authors of this paper.

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Supplementary Materials

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Public Health Significance Statement
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