Firearm violence exposures and cannabis, commercial tobacco, and harmful alcohol consumption: findings from a nationally representative survey of U.S. adults

Authors

• LA Marineau
• K Hacker
• A Azeem
• K Zarei
• K Hamilton-Moseley
• B Jewett
• SN Zenk
• K Choi

Abstract

We examined the association between firearm violence exposures (FVEs) and cannabis, commercial tobacco, and harmful alcohol consumption among a nationally representative sample of U.S. adults 21+ years (n=3200) using cross-sectional data from a web-based survey. Cannabis and commercial tobacco use were measured based on reported current use. Harmful alcohol consumption was measured using the 10-item AUDIT (range 0-40) and was dichotomized (<8: lower risk consumption; >= 8: harmful consumption). Lifetime FVEs were measured using a 4-item scale (threatened by firearm, shot by firearm, family/friend shot, witnessed/heard of shooting in neighborhood). Cumulative FVEs were summed and categorized as 0, 1, 2, or 3+ FVEs. Weighted logistic regression estimated associations of FVEs with cannabis, commercial tobacco, and harmful alcohol consumption, adjusting for each other, demographic factors, census region, and neighborhood characteristics. Over 36% of U.S. adults reported at least one FVE and 7% reported 3+ FVEs: 18% reported direct FVEs, 19% reported a family/friend being shot, and 22% reported witnessing/hearing about a shooting. There was a general dose response relationship between cumulative FVEs and cannabis, tobacco, and harmful alcohol consumption (e.g., cannabis use: aOR ranged from 1.79 (1 FVE) - 3.26 (3+ FVEs)). All types of FVEs (direct FVE, family/friend shot, and witnessed/heard shooting) were associated with increased odds of cannabis, tobacco, and harmful alcohol consumption (e.g., cannabis use: direct FVEs aOR 2.34, 95% CI 1.76-3.12; family/friend shot aOR 2.26, 95% CI 1.71-2.99; witnessed/heard shooting aOR 1.90, 95% CI 1.45-2.50). Cannabis, tobacco, and alcohol may be used for coping with violence-related trauma.

Scientific Focus Area: Social and Behavioral Sciences

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