title: Racial/ethnic workplace discrimination: association with tobacco and alcohol use.
abstract: BACKGROUND
  Experiences of discrimination are associated with tobacco and alcohol use, and work is a common setting where individuals experience racial/ethnic discrimination. Few studies have evaluated the association between workplace discrimination and these behaviors, and none have described associations across race/ethnicity.
  
  
  OBJECTIVE
  To examine the association between workplace discrimination and tobacco and alcohol use in a large, multistate sample of U.S. adult respondents to the Behavioral Risk Factor Surveillance System survey Reactions to Race Module (2004-2010).
  
  
  METHODS
  Multivariable logistic regression analyses evaluated cross-sectional associations between self-reported workplace discrimination and tobacco (current and daily smoking) and alcohol use (any and heavy use, and binge drinking) among all participants and stratified by race/ethnicity, adjusting for relevant covariates. Data were analyzed in 2013.
  
  
  RESULTS
  Among respondents, 70,080 completed the workplace discrimination measure. Discrimination was more common among black non-Hispanic (21%), Hispanic (12%), and other race respondents (11%) than white non-Hispanics (4%) (p<0.001). In the total sample, discrimination was associated with current smoking (risk ratio [RR]=1.32, 95% CI=1.19, 1.47), daily smoking (RR=1.41, 95% CI=1.24, 1.61), and heavy drinking (RR=1.11, 95% CI=1.01, 1.22), but not binge or any drinking. Among Hispanics, workplace discrimination was associated with increased heavy and binge drinking, but not any alcohol use or smoking. Workplace discrimination among black non-Hispanics and white Non-Hispanics was associated with increased current and daily smoking, but not alcohol outcomes.
  
  
  CONCLUSIONS
  Workplace discrimination is common, associated with smoking and alcohol use, and merits further policy attention, given the impact of these behaviors on morbidity and mortality.
authors.affiliation: Department of Health Services, School of Public Health, University of Washington; Veterans Affairs (VA) Puget Sound Health Services Research & Development, VA Health Care Systems, Seattle, Washington. Electronic address: ljchavez@u.washington.edu.
authors.forename: Laura J
authors.initials: LJ
authors.lastname: Chavez
authors.affiliation: Department of Health Services, School of Public Health, University of Washington.
authors.forename: India J
authors.initials: IJ
authors.lastname: Ornelas
authors.affiliation: Division of General Internal Medicine, San Francisco General Hospital; Center for Vulnerable Populations, San Francisco, California.
authors.forename: Courtney R
authors.initials: CR
authors.lastname: Lyles
authors.affiliation: Department of Health Services, School of Public Health, University of Washington; Veterans Affairs (VA) Puget Sound Health Services Research & Development, VA Health Care Systems, Seattle, Washington.
authors.forename: Emily C
authors.initials: EC
authors.lastname: Williams
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking / Q000208:ethnology*; D040343:Behavioral Risk Factor Surveillance System; D063425:Binge Drinking / Q000208:ethnology; D003430:Cross-Sectional Studies; D005260:Female; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011287:Prejudice / Q000706:statistics & numerical data*; D012907:Smoking / Q000208:ethnology*; D012931:Social Environment; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology; D017132:Workplace; D055815:Young Adult