Even worse for Black girls: the longitudinal association of racial bullying with the initiation of alcohol and tobacco use.

ABSTRACT

We used Poisson's linear regression to examine the association between racial bullying (RB) and the initiation of alcohol and tobacco uses after 9 months. Two cluster-randomized controlled trials were conducted in 2019 with children in grades five (girls 50.0%; 10 years old 82.0%; White 36.8%; Black 58.7%; others 4.5%) and seven (girls 49.5%; 12 years old 78.1%; White 33.2%; Black 60.4%; others 6.4%) from 30 public schools in the municipality of São Paulo, Brazil. We restricted our analyses to 2 subsets of students in each grade those who reported no lifetime alcohol use at baseline and those who reported no lifetime baseline tobacco use. At baseline, 16.2% of fifth and 10.7% of seventh graders reported suffering from RB in the 30 days before data collection. After 9 months, 14.9% of fifth graders started using alcohol and 2.5%, tobacco. Among seventh graders, the figures were 31.2% and 7.7%, respectively. RB predicted the initiation of use of alcohol (risk ratio [RR] = 1.36; 95% CI, 1.07-1.70) and tobacco (RR = 1.81; 95% CI, 1.14-2.76) among seventh graders, with race-gender differences, particularly in Black girls (alcohol RR = 1.45; 95% CI, 1.07-1.93; tobacco RR = 2.34; 95% CI, 1.31-3.99). School-based programs and policies must explicitly address issues related to racism and gender in alcohol and tobacco prevention strategies.