Unmet Health-Related Social Needs Among Black Adults Who Smoke

Unmet health-related social needs (HRSNs) are closely associated with cigarette smoking, yet limited research has examined this relationship among Black adults who smoke. This study aimed to determine the prevalence and specific types of unmet HRSNs reported by Black adults who smoke and investigate the associations between unmet HRSNs and cigarette dependence, perceived barriers for smoking cessation, severity of problems when trying to quit, and smoking abstinence expectancies. A total of 498 Black adults who reported daily combustible cigarette smoking (M_age = 45.37 years, SD = 14.68; age range = 18-73 years; 51.4% female) were recruited between November and December 2023 through an online survey platform, using a convenience national sampling approach. Hierarchical linear regression models were used to examine associations between study variables. Results indicated that Black adults who smoke experienced substantial levels of unmet HRSNs (e.g., food insecurity [86.1%], mental health needs [72.9%], housing/living situation [51.2%], transportation [38.6%], financial strain [62.7%], and physical activity [63.9%]), which were consistently associated with greater cigarette dependence, more perceived barriers for smoking cessation, and stronger expectations of negative outcomes during abstinence, even after adjusting for demographic and behavioral covariates. These findings indicate that the constellation of unmet HRSNs among Black adults who smoke plays a significant role in the severity of smoking processes and cessation-related challenges. Addressing such HRSNs may enhance the effectiveness of cessation interventions and reduce disparities in smoking-related outcomes in this population.