Mortality Risks by Occupation During the Early Wave of the COVID-19 Pandemic in New York City.

Young adulthood is a developmental period characterized by greater risk for the onset of mental health problems and substance use, including tobacco and nicotine (herein referred to as tobacco) products, cannabis, and alcohol compared to other periods of development (; ; ; ; ). In 2022, rates of past-month (i.e., current) tobacco and cannabis use were higher among young adults (YAs) ages 18–25 (tobacco: 30.0% and cannabis: 25.9%), relative to both adolescents ages 12–17 (tobacco: 7.3% and cannabis: 6.4%) and adults ages 26 and older (tobacco: 23.3% and cannabis: 14.3%) (). Rates of alcohol use were higher among YAs (50.2%) relative to adolescents (6.8%) and similar to those of adults (53.4%) (). Past-year rates of mental health diagnoses were also higher among YAs (36.2%) than adults 26 and older (21.1%) (). Also common during young adulthood is polysubstance use or the use of two or more substances within the past month, which is associated with greater substance use dependence and difficulty quitting relative to the use of a single substance (; ; ). Among young adults reporting any tobacco, cannabis, or alcohol use in 2022, ~52% reported use of at least two of these substances (). Sexual minority-identifying (SM; i.e., gay, lesbian, bisexual, pansexual, queer, and/or another non-heterosexual identity; ) YAs are even further impacted by mental health symptoms and substance use (; ; ; ). Relative to their heterosexual peers, SM individuals displayed significantly higher rates of current tobacco, alcohol, and polysubstance use and were twice as likely to report past-year mental health symptoms and cannabis use (; ; ; ; ; ). Minority stress theory suggests that sexual minority young adults (SMYAs) face greater internal (e.g., internalized stigma) and external stressors (e.g., discrimination) related to their stigmatized sexual identity, which are associated with greater mental health symptoms and coping-related substance use (; ; ; ; ). Parents may be a source of minority stress for SMYAs (). Indeed, SM youth and YAs who report greater parental rejection and/or less acceptance show persistent disparities in both mental health symptoms and substance use, relative to their peers reporting less rejection and/or greater acceptance from their parents (; ; ; ). Among adults generally, stronger religious beliefs and conservative values are associated with greater negative attitudes and more rejecting behaviors toward SM individuals (; ). Among parents of SMYAs specifically, those with stronger religious beliefs and conservative values are perceived as more rejecting of their SMYA children’s sexual identity (; ; ; ); these parental beliefs are also associated with greater likelihood of mental health symptoms and substance use among their SM youth and YA children (e.g., cannabis and alcohol) (; ).