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Over a third of respondents reported using any substance before COVID-19, and initiating\/increasing substance use during COVID-19. The most common substances used before COVID-19 and initiated\/increased during COVID-19 were smoking (20.8% vs. 18.3%), marijuana (18.8% vs. 15.3%), and vaping (14.2% and 11.4%). The percentages of any hard drug use were 7.3% and 3.4%, respectively. After adjustment, residents with mild (Prevalence Ratio [PR]\u2009=\u20092.86, 95% CI 1.65, 4.92) and moderate (PR\u2009=\u20093.21, 95% CI 1.86, 5.56) symptoms of depression, and housing insecurity (PR\u2009=\u20091.47, 95% CI 1.12, 1.91) had at least a 47% greater probability of initiating and\/or increasing substance use. Conversely, respondents with employment insecurity (PR\u2009=\u20090.71, 95% CI 0.57, 0.88) were 29% less likely to report such patterns. No association was found between substance use initiation and\/or increase and food insecurity. High prevalence of substance use during COVID-19 may lead residents to turn to substance use as a coping mechanism for psychosocial stressors. Thus, it is essential to provide accessible and culturally sensitive mental health and substance use services.<\/jats:p>","DOI":"10.1007\/s10900-023-01253-1","type":"journal-article","created":{"date-parts":[[2023,7,7]],"date-time":"2023-07-07T16:01:58Z","timestamp":1688745718000},"page":"937-944","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Substance Use Patterns and Their Association with Depression and Social Factors During COVID-19 Among Harlem Residents in New York City"],"prefix":"10.1007","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1304-4059","authenticated-orcid":false,"given":"Thinh T.","family":"Vu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph P.","family":"Dario","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pedro","family":"Mateu-Gelabert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deborah","family":"Levine","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Malcolm A.","family":"Punter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luisa N.","family":"Borrell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victoria K.","family":"Ngo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,7,7]]},"reference":[{"key":"1253_CR1","unstructured":"American Public Health Association. 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