{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,13]],"date-time":"2026-09-13T05:04:58Z","timestamp":1789275898131,"version":"build-2803163510"},"reference-count":47,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T00:00:00Z","timestamp":1789084800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100007904","name":"Texas A&M University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100007904","id-type":"DOI","asserted-by":"crossref"}]},{"id":[{"id":"https:\/\/ror.org\/01f5ytq51","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Epidemiologia"],"abstract":"<jats:p>Background and Objectives: This study aimed to examine the associations between exclusive cigarette smoking, dual-tobacco use, and poly-tobacco use and sleep duration and sleep problems among non-Hispanic Black and Hispanic men with chronic conditions. Materials and Methods: Cross-sectional, internet-administered survey data were collected in September\u2013November 2019 from 1673 U.S. non-Hispanic Black and Hispanic men aged \u226540 years. Current (past 30-day) tobacco use was classified as non-tobacco use, exclusive combustible cigarette smoking, dual-tobacco use (cigarettes plus one additional tobacco product), and poly-tobacco use (cigarettes plus \u2265 2 additional tobacco products). Other tobacco products included cigars, electronic cigarettes, hookah, pipes, and bidis. Insufficient sleep duration was classified as &lt;7 h, and sleep problems were defined as having sleep concerns in the past week. Two multivariable logistic regression models were performed to estimate adjusted odds ratios (AORs) and 95% confidence intervals (95%CIs) for insufficient sleep and sleep problems while adjusting for sociodemographics, body mass index (BMI), and number of chronic conditions. Participants that were missing data on tobacco use, sleep outcomes, and BMI were excluded. Results: Overall, 46.9% of participants reported insufficient sleep duration, and 46.2% reported sleep problems. Exclusive combustible cigarette smokers (AOR = 1.43, 95%CI = 1.07\u20131.92) and dual-tobacco users (AOR = 1.56, 95%CI = 1.06\u20132.28) had significantly higher odds of insufficient sleep than non-tobacco users. Dual-tobacco users (AOR = 1.96, 95%CI = 1.32\u20132.91) and poly-tobacco users (AOR = 1.66, 95%CI = 1.01\u20132.74) had significantly higher odds of sleep problems than non-tobacco users. Conclusions: Findings suggest that cigarette smoking, whether exclusively or in combination with other tobacco products, may exacerbate sleep disparities among middle-aged and older non-Hispanic Black and Hispanic men with chronic conditions.<\/jats:p>","DOI":"10.3390\/epidemiologia7050127","type":"journal-article","created":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T08:17:42Z","timestamp":1789114662000},"page":"127","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Current Tobacco Use Status Associated with Insufficient Sleep Duration and Sleep Problems Among Non-Hispanic Black and Hispanic Men with Chronic Conditions"],"prefix":"10.3390","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5640-7227","authenticated-orcid":false,"given":"Ashley L.","family":"Merianos","sequence":"first","affiliation":[{"name":"School of Human Services, University of Cincinnati, Cincinnati, OH 45221, USA"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-4777-6503","authenticated-orcid":false,"given":"Jodi L.","family":"Kaminski","sequence":"additional","affiliation":[{"name":"School of Human Services, University of Cincinnati, Cincinnati, OH 45221, USA"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-1506-811X","authenticated-orcid":false,"given":"Jahmai","family":"Irehovbude","sequence":"additional","affiliation":[{"name":"School of Human Services, University of Cincinnati, Cincinnati, OH 45221, USA"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3893-885X","authenticated-orcid":false,"given":"E. Melinda","family":"Mahabee-Gittens","sequence":"additional","affiliation":[{"name":"Division of Emergency Medicine, Cincinnati Children\u2019s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH 45229, USA"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0858-9967","authenticated-orcid":false,"given":"Ledric D.","family":"Sherman","sequence":"additional","affiliation":[{"name":"Department of Health Behavior, School of Public Health, Texas A&M University, College Station, TX 77843, USA"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"funding-acquisition","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"}]},{"given":"Caroline D.","family":"Bergeron","sequence":"additional","affiliation":[{"name":"LIFE Research Institute, University of Ottawa, Ottawa, ON K1N 6N5, Canada"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8232-9285","authenticated-orcid":false,"given":"Matthew Lee","family":"Smith","sequence":"additional","affiliation":[{"name":"School of Public Health\u2014Bloomington, Indiana University, Bloomington, IN 47405, USA"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"},{"role":"formal-analysis","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"funding-acquisition","vocabulary":"credit"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,11]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"246","DOI":"10.1016\/j.sleep.2016.08.006","article-title":"Short Sleep Duration and Health Outcomes: A Systematic Review, Meta-Analysis, and Meta-Regression","volume":"32","author":"Itani","year":"2017","journal-title":"Sleep Med."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Fasokun, M., Akinyemi, O., Ogunyankin, F., Ndebele-Ngwenya, P., Gordon, K., Ikugbayigbe, S., Nwosu, U., Michael, M., Hughes, K., and Ogundare, T. (2026). Associations between Sleep Duration and Depression, Mental Health, Physical Health, and General Health in U.S. Adults: A Population-Based Study. PLoS ONE, 21.","DOI":"10.1371\/journal.pone.0321347"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1016\/j.sleh.2016.11.006","article-title":"National Sleep Foundation\u2019s Sleep Quality Recommendations: First Report","volume":"3","author":"Ohayon","year":"2017","journal-title":"Sleep Health"},{"key":"ref_4","first-page":"79","article-title":"Systematic Review: The Impact of Poor Sleep Quality on Psychological and Physical Health","volume":"30","author":"Sneha","year":"2025","journal-title":"J. Heart Valve Dis."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1016\/j.sleh.2015.10.004","article-title":"National Sleep Foundation\u2019s Updated Sleep Duration Recommendations: Final Report","volume":"1","author":"Hirshkowitz","year":"2015","journal-title":"Sleep Health"},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"(2022). Centers for Disease Control and Prevention QuickStats: Percentage of Adults Aged \u226518 Years Who Sleep 7 Hours on Average in a 24-Hour Period, by Sex and Age Group\u2014National Health Interview Survey, United States, 2020. MMWR Morb. Mortal Wkly Rep., 71, 393.","DOI":"10.15585\/mmwr.mm7110a6"},{"key":"ref_7","unstructured":"Centers for Disease Control and Prevention (2026, February 10). About Sleep, Available online: https:\/\/www.cdc.gov\/sleep\/about\/index.html."},{"key":"ref_8","first-page":"1","article-title":"Sleep Difficulties in Adults: United States, 2020","volume":"436","author":"Ng","year":"2022","journal-title":"NCHS Data Brief"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"151","DOI":"10.2147\/NSS.S134864","article-title":"Short- and Long-Term Health Consequences of Sleep Disruption","volume":"9","author":"Medic","year":"2017","journal-title":"Nat. Sci. Sleep"},{"key":"ref_10","unstructured":"U.S. Department of Health and Human Services (2020). Smoking Cessation: A Report of the Surgeon General."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"118","DOI":"10.15585\/mmwr.mm7407a3","article-title":"Notes from the Field: Tobacco Product Use Among Adults\u2014United States, 2017\u20132023","volume":"74","author":"Arrazola","year":"2025","journal-title":"MMWR Morb. Mortal. Wkly. Rep."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"220086","DOI":"10.5888\/pcd19.220086","article-title":"Cigarette Smoking Among US Adults with Selected Chronic Diseases Associated with Smoking, 2010\u20132019","volume":"19","author":"Loretan","year":"2022","journal-title":"Prev. Chronic Dis."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"475","DOI":"10.15585\/mmwr.mm7218a1","article-title":"Tobacco Product Use Among Adults\u2014United States, 2021","volume":"72","author":"Cornelius","year":"2023","journal-title":"MMWR Morb. Mortal Wkly Rep."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"775","DOI":"10.17269\/s41997-020-00308-3","article-title":"Smoking and Risk of Sleep-Related Issues: A Systematic Review and Meta-Analysis of Prospective Studies","volume":"111","author":"Amiri","year":"2020","journal-title":"Can. J. Public Health"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"100028","DOI":"10.1016\/j.sleepe.2022.100028","article-title":"Sleep Quality of Adult Tobacco Users: A Systematic Review of Literature and Meta-Analysis","volume":"2","author":"Costa","year":"2022","journal-title":"Sleep Epidemiol."},{"key":"ref_16","first-page":"e49162","article-title":"Effects of Nicotine on the Central Nervous System and Sleep Quality in Relation to Other Stimulants: A Narrative Review","volume":"15","author":"Singh","year":"2023","journal-title":"Cureus"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1669","DOI":"10.1007\/s11325-019-01944-x","article-title":"Sleep Disturbances and Nicotine Addiction: A Bidirectional Relationship?","volume":"24","author":"Leonel","year":"2020","journal-title":"Sleep Breath"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1534","DOI":"10.1093\/ntr\/ntaf056","article-title":"Bidirectional Relationships between Sleep Quality and Nicotine Vaping: Studying Young Adult e-Cigarette Users in Real Time and Real Life","volume":"27","author":"Nam","year":"2025","journal-title":"Nicotine Tob. Res."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Smith, M.L., Bergeron, C.D., Sherman, L.D., Goidel, K., and Merianos, A.L. (2022). Contextualizing the Chronic Care Model among Non-Hispanic Black and Hispanic Men with Chronic Conditions. Int. J. Environ. Res. Public Health, 19.","DOI":"10.3390\/ijerph19063655"},{"key":"ref_20","unstructured":"Qualtrics (2021). Qualtrics XM Platform, Qualtrics."},{"key":"ref_21","unstructured":"Centers for Disease Control and Prevention (2020). Behavioral Risk Factor Surveillance System Survey Data."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"301","DOI":"10.5664\/jcsm.5570","article-title":"Validation of the Behavioral Risk Factor Surveillance System Sleep Questions","volume":"12","author":"Jungquist","year":"2016","journal-title":"J. Clin. Sleep Med."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"992","DOI":"10.1097\/MLR.0b013e3182a95dd1","article-title":"Successes of a National Study of the Chronic Disease Self-Management Program: Meeting the Triple Aim of Health Care Reform","volume":"51","author":"Ory","year":"2013","journal-title":"Med. Care"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1258","DOI":"10.1177\/0898264313502531","article-title":"National Study of Chronic Disease Self-Management: Six-Month Outcome Findings","volume":"25","author":"Ory","year":"2013","journal-title":"J. Aging Health"},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Grigoriou, I., Kotoulas, S.-C., Porpodis, K., Spyratos, D., Papagiouvanni, I., Tsantos, A., Michailidou, A., Mourelatos, C., Mouratidou, C., and Alevroudis, I. (2024). The Interactions between Smoking and Sleep. Biomedicines, 12.","DOI":"10.20944\/preprints202406.1402.v1"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1093\/aje\/kwj231","article-title":"Cigarette Smoking and Nocturnal Sleep Architecture","volume":"164","author":"Zhang","year":"2006","journal-title":"Am. J. Epidemiol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"747","DOI":"10.1111\/adb.12151","article-title":"Sleep Changes in Smokers before, during and 3 Months after Nicotine Withdrawal","volume":"20","author":"Jaehne","year":"2015","journal-title":"Addict. Biol."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Pintilie, A.-L., Zabara Antal, A., Ciuntu, B.-M., Toma, D., Tiron, R., Stirbu, R., Zabara, M.L., and Crisan Dabija, R. (2025). A Possible Missing Link Between Obstructive Sleep Apnea Syndrome (OSA) Associated with Tobacco Use and Inflammation Biomarkers. Healthcare, 13.","DOI":"10.3390\/healthcare13101177"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"103349","DOI":"10.1016\/j.pmedr.2025.103349","article-title":"Adult Dual and Polytobacco Use in the United States: Findings from the 2021\u20132023 National Survey on Drug Use and Health","volume":"66","author":"Pacek","year":"2025","journal-title":"Prev. Med. Rep."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1086","DOI":"10.1093\/ntr\/ntz132","article-title":"Biochemical Verification of Tobacco Use and Abstinence: 2019 Update","volume":"22","author":"Benowitz","year":"2020","journal-title":"Nicotine Tob. Res."},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Poudel, L., Baral, A., Abdshah, A., Grealis, K., Aka, A., Paudel, S., and Vidot, D.C. (2025). Sleep Disturbances among Young Adult Dual Users of Cigarettes and E-Cigarettes: Analysis of the 2020 National Health Interview Survey. PLoS ONE, 20.","DOI":"10.1371\/journal.pone.0320748"},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Sun, H., and Li, S. (2024). Exploring the Relationship between Smoking and Poor Sleep Quality: A Cross-Sectional Study Using NHANES. Front. Psychiatry, 15.","DOI":"10.3389\/fpsyt.2024.1407741"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"2536","DOI":"10.1038\/s41598-022-06445-8","article-title":"Dual Use of E-Cigarettes with Conventional Tobacco Is Associated with Increased Sleep Latency in Cross-Sectional Study","volume":"12","author":"Advani","year":"2022","journal-title":"Sci. Rep."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"77","DOI":"10.4274\/imj.galenos.2026.16132","article-title":"The Effect of Chronic Diseases on Sleep Quality: A Single-Center Study from a Family Medicine Perspective","volume":"27","year":"2026","journal-title":"Istanb. Med. J."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"E77","DOI":"10.5888\/pcd20.230197","article-title":"Sleep Deprivation, Sleep Disorders, and Chronic Disease","volume":"20","author":"Ramos","year":"2023","journal-title":"Prev. Chronic Dis."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"2987","DOI":"10.1038\/s41598-025-86420-1","article-title":"Effects of Chronic Diseases on Health Related Quality of Life Is Mediated by Sleep Difficulty in Middle Aged and Older Adults","volume":"15","author":"Wu","year":"2025","journal-title":"Sci. Rep."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1146\/annurev-psych-010213-115205","article-title":"Why Sleep Is Important for Health: A Psychoneuroimmunology Perspective","volume":"66","author":"Irwin","year":"2015","journal-title":"Annu. Rev. Psychol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1016\/j.metabol.2018.02.010","article-title":"Sleep Influences on Obesity, Insulin Resistance, and Risk of Type 2 Diabetes","volume":"84","author":"Reutrakul","year":"2018","journal-title":"Metabolism"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1016\/j.sleep.2021.09.004","article-title":"Age-Associated Differences in Sleep Duration in the US Population: Potential Effects of Disease Burden","volume":"87","author":"Shochat","year":"2021","journal-title":"Sleep Med."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"A416","DOI":"10.1093\/sleep\/zsaf090.0960","article-title":"0960 Age-Related Patterns in Sleep Duration across the Adult Lifespan in the U.S.: Insights from a Large-Scale Study Using Wearable Technology","volume":"48","author":"Lee","year":"2025","journal-title":"Sleep"},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Senaratna, C.V., English, D.R., Currier, D., Perret, J.L., Lowe, A., Lodge, C., Russell, M., Sahabandu, S., Matheson, M.C., and Hamilton, G.S. (2016). Sleep Apnoea in Australian Men: Disease Burden, Co-Morbidities, and Correlates from the Australian Longitudinal Study on Male Health. BMC Public Health, 16.","DOI":"10.1186\/s12889-016-3703-8"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1038\/s41367-020-0019-z","article-title":"Sleep Disturbances: One of the Culprits of Obesity-Related Cardiovascular Risk?","volume":"10","author":"Muscogiuri","year":"2020","journal-title":"Int. J. Obes. Suppl."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"zsaf190","DOI":"10.1093\/sleep\/zsaf190","article-title":"Multiple Psychosocial Stressors and Coping Strategies in Relation to Sleep Health","volume":"49","author":"Alhasan","year":"2026","journal-title":"Sleep"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"zsac087","DOI":"10.1093\/sleep\/zsac087","article-title":"Mediating Role of Psychological Distress in the Associations between Neighborhood Social Environments and Sleep Health","volume":"45","author":"Kim","year":"2022","journal-title":"Sleep"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"230","DOI":"10.1007\/s11524-019-00418-5","article-title":"Broken Windows, Broken Zzs: Poor Housing and Neighborhood Conditions Are Associated with Objective Measures of Sleep Health","volume":"97","author":"Troxel","year":"2020","journal-title":"J. Urban Health"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1016\/j.sleh.2014.12.004","article-title":"Racial\/Ethnic Disparities in Sleep Health and Health Care: Importance of the Sociocultural Context","volume":"1","author":"Williams","year":"2015","journal-title":"Sleep Health"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"731","DOI":"10.1093\/ntr\/nty230","article-title":"Evidence for Genetic Correlations and Bidirectional, Causal Effects between Smoking and Sleep Behaviors","volume":"21","author":"Gibson","year":"2019","journal-title":"Nicotine Tob. Res."}],"container-title":["Epidemiologia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2673-3986\/7\/5\/127\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,13]],"date-time":"2026-09-13T04:17:12Z","timestamp":1789273032000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2673-3986\/7\/5\/127"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,11]]},"references-count":47,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2026,10]]}},"alternative-id":["epidemiologia7050127"],"URL":"https:\/\/doi.org\/10.3390\/epidemiologia7050127","relation":{},"ISSN":["2673-3986"],"issn-type":[{"value":"2673-3986","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,11]]}}}