Introduction: Latino immigrant men face many stressors, including perceived racism, which put them at risk for binge drinking and cigarette smoking. Few studies have assessed the relationship between perceived racism and substance use in this population. Methods: This study was a secondary analysis of data from 291 Latino immigrant men in North Carolina. The study's aims were: (1) to evaluate the utility of the Reactions to Race measure of perceived racism, (2) to examine the relationship between perceived racism and substance use behaviors, (3) to examine whether the relationship between perceived racism and substance use was mediated by stress responses to perceived racism, and (4) to examine whether the relationship between perceived racism and substance use was mediated or moderated by coping resources. The reliability and validity of the perceived racism measure was evaluated using correlations and factor analysis. Logistic regression was used to test for the association between perceived racism and odds of having engaged in binge drinking in the past 30 days and being a current cigarette smoker as well as mediation and moderation of this relationship. Results: The Reactions to Race items measured three key dimensions of perceived racism: racial consciousness, unfair racial treatment in work and health care settings, and responses to unfair racial treatment. However, the measure did not capture the dimensions of language and legal status discrimination, which were the most cited sources of discrimination. The percentage of binge drinkers (44%) and current cigarette smokers (36%) in our sample were higher than those reported by previous studies of Latinos in North Carolina. Language (OR = 2.69, 95% CI: 1.56 - 4.64) and legal status (OR = 2.05, 95% CI: 1.20 - 3.49) discrimination were associated with increased odds of having engaged in binge drinking in both crude and adjusted models. Perceived racism was not significantly associated with cigarette smoking. Stress responses did not mediate the relationship between perceived racism and binge drinking, nor did coping resources mediate or moderate this relationship. Conclusion: Further research is needed on perceived racism, stress, coping and health among Latino immigrants, especially the effects of language and legal status discrimination
