Abstract:
BACKGROUND:Although neighborhoods with more collective efficacy have better health in general, recent work suggests that social norms and collective efficacy may in combination influence health behaviors such as smoking. METHODS:Using data from the New York Social Environment Study (conducted in 2005; n=4000), we examined the separate and combined associations of neighborhood collective efficacy and anti-smoking norms with individual smoking. The outcome was current smoking, assessed using the World Mental Health Comprehensive International Diagnostic Interview (WMH-CIDI) tobacco module. Exposures of interest were neighborhood collective efficacy, measured as the average neighborhood response on a well-established scale, and neighborhood anti-smoking norms, measured as the proportion of residents who believed regular smoking was unacceptable. All analyses adjusted for demographic and socioeconomic characteristics, as well as history of smoking prior to residence in the current neighborhood, individual perception of smoking level in the neighborhood, individual perception of collective efficacy, and individual smoking norms. RESULTS:In separate generalized estimating equation logistic regression models, neighborhood collective efficacy was not associated with smoking (OR 1.06, 95% CI 0.84-1.34) but permissive neighborhood smoking norms were associated with more smoking (OR 1.34, 95% CI 1.03-1.74), particularly among residents with no prior history of smoking (OR 2.88, 95% CI 1.92-4.30). When considered in combination, where smoking norms were permissive, higher collective efficacy was associated with more smoking; in contrast, where norms were strongly anti-smoking, higher collective efficacy was associated with less smoking. CONCLUSIONS:Features of the neighborhood social environment may need to be considered in combinations to understand their role in shaping health and health behavior.
journal_name
Drug Alcohol Dependjournal_title
Drug and alcohol dependenceauthors
Ahern J,Galea S,Hubbard A,Syme SLdoi
10.1016/j.drugalcdep.2008.09.012subject
Has Abstractpub_date
2009-02-01 00:00:00pages
138-45issue
1-2eissn
0376-8716issn
1879-0046pii
S0376-8716(08)00352-9journal_volume
100pub_type
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