Association between cigarette smoking and social capital in the Black Belt region of Alabama

The Black Belt region of Alabama is characterized by a rural, largely African American population with high poverty rates and excessive disease burden. Previous research has demonstrated that health status is positively related to measures of social capital, which can be described as community social organization. This study examined the association of cigarette smoking and social capital in this traditionally underserved area. To accomplish this goal, an interviewer-administered, in-person survey was completed with 1380 adult residents of seven Black Belt counties in Alabama. Questions regarding cigarette smoking ascertained if participants ever smoked, currently smoke, smoke daily, and have smoked 100 or more cigarettes in their lives. Social capital questions examined community differences, community limitations, trust, selfishness, and participation in general, charitable, and protest activities. Overall, about 35% of the respondents had ever smoked and 18% currently smoke. Of those who do smoke, 70% smoke daily and 75% have smoked at least 100 cigarettes in their lifetime. Bivariate analyses revealed that several social capital measures were significantly associated with ever smoking, current smoking, and daily smoking. Multivariate analyses demonstrated that ratings of community selfishness were significantly associated with all smoking measures. In addition, having ever smoked was significantly related to general and charitable participation, while current smoking was significantly associated with ratings of community differences and charitable participation. Consequently, efforts to improve social capital may result in reduced levels of smoking in that community. Thus, in designing interventions targeting smoking behavior, researchers should consider ways to increase social capital.