Understanding spatial patterns of smoking prevalence among african american women in Harlem, New York: A story told through GIS mapping

Introduction: Tobacco use in the African American community has long been associated with SES, level of education, and cultural influence. Some researchers believe that the neighborhood in which the smoker lives is an important factor for smoking. Smoking in the Black community has achieved social acceptance based on the perception that it is a “lesser evil” compared to other larger social concerns. Methods: The analysis of data collected from a survey of an African American community in NYC was used to demonstrate that an association exists between where an individual lives and smoking prevalence. A random digit dialed phone survey was conducted in Harlem, a predominantly African American community in NYC. Findings: 632 women were interviewed about their smoking behavior and current smoking status. African American women made up 63% of respondents. At the time of the survey 64% or roughly 2/3 of those who ever smoked, were current smokers. Among current smokers 71% reported smoking every day, with 49% smoking at least half pack every day and 20% smoking a pack or more per day. Based on address level information, a spacial analysis was performed using ArcGIS. A map showing the distribution of where smoking, and non-smoking respondents lived, revealed a clear neighborhood effect. Conclusion: The concentration of smokers in Central Harlem may be attributed to a higher concentration of and easier access to smoking outlets, tobacco advertising prevasiveness, and neighborhood disorganization. Community norms and social stresses are important factor in understanding the social context of smoking in Harlem.