A failure of theory? Associations between neighborhood socioeconomic status, affect and daily smoking

Background: Prior research has noted associations between neighborhood disadvantage and increased tobacco use. Theories suggest neighborhood disadvantage may increase smoking by increasing distress. In contrast, neighborhood affluence may reduce smoking by increasing positive affect. Methods: Using pooled cross-sectional data from the 2000 and 2005 National Alcohol Surveys (N = 12,393) and the 2000 Decennial Census, we examined simultaneous multivariate path models of relationships between neighborhood disadvantage and affluence on daily smoking operating through distress and positive affect. Multiple groups analysis assessed differences by sex and race/ethnicity. Covariates included neighborhood immigrant concentration and individual-level demographics. Results: In the full sample, neighborhood disadvantage had a significant direct path to increased smoking, neighborhood affluence had a significant direct path to decreased smoking, and there were no indirect paths through either distress or positive affect. Distress was significantly associated with increased smoking, but positive affect was not associated with smoking. Sub-group analyses revealed a protective effect of neighborhood affluence resulting in decreased smoking unique to Hispanics that was explained by reduced distress. The relationships between affect and smoking also varied by race/ethnicity, with distress positively associated with smoking for all groups but Whites, and positive affect negatively associated with smoking for Whites only. There were no significant differences by sex. Conclusions: Existing theories of neighborhood effects are insufficient to explain smoking. Further research to develop and test new models in diverse groups is needed, but interventions targeting neighborhood socioeconomic status and distress may help reduce smoking.