262093 Effects of Neighborhood Deprivation and Social Cohesion on Individuals' Attempts to Quit Smoking Cigarettes: A Cohort Study

Tuesday, October 30, 2012

Anne Philipneri, MPH , Dalla Lana School of Public Health, University of Toronto, Ontario Tobacco Research Unit, Toronto, ON, Canada
Michael Chaiton , Ontario Tobacco Research Unit, University of Toronto, Toronto, ON, Canada
Susan Bondy, PhD , Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
Maritt Kirst, Phd , Ontario Tobacco Research Unit, Dalla Lana School of Public Health Sciences, University of Toronto, Toronto, ON, Canada
John M. Garcia, PhD , School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada
Objective: To measure the combined effects of neighborhood deprivation and sense of community social cohesion on individuals' quit attempts.

Methods: Current smokers (n=3293) from the Ontario Tobacco Survey (2006-2008) were followed for three years at 6-month intervals. Quit attempt was defined as making any attempt to quit in the past 6 months. Neighborhood deprivation was derived using six socio-economic measures from the 2006 Canadian Census. The main independent variable comprised four-levels of neighborhood deprivation and social cohesion measures: deprivation and low cohesion (DLC); deprivation and high cohesion (DHC); low deprivation and low cohesion (LDLC); low deprivation and high cohesion (LDHC). Covariates included age, sex, education, and daily/occasional smoking. Generalized estimating equations were used to control for repeated observations.

Results: In deprived neighborhoods, smokers with high cohesion showed higher odds for a quit attempt compared to those with low cohesion (AOR=1.39; 95% CI: 1.10-1.76). Among smokers with low cohesion (DLC and LDLC), no differences were observed. Smokers living in the healthiest environment (LDHC) showed higher odds for a quit attempt compared to smokers in the least healthy environment (DLC) (AOR=1.27; 95% CI: 1.02-1.58). Controlling for cigarette consumption per day attenuated the effects of deprivation and cohesion on quit attempts. Cigarette consumption was independently related to deprivation/cohesion and quit attempts.

Conclusion: Smokers' neighborhood status and their social cohesion in the community play an integral part in the cessation process. However, cigarette consumption appears to be a mediator in the relationship between deprivation/cohesion and quit attempts.

Learning Areas:
Assessment of individual and community needs for health education
Biostatistics, economics
Epidemiology
Social and behavioral sciences

Learning Objectives:
1. Demonstrate the importance of social cohesion for studies examining smokers’ neighborhood socio-economic status 2. Illustrate that social cohesion by neighborhood deprivation still plays an important role in smokers’ cessation behavior, even after controlling for individual socio-economic status (i.e. education). 3. Discuss the importance of examining mediators when looking at relationships between neighborhood-level predictors and smoking behavior.

Keywords: Tobacco Control, Epidemiology

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am research officer at the Ontario Tobacco Research Unit and PhD candidate in the program of health research methodology. My professional interests are in epidemiology and biostatistics. My research interests are in monitoring and surveillance of tobacco use.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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