Association between neighborhood context and smoking prevalence among Asian Americans.
OBJECTIVE
To study neighborhood-level determinants of smoking among Asian Americans, we examined 3 neighborhood factors (ethnic enclave, socioeconomics, and perceived social cohesion) and smoking prevalence in a population-based sample.


METHODS
We linked data from the 2003 California Health Interview Survey to tract-level data from the 2000 Census. We used multivariate logistic regression models to estimate the associations between smoking and neighborhood-level factors, independent of individual factors.


RESULTS
Twenty-two percent of 1693 Asian men and 6% of 2174 Asian women reported current smoking. Women living in an Asian enclave were less likely to smoke (adjusted odds ratio [AOR] = 0.27; 95% confidence interval [CI] = 0.08, 0.88). Among men, higher levels of perceived neighborhood social cohesion were associated with lower odds of smoking (AOR = 0.74; 95% CI = 0.61, 0.91).


CONCLUSIONS
The association between contextual factors and smoking differed for men and women. For women, living in an Asian enclave may represent cultural behavioral norms. For men, neighborhood trust and cohesiveness may buffer stress. Smoking prevention and cessation interventions among Asian Americans may be more effective if they address contextual factors.
Kandula
Namratha R
NR
Division of General Internal Medicine, Feinberg School of Medicine, Northwestern University, 750 North Lakeshore Dr, 10th floor, Chicago, IL 60611, USA. n-kandula@northwestern.edu
Wen
Ming
M
Jacobs
Elizabeth A
EA
Lauderdale
Diane S
DS
D000328:Adult; D000368:Aged; D001213:Asian / Q000706:statistics & numerical data*; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D005260:Female; D006798:Housing / Q000706:statistics & numerical data*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D015995:Prevalence; D012737:Sex Factors; D012907:Smoking / Q000453:epidemiology*; D000074606:Smoking Prevention; D014481:United States / Q000453:epidemiology