title: Smoking, sociodemographic determinants, and stress in the Alabama Black Belt.
abstract: OBJECTIVE
  In the Alabama Black Belt, poverty is high, and the educational level is low. Studies have found increased tobacco use among individuals exposed to high levels of stress. Few studies have been conducted in this region to measure smoking status, its sociodemographic determinants, and how smoking status relates to stressful environmental conditions.
  
  
  METHODS
  A cross-sectional questionnaire survey of 1,387 individuals.
  
  
  RESULTS
  Approximately 25% of the respondents currently smoked cigarettes. Females were less likely to smoke compared to males (OR, 0.29; 95% CI, 0.23-0.38). Blacks were less likely to smoke cigarettes compared to whites (OR, 0.64; 95% CI, 0.43-0.95). Compared to individuals who were employed, participants who were unemployed or retired had increased odds of smoking (OR, 1.68; 95% CI, 1.15-2.20). The odds of being a current smoker were increased in the presence of moderate level stress (OR, 2.06; 95% CI, 1.38-3.07) or when there was a high level of stress (OR, 2.21; 95% CI, 1.47-3.31). Smoking was associated with increased odds of having a moderate level (OR, 2.06; 95% CI, 1.38-3.08) and a high level of stress (OR, 2.21; 95% CI, 1.47-3.32). Females who reported moderate to high levels of stress had increased odds of being smokers compared to males. Interaction between gender and stress showed deviation from additivity.
  
  
  CONCLUSIONS
  Our findings suggest a high rate of cigarette use in the area. Increased stress levels appear to predispose females more than males to cigarette smoking. The implications of this association may guide interventions targeted at reducing smoking and its complications.
authors.affiliation: Department of Epidemiology, Ryals School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama 35294-0022, USA.
authors.forename: Faisal
authors.initials: F
authors.lastname: Shuaib
authors.forename: H R
authors.initials: HR
authors.lastname: Foushee
authors.forename: John
authors.initials: J
authors.lastname: Ehiri
authors.forename: Suparna
authors.initials: S
authors.lastname: Bagchi
authors.forename: Angela
authors.initials: A
authors.lastname: Baumann
authors.forename: Connie
authors.initials: C
authors.lastname: Kohler
mesh_terms: D000328:Adult; D001741:Black or African American; D000367:Age Factors; D000368:Aged; D000407:Alabama; D003430:Cross-Sectional Studies; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D012737:Sex Factors; D012907:Smoking / Q000009:adverse effects / Q000208:ethnology*; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000150:complications / Q000208:ethnology*