title: Psychosocial stressors and cigarette smoking among African American adults in midlife.
abstract: BACKGROUND
  Psychosocial stress is a significant risk factor for smoking, and Blacks experience higher levels of psychosocial stress relative to other racial/ethnic groups. Limited research has comprehensively examined psychosocial stressors in relation to smoking among Blacks.
  
  
  METHODS
  We examined psychosocial stressors in relation to smoking status (current, previous, and never) in middle-aged Blacks (34-85 years, n = 592) from Milwaukee, Wisconsin, a subset of the Midlife in the United States Study II (2004-2006). Eleven stressor domains were assessed, including psychological and physical work stress, work-family conflict, perceived inequality, relationship stress, neighborhood stress, discrimination, financial stress, recent problems, stressful events, and childhood adversity. We also calculated a cumulative score. Multinomial models were adjusted for age, gender, education, and income.
  
  
  RESULTS
  Seven of the 11 stressors and the cumulative score were associated with higher odds of being a current smoker compared with a never-smoker: neighborhood, financial, relationship, and psychological work stress, perceived inequality, stressful events, childhood adversity (p values <.05; ORs ranged from 1.28 to 1.77). Three stressors and the cumulative score were associated with higher odds of being a previous smoker versus a never-smoker (p < .05). Individuals who scored in the top quartile on 5 or more stressors were 3.74 (95% CI = 2.09-6.71) times as likely to be current smokers, and more than twice as likely to be previous smokers, compared with individuals with no high stressors.
  
  
  CONCLUSIONS
  These results demonstrate a strong relationship between stress and smoking among urban middle-aged Blacks and suggest that cessation programs should address modifiable individual and community-level stressors.
authors.affiliation: Center on the Developing Child, Harvard University, 50 Church Street, 4th Floor, Cambridge, MA 02138, USA. nslopen@hsph.harvard.edu
authors.forename: Natalie
authors.initials: N
authors.lastname: Slopen
authors.forename: Lauren M
authors.initials: LM
authors.lastname: Dutra
authors.forename: David R
authors.initials: DR
authors.lastname: Williams
authors.forename: Mahasin S
authors.initials: MS
authors.lastname: Mujahid
authors.forename: Tené T
authors.initials: TT
authors.lastname: Lewis
authors.forename: Gary G
authors.initials: GG
authors.lastname: Bennett
authors.forename: Carol D
authors.initials: CD
authors.lastname: Ryff
authors.forename: Michelle A
authors.initials: MA
authors.lastname: Albert
mesh_terms: D000328:Adult; D001741:Black or African American / Q000523:psychology*; D000368:Aged; D000369:Aged, 80 and over; D003710:Demography; D005260:Female; D006801:Humans; D008016:Life Change Events; D008297:Male; D008875:Middle Aged; D012111:Residence Characteristics; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology / Q000523:psychology*; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000150:complications*; D014922:Wisconsin / Q000453:epidemiology