Neighborhood safety as a correlate of tobacco use in a sample of urban, pregnant women.
OBJECTIVE
Environmental context has been increasingly recognized as an important determinant of health behavior. This study examined the effects of self-reported neighborhood violence and perceived safety on tobacco use in a sample of low-income, pregnant women.


METHODS
Pregnant women (N=1521) being treated at an urban emergency room completed a baseline interview where neighborhood safety (self-reported neighborhood violence and perceived safety) as well as individual (demographics, depression symptoms, stress, tobacco use, substance abuse) and social variables (prenatal social environment and number of close friends) were evaluated cross-sectionally. Tobacco use was measured again in a telephone interview at 22 weeks gestation.


RESULTS
In a logistic regression model of baseline smoking status, self-reported neighborhood violence was significantly associated with being a smoker independent of age, education status, attendance to prenatal care, gestational age and lifetime use of cocaine and marijuana. In a regression model estimating the relationship between these baseline variables and continued prenatal smoking, baseline smoking emerged as the strongest correlate of continued smoking during pregnancy.


CONCLUSIONS
These findings suggest that self-reported neighborhood violence had a stronger association with early pregnancy cigarette use compared to ongoing cigarette use in a sample of low-income, pregnant women. Prospective trials are needed to fully elucidate the relationship between individual and social-environmental determinants of tobacco use in this high-risk population.
Department of Public Health, Temple University, Philadelphia, PA 19122, USA.
Freda
F
Patterson
Laura
L
Seravalli
Alexandra
A
Hanlon
Deborah B
DB
Nelson
D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D011203:Poverty; D011247:Pregnancy; D012111:Residence Characteristics / Q000706:statistics & numerical data*; D012307:Risk Factors; D012449:Safety; D057566:Self Report; D012907:Smoking / Q000453:epidemiology* / Q000523:psychology; D014504:Urban Health; D014754:Violence / Q000523:psychology / Q000706:statistics & numerical data*; D055815:Young Adult