title: Objective and perceived neighborhood characteristics and tobacco use among young adults.
abstract: BACKGROUND
  In the US, past month tobacco use is higher among young adults aged 18-25 years than among any other age group. Neighborhood disorder may be a malleable environmental determinant of tobacco use among young adults; its correlation with tobacco use is understudied. The purpose of this study is to examine whether perceived and objectively measured neighborhood factors are associated with tobacco use among young adults in Baltimore City.
  
  
  METHODS
  This cross-sectional study of predominately African American young adults (n=359) used logistic regression models via generalized estimating equations (GEE) to estimate the association of perceived and objective neighborhood disorder with past month tobacco use, adjusting for race, age, sex, income, and other substance use. Two measures of perceived neighborhood environment - neighborhood drug involvement, and neighborhood social cohesion - were derived from the Neighborhood Environment Scale (NES). Objective neighborhood disorder was measured via trained field raters using the Neighborhood Inventory for Environmental Typology (NIfETy) instrument.
  
  
  RESULTS
  Sex modified the relationship between perceived neighborhood drug involvement and past month tobacco use, and the association was significant among women only (aOR=1.49; 95% CI=1.19-1.88). Perceptions of neighborhood social cohesion (aOR=0.97; 95% CI=0.83-1.13), and objective neighborhood disorder (aOR=1.17; 95% CI=0.98-1.38) were not significantly associated with past month tobacco use.
  
  
  CONCLUSIONS
  Understanding the correlation between perceived and objective neighborhood disorder, and their independent association with tobacco use can potentially lead to environmentally based interventions aimed at reducing tobacco use among young adults who live in urban environments.
authors.affiliation: Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 North Broadway 8th Floor, Baltimore, MD 21205, USA. Electronic address: qbrown@jhofi.com.
authors.forename: Qiana L
authors.initials: QL
authors.lastname: Brown
authors.affiliation: Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 North Broadway 8th Floor, Baltimore, MD 21205, USA.
authors.forename: Adam J
authors.initials: AJ
authors.lastname: Milam
authors.affiliation: Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 North Broadway 8th Floor, Baltimore, MD 21205, USA.
authors.forename: Mieka J
authors.initials: MJ
authors.lastname: Smart
authors.affiliation: Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 North Broadway 8th Floor, Baltimore, MD 21205, USA.
authors.forename: Renee M
authors.initials: RM
authors.lastname: Johnson
authors.affiliation: Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 624 North Broadway 8th Floor, Baltimore, MD 21205, USA.
authors.forename: Sabriya L
authors.initials: SL
authors.lastname: Linton
authors.affiliation: Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 North Broadway 8th Floor, Baltimore, MD 21205, USA.
authors.forename: C Debra M
authors.initials: CDM
authors.lastname: Furr-Holden
authors.affiliation: Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 North Broadway 8th Floor, Baltimore, MD 21205, USA.
authors.forename: Nicholas S
authors.initials: NS
authors.lastname: Ialongo
mesh_terms: D000293:Adolescent; D001741:Black or African American / Q000208:ethnology*; D015142:Baltimore / Q000208:ethnology; D003430:Cross-Sectional Studies; D018479:Early Intervention, Educational / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D010465:Perception; D012111:Residence Characteristics; D012931:Social Environment; D064424:Tobacco Use / Q000208:ethnology* / Q000517:prevention & control; D055815:Young Adult
keywords: NES; NIfETy, African American; Neighborhood disorder; Tobacco; Young adults