title: Association Between Neighborhood-Level Smoking and Individual Smoking Risk: Maternal Smoking Among Latina Women in Pennsylvania.
abstract: OBJECTIVE
  We examined whether or not high maternal smoking rates at the neighborhood level increase the likelihood of individual smoking by Latina women in the three months prior to and during pregnancy, independent of other individual and neighborhood factors.
  
  
  METHODS
  This study was observational in nature, using linked vital statistics records for 24,443 Latina women in Pennsylvania (2009-2010) and U.S. Census data for 2,398 census tracts. We used multilevel logistic regression models to determine the individual odds of self-reported maternal smoking given different census tract-level rates of maternal smoking in the previous three years (2006-2008), adjusting for maternal and census-tract characteristics, including ethnic density, population density, and poverty.
  
  
  RESULTS
  Higher levels of maternal smoking at the census-tract level were associated with increased individual odds of smoking among Latina mothers. In the fully adjusted model, a 10% increase in the neighborhood smoking rate was associated with a 1.28 (95% confidence interval 1.22, 1.34) increase in the individual odds of smoking.
  
  
  CONCLUSIONS
  Latina women living in census tracts where more women have smoked during or immediately prior to pregnancy are themselves at higher risk of smoking during this period.
authors.affiliation: The Children's Hospital of Philadelphia PolicyLab, Division of General Pediatrics, Philadelphia, PA ; Current affiliation: Baylor College of Medicine, Houston, TX.
authors.forename: Arina
authors.initials: A
authors.lastname: Chesnokova
authors.affiliation: University of Pennsylvania Perelman School of Medicine, Center for Clinical Epidemiology and Biostatistics, Philadelphia, PA.
authors.forename: Benjamin
authors.initials: B
authors.lastname: French
authors.affiliation: University of Pennsylvania Perelman School of Medicine, Center for Clinical Epidemiology and Biostatistics, Philadelphia, PA.
authors.forename: Douglas
authors.initials: D
authors.lastname: Weibe
authors.affiliation: Yale School of Medicine, Department of Pediatrics, New Haven, CT.
authors.forename: Deepa R
authors.initials: DR
authors.lastname: Camenga
authors.affiliation: The Children's Hospital of Philadelphia PolicyLab, Division of General Pediatrics, Philadelphia, PA ; University of Pennsylvania Perelman School of Medicine, Department of Pediatrics, Philadelphia, PA.
authors.forename: Katherine
authors.initials: K
authors.lastname: Yun
mesh_terms: D005260:Female; D006630:Hispanic or Latino; D006801:Humans; D016015:Logistic Models; D009035:Mothers; D010414:Pennsylvania / Q000453:epidemiology; D011247:Pregnancy; D012907:Smoking / Q000453:epidemiology*