title: Beyond Smoking Prevalence: Exploring the Variability of Associations between Neighborhood Exposures across Two Nested Spatial Units and Two-Year Smoking Trajectory among Young Adults.
abstract: Young adults have the highest prevalence of smoking amongst all age groups. Significant uptake occurs after high school age. Although neighborhood exposures have been found to be associated with smoking behavior, research on neighborhood exposures and the smoking trajectories among young adults, and on the role of geographic scale in shaping findings, is scarce. We examined associations between neighborhood exposures across two nested, increasingly large spatial units and smoking trajectory over two years among young adults living in Montreal, Canada. A sample of 2093 participants aged 18-25 years from the Interdisciplinary Study of Inequalities in Smoking (ISIS) was surveyed. The dependent variable was self-reported smoking trajectory over the course of two years. Residential addresses, data on presence of tobacco retail outlets, and the presence of smoking accommodation facilities were coded and linked to spatial units. Three-level multinomial models were used to examine associations. The likelihood of being a smoker for 2+ years was significantly greater among those living in larger spatial unit neighborhoods that had a greater presence of smoking accommodation. This association was not statistically significant at the smaller spatial units. Our findings highlight the importance of studying young adults' smoking trajectories in addition to static smoking outcomes, and point to the relevance of considering spatial scale in studies of neighborhoods and smoking.
authors.affiliation: Département de Médecine Sociale et Préventive, École de Santé Publique (ESPUM), Université de Montréal, 7101, Av. du Parc, Montreal, QC H3N 1X9, Canada. ae.ghenadenik@umontreal.ca.|Institut de Recherche en Santé Publique de l'Université de Montréal (IRSPUM), 7101, Av. du Parc, Montreal, QC H3N 1X9, Canada. ae.ghenadenik@umontreal.ca.|Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), 850 Saint Denis Street, Montreal, QC H2X 0A9, Canada. ae.ghenadenik@umontreal.ca.
authors.forename: Adrian E
authors.initials: AE
authors.lastname: Ghenadenik
authors.affiliation: Département de Médecine Sociale et Préventive, École de Santé Publique (ESPUM), Université de Montréal, 7101, Av. du Parc, Montreal, QC H3N 1X9, Canada. katherine.frohlich@umontreal.ca.|Institut de Recherche en Santé Publique de l'Université de Montréal (IRSPUM), 7101, Av. du Parc, Montreal, QC H3N 1X9, Canada. katherine.frohlich@umontreal.ca.
authors.forename: Katherine L
authors.initials: KL
authors.lastname: Frohlich
authors.affiliation: Département de Médecine Sociale et Préventive, École de Santé Publique (ESPUM), Université de Montréal, 7101, Av. du Parc, Montreal, QC H3N 1X9, Canada. lise.gauvin.2@umontreal.ca.|Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), 850 Saint Denis Street, Montreal, QC H2X 0A9, Canada. lise.gauvin.2@umontreal.ca.
authors.forename: Lise
authors.initials: L
authors.lastname: Gauvin
mesh_terms: D000293:Adolescent; D000328:Adult; D002170:Canada / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D015995:Prevalence; D012111:Residence Characteristics / Q000706:statistics & numerical data*; D012907:Smoking / Q000453:epidemiology* / Q000523:psychology*; D012931:Social Environment; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: multilevel; neighborhood exposures; smoking trajectory; spatial scale; young adults