Objectives: To assess the effects of neighbourhood level socioeconomic status (SES) and convenience store concentration on individual level smoking, after consideration of individual level characteristics.
Design: Individual sociodemographic characteristics and smoking were obtained from five cross sectional surveys (1979–1990). Participants’ addresses were geocoded and linked with census data for measuring neighbourhood SES and with telephone yellow page listings for measuring convenience store concentration (density in a neighbourhood, distance between a participant’s home and the nearest convenience store, and number of convenience stores within a one mile radius of a participant’s home). The data were analysed with multilevel Poisson regression models.
Setting: 82 neighbourhoods in four northern California cities.
Participants: 8121 women and men aged 25–74 from the Stanford heart disease prevention programme.
Main results: Lower neighbourhood SES and higher convenience store concentration, measured by density and distance, were both significantly associated with higher level of individual smoking after taking individual characteristics into account. The association between convenience store density and individual smoking was modified by individual SES and neighbourhood SES.
Conclusions: These findings are consistent with a growing body of literature suggesting that the socioeconomic and physical environments of neighbourhoods are associated with individual level smoking.
- neighbourhood characteristics
- socioeconomic factors
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Funding: this work was co-funded by the National Institute of Environmental Health Sciences and the National Heart, Lung, and Blood Institute, USA: grant RO1 HL67731 to Dr Winkleby.
Conflicts of interest: none declared.
Ethics approval: all research was approved by the ethics committee at Stanford University, School of Medicine and conforms to the principles of the Declaration of Helsinki.
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