Does the Relationship Between Cigarette Smoking and Other Key Health Behaviors Vary by Geographic Area Among US Young Adults? A Multilevel Analysis
Does the Relationship Between Cigarette Smoking and Other Key Health Behaviors Vary by Geographic Area Among US Young Adults? A Multilevel Analysis
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DOI：
10.1007/s12529-014-9452-0
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发表时间：
2015-08-01
影响因子：
2.7
通讯作者：
Lin, Hsien-Chang
中科院分区：
文献类型：
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作者：
Lee, Chung Gun;Seo, Dong-Chul;Lin, Hsien-Chang
尽管研究人员和实践者很早就意识到健康行为之间的相互依赖，但他们在研究和实践中往往将健康行为区分开来。这项研究调查了美国180个大都市和小城市统计区(MMSA)中吸烟与其他关键健康行为的差异，这些行为包括剧烈的体育活动、水果和蔬菜的消费以及酗酒。2009年行为风险因素监测系统(BRFSS)中的19027名年轻人的数据被用多水平Logistic回归模型分析。剧烈的体力活动和水果和蔬菜的消费都与吸烟负相关，而酗酒与吸烟正相关。吸烟与剧烈体力活动、水果和蔬菜消费以及酗酒的关系在180个MMSA中存在显著差异。这些差异与每个MMSA吸烟和酗酒的流行率有关。正如社会学习理论所表明的那样，特定地区的健康行为流行率似乎反映了关于这些行为的群体规范，而这些规范反过来又影响到相应地区的健康行为的聚集。
Although researchers and practitioners have long been aware of interdependence among health behaviors, they tend to compartmentalize health behaviors in research and practice. This kind of approach often fails to acknowledge the syndemic nature of health behaviors.This study investigated differences in the relationship between cigarette smoking and other key health behaviors, such as vigorous physical activity, fruit and vegetable consumption, and binge drinking among young adults (ages 18 to 30 years) across 180 metropolitan and micropolitan statistical areas (MMSAs) in the USA.A total of 19,027 young adults in the 2009 Behavioral Risk Factor Surveillance System (BRFSS) data were analyzed using multilevel logistic regression models.Both vigorous physical activity and fruit and vegetable consumption were negatively associated with cigarette smoking, whereas binge drinking was positively associated with smoking. There were significant differences in the relation of smoking with vigorous physical activity, fruit and vegetable consumption, and binge drinking across the 180 MMSAs. These differences were associated with the prevalence of cigarette smoking and binge drinking for each MMSA.As indicated by the social learning theory, geographic area-specific prevalence of health behaviors appears to reflect group norms regarding those behaviors which, in turn, affect the clustering of health behaviors in the respective area.