The Effects of Neighborhood Characteristics on Smoking Cessation

描述(申请人提供)：与烟草有关的肺癌是成人死亡的主要原因，烟草使用占癌症发病率和死亡率的-30%。因此，消除吸烟率，提高戒烟率，防止吸烟复发是预防癌症的基石。此外，重点关注受烟草使用影响不成比例的群体(例如，少数群体、社会经济地位低的群体或复发风险较高的人群)在抗击癌症方面显然很重要。以前的研究表明，社区水平的SES与更高的吸烟率独立相关，但在特定的戒烟尝试中，社区对吸烟结果的作用尚未被研究。这项研究的主要目的是研究社区特征如何影响在癌症健康差异风险增加的不同社区样本中特定戒烟尝试过程中潜在的戒烟和复发预防过程的机制。将检查4个研究人群的档案数据：说西班牙语的西班牙裔吸烟者(n=297)，非裔美国人吸烟者(n=400)，非裔美国人，说英语的西班牙裔吸烟者和高加索吸烟者(n=420)，以及戒烟并希望保持产后戒烟的孕妇(n=450)。本项目的具体目的是：1)评价邻里特征(包括邻里层面的社会经济地位、种族/民族构成、邻里问题、警觉性、社会凝聚力和社会控制)与戒烟的关系；2)评价压力、抑郁、负面情绪、自我效能和社会支持分别与邻里特征和戒烟之间的关系；3)评价自我效能、抑郁、负向情感、压力和/或社会支持是否在邻里特征和戒烟之间起中介作用。在一系列的4项研究中，我将使用多水平建模来研究社区环境通过问卷和生态瞬时评估数据以及复杂的地理软件绘制社区水平的人口和经济数据来影响戒烟的路径。这些努力将有助于更好地了解服务不足人群中吸烟状况的差异，并为改善对这些社区个人的服务提供重要信息，从而影响公众健康。

DESCRIPTION (provided by applicant): Tobacco-related lung cancer is a leading cause of death among adults, and tobacco use accounts for -30% of cancer incidence and mortality. Therefore, eliminating tobacco uptake, increasing rates of tobacco cessation, and preventing smoking relapse are the cornerstones of cancer prevention. Moreover, a focus on groups disproportionately affected by tobacco use (e.g., minorities, low socioeconomic status (SES) groups, or populations at increased risk of relapse) is of clear importance in the fight against cancer. Previous research has shown that neighborhood-level SES is independently associated with higher smoking prevalence, but the role of the neighborhood in smoking outcome during a specific quit attempt has not been studied. The primary aim of this research is to examine how neighborhood characteristics influence the mechanisms underlying the process of smoking cessation and relapse prevention during a specific quit attempt among diverse community samples at increased risk for health disparities in cancer. Archival data will be examined from 4 study populations: Spanish speaking Hispanic smokers (n = 297), African-American smokers (n = 400), African-American, English speaking Hispanic, and Caucasian smokers in equal numbers (n = 420), and pregnant women who quit smoking and want to remain quit postpartum (n = 450). Specific aims of this project are to: i) Evaluate the relation between neighborhood characteristics (including neighborhood-level SES, racial/ethnic composition, neighborhood problems, vigilance, social cohesion, and social control) and smoking abstinence; 2) Evaluate the relation of stress, depression, negative affect, self-efficacy, and social support with neighborhood characteristics and with smoking abstinence, respectively; and 3) Evaluate whether self-efficacy, depression, negative affect, stress, and/or social support mediate an observed association between neighborhood characteristics and abstinence. In a series of 4 studies, I will use multilevel modeling to examine the pathways through which the neighborhood context influences cessation using both questionnaire and ecological momentary assessment data, as well as sophisticated geographical software to map neighborhood-level demographic and economic data. These efforts will result in a better understanding of disparities in smoking status among underserved populations and provide information important for improving service to individuals from those communities, thereby affecting public health.