The Effects of Neighborhood Characteristics on Smoking Cessation

描述（由申请人提供）：烟草相关肺癌是成年人死亡的主要原因，烟草使用占癌症发病率和死亡率的-30%。因此，消除烟草摄取、提高戒烟率和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不成比例影响的群体（例如，少数民族、低社会经济地位群体或复发风险增加的人群）在防治癌症方面显然具有重要意义。先前的研究表明，社区水平的SES与较高的吸烟率独立相关，但在特定的戒烟尝试中，社区在吸烟结果中的作用尚未得到研究。本研究的主要目的是研究在不同社区样本中，在癌症健康差异风险增加的情况下，社区特征如何影响戒烟和复发预防过程的潜在机制。档案数据将从4个研究人群中进行检查：讲西班牙语的西班牙裔吸烟者（n = 297），非裔美国人吸烟者（n = 400），同等数量的非裔美国人，讲英语的西班牙裔美国人和高加索人吸烟者（n = 420），以及戒烟并希望产后戒烟的孕妇（n = 450）。该项目的具体目标是：i)评估社区特征（包括社区层面的社会经济状况、种族/民族构成、社区问题、警惕性、社会凝聚力和社会控制）与戒烟之间的关系；2)分别评价应激、抑郁、消极情绪、自我效能感和社会支持与邻里特征和戒烟的关系；3)评估自我效能、抑郁、负面影响、压力和/或社会支持是否介导邻里特征与戒断之间的关联。在一系列的4项研究中，我将使用多层次建模来检查社区环境影响戒烟的途径，使用问卷调查和生态瞬间评估数据，以及复杂的地理软件来绘制社区层面的人口和经济数据。这些努力将有助于更好地了解服务不足的人群中吸烟状况的差异，并提供重要信息，以改善对这些社区个人的服务，从而影响公共健康。

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.