Neighborhood safety as a correlate of tobacco use in a sample of urban, pregnant women

• Published in: Addictive behaviors Vol. 37; no. 10; pp. 1132 - 1137
• Main Authors: Patterson, Freda, Seravalli, Laura, Hanlon, Alexandra, Nelson, Deborah B
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.10.2012; Elsevier Science Ltd
• Subjects: Adolescent; Adult; Cross-Sectional Studies; Female; Follow-Up Studies; Health behavior; Humans; Low income groups; Neighborhood violence; Neighborhoods; Poverty; Pregnancy; Psychiatry; Residence Characteristics - statistics & numerical data; Risk Factors; Safety; Self Report; Smoking; Smoking - epidemiology; Smoking - psychology; Tobacco; Urban Health; Violence - psychology; Violence - statistics & numerical data; Young Adult; Pregnancy; Neighborhood violence; Smoking
• ISSN: 0306-4603; 1873-6327
• DOI: 10.1016/j.addbeh.2012.05.011

Abstract Objectives Environmental context has been increasingly recognized as an important determinant of health behavior. This study examined the effects of self-reported neighborhood violence and perceived safety on tobacco use in a sample of low-income, pregnant women. Methods Pregnant women (N = 1521) being treated at an urban emergency room completed a baseline interview where neighborhood safety (self-reported neighborhood violence and perceived safety) as well as individual (demographics, depression symptoms, stress, tobacco use, substance abuse) and social variables (prenatal social environment and number of close friends) were evaluated cross-sectionally. Tobacco use was measured again in a telephone interview at 22 weeks gestation. Results In a logistic regression model of baseline smoking status, self-reported neighborhood violence was significantly associated with being a smoker independent of age, education status, attendance to prenatal care, gestational age and lifetime use of cocaine and marijuana. In a regression model estimating the relationship between these baseline variables and continued prenatal smoking, baseline smoking emerged as the strongest correlate of continued smoking during pregnancy. Conclusions These findings suggest that self-reported neighborhood violence had a stronger association with early pregnancy cigarette use compared to ongoing cigarette use in a sample of low-income, pregnant women. Prospective trials are needed to fully elucidate the relationship between individual and social-environmental determinants of tobacco use in this high-risk population.