Associations of smoking prevalence with individual and area level social cohesion.

STUDY OBJECTIVE To discover if area level social cohesion, neighbourhood safety, and home safety are associated with current cigarette smoking among adults after adjustment for concentrations of poverty and low education. DESIGN Cross sectional survey of a random sample of adults, stratified by 19 geographical areas. SETTING SHAPE, Survey of the Health of Adults, the Population, and the Environment-conducted in 1998 by the Hennepin County Community Health Department and the Minneapolis Department of Health and Family Support in Minnesota. PARTICIPANTS 5256 men and 4806 women, 18 years and older, randomly selected from 19 geographical areas in an urban county. MAIN RESULTS Overall, 21.2% of survey respondents reported current cigarette smoking. Both higher area level social cohesion (OR = 0.85, 95% CI = 0.74 to 0.98) and higher individual social cohesion (OR = 0.96, 95% CI = 0.92 to 0.99) were associated with lower likelihoods of smoking. Similar models were obtained for neighbourhood safety and home safety. CONCLUSIONS These findings contribute to the growing literature on the important role of social cohesion and other area level characteristics on smoking behaviour among adults.