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.