Neighborhood Context and Smoking Cessation: A Comparison Between Latinos and Asian Americans

Purpose: Smoking is the single most important preventable cause of premature death in the United States. It is also a significant public health problem among Asian Americans and Latinos, the two fastest growing minority groups in the United States. Studies on smoking showed that neighborhood cohesion was inversely associated with tobacco smoking (Brown et al, 2006; Kandula et al, 2009; Sapag et al, 2010). But few studies have analyzed whether neighborhood cohesion is associated with smoking cessation and whether the associations differ across racial and gender groups. This paper fills the knowledge gap by assessing racial and gender differences/similarities in the relationships between neighborhood cohesion and smoking cessation among Latinos and Asian American populations.

Method: The study analyzed data from the National Latino and Asian Americans Study(NLAAS), a nationally representative sample of Asian and Latino Americans interviewed in English or their native languages. Ever smokers were those who reported having smoked at least 100 cigarettes during their lifetime, or at the time of interview, identified themselves as current smokers (CDC, 2009). Smoking cessation is defined as being ever-smokers, but not self reported as current smokers. We created a neighborhood cohesion scale based on the result of factor analysis of items that measured the cohesion, reciprocity, and disorder in respondents' communities. We then constructed a series of logistic regression models to predict the cessation of smoking, stratified by race and gender. First, we examined the associations between smoking cessation and individual and family level variables. Next, we sequentially added the neighborhood factor to the model. All estimates and analyses were weighted to adjust for the complex survey design.

Results: A total of 1,807 respondents (including 1,131 Latinos and 676 Asian Americans), aging from 18-89, were identified as ever smokers. Overall, Latinos had a higher rate of ever smokers (44.2% vs. 32.3%), but lower rate of smoking cessation than Asian Americans (54.8% vs. 59%). Analysis showed that, at individual and family levels, only age was positively associated with smoking cessation for Latino men, while for Latino women, both age and income were positive and significant. . For Asian American men, higher income and education, and stronger religion belief were positively associated with smoking cessation, while experiencing discrimination or increased contacts with relatives were negatively associated with smoking cessation. For Asian women, except for age positively related with smoking cessation, increased levels of contacts with friends, relatives, or family conflict were all negatively related to smoking cessation. Most important, the study found that neighborhood cohesion was significantly and positively associated with smoking cessation for both Latinos and Asian Americans (slightly less so for Asian men).

Implications: The findings of this study provide strong evidence that neighborhood cohesion might be beneficial for smoking cessation. Smoking prevention and cessation interventions among Latinos and Asian American populations may be more effective if they adopt strategies to enhance social cohesion at community level.