Neighborhood Influences on Smoking and Marijuana Use Among Low-Income African American and Latino Adolescents

Background and Purpose: Smoking and substance use among adolescents have been of great health concern in the United States. Although environmental characteristics have been identified as critical factors in explaining smoking and substance use among adolescents, empirical evidence that simultaneously controls for multiple neighborhood contexts is limited. To address this concern,  our research questions examine: (1) What is the likelihood that low-income, African American and Latino children will start smoking and using marijuana during adolescence?; (2) Are there significant differences in their smoking and marijuana use that can be attributed to differences in their neighborhood environments, controlling for child, caregiver and household characteristics?; and (3) Are there significant gender and ethnic differences in adolescent smoking and marijuana use?

Methods: Data analyzed come from administrative records and surveys with primary caregivers who participated in the Denver Child Study, a natural experiment that allows us to control for parental geographic selection bias – one of the key methodological challenges in the estimation of neighborhood effects. This is a retrospective panel study of adolescents (N=760 for smoking; 746 for marijuana use) who resided at least 2 years in randomly assigned public housing units during adolescence and prior to the onset of smoking and marijuana use.  We estimated normalized Cox Proportional Hazards (PH) models with clustered robust standard errors to predict the onset of smoking and marijuana use during adolescence. Our empirical models include a battery of neighborhood indicators measuring neighborhood safety, social status, ethnic composition, and physical environment as well as child, caregiver, and household controls. Stratified models estimated differences in these neighborhood influences for African Americans and Latinos as well as male and female youth.

Results: Prevalence of adolescent smoking was 13.2%; 10.5% for marijuana use. The results from the Cox PH analyses indicate that aspects of neighborhood safety and physical environment were significant risk factors: one standard deviation higher property crime rates were associated with 60% and 170% higher risks of smoking and marijuana use, respectively. Residence in neighborhoods with older housing increased the risk of marijuana use by 46%. Neighborhood influence varied significantly by gender and ethnicity. Increased property crime posed higher risks of smoking for females (HR=1.70, p < .05) and marijuana use for Latino youth (HR=2.15, p < .05). Living in older neighborhoods increased the risk of marijuana use for females by 211%.

Conclusions and Implications: Neighborhood characteristics do matter for adolescent smoking and substance use, although this influence varies by gender and ethnicity. These findings have significant implications for community-based interventions that target the improvement of the residential environment as a strategy for reducing adolescent smoking and substance use.