Individual- and area-level unemployment influence smoking cessation among African Americans participating in a randomized clinical trial

Abstract

African Americans suffer disproportionately from the adverse health consequences of smoking, and also report substantially lower socioeconomic status than Whites and other racial/ethnic groups in the U.S. Although socioeconomic disadvantage is known to have a negative influence on smoking cessation rates and overall health, little is known about the influence of socioeconomic status on smoking cessation specifically among African Americans. Thus, the purpose of the current study was to characterize the impact of several individual- and area-level indicators of socioeconomic status on smoking cessation among African Americans. Data were collected as part of a smoking cessation intervention study for African American smokers (N = 379) recruited from the Houston, Texas, metropolitan area, who participated in the study between 2005 and 2007. The separate and combined influences of individual-level (insurance status, unemployment, education, and income) and area-level (neighborhood unemployment, education, income, and poverty) indicators of socioeconomic status on continuous smoking abstinence were examined across time intervals using continuation ratio logit modeling. Individual-level analyses indicated that unemployment was significantly associated with reduced odds of smoking abstinence, while higher income was associated with greater odds of abstinence. However, only unemployment remained a significant predictor of abstinence when unemployment and income were included in the model together. Area-level analyses indicated that greater neighborhood unemployment and poverty were associated with reduced odds of smoking abstinence, while greater neighborhood education was associated with higher odds of abstinence. However, only neighborhood unemployment remained significantly associated with abstinence status when individual-level income and unemployment were included in the model. Overall, findings suggest that individual- and area-level unemployment have a negative impact on smoking cessation among African Americans. Addressing unemployment through public policy and within smoking cessation interventions, and providing smoking cessation treatment for the unemployed may have a beneficial impact on tobacco-related health disparities.

Smoking Cessation During Pregnancy Among Roma and Non-Roma Women in Hungary’s Underdeveloped Regions

“…Concerning the socioeconomic status and contrasted to a recent study targeting African American women (Kendzor et al, 2012), our findings reaffirm previous research that unemployment and deep povertyare significant predictors of continued smoking during the pregnancy. However, because of the difference in samples between the Kendzor et al (2012) study and ours, we can conclude that deep poverty among pregnant women was definitely not associated with greater odds of quitting for economic reasons.…”

“…However, because of the difference in samples between the Kendzor et al (2012) study and ours, we can conclude that deep poverty among pregnant women was definitely not associated with greater odds of quitting for economic reasons.…”

Social disparities in tobacco use in India: The roles of occupation, education and gender

“…[21,22] Greater neighborhood unemployment and poverty were associated with reduced odds of smoking abstinence, while greater neighborhood education was associated with higher odds of abstinence. [26] Education independently reduces the odds of a manual class person smoking relative to a non-manual by 12%. [27] When compared to their individual effect, the present study highlights that together they greatly increase the risk.…”

Growth Models of Maternal Smoking Behavior: Individual and Contextual Factors

“…Glass and McAtee (2006) characterize the development of health actions or behaviors over the stream of time — potentially marked and influenced by turning points such as pregnancy and the transition to parenthood (Rutter, 1996) as well as individual age (Pickett & Pearl, 2001) — with social structures influencing the quality, direction, and intensity of health behaviors. Stressful economic conditions such as individual and area unemployment and poverty are fundamental mechanisms by which neighborhood contexts may influence smoking behavior (Kendzor et al, 2012; Lantz & Pritchard, 2010; Nkansah-Amankra, 2010; Schempf, Strobino, & O’Campo, 2009). Although maternal smoking during pregnancy moderates the effect of neighborhood variables on child outcomes (Nkansah-Amankra, 2010; Rich-Edwards, Buka, Brennan, & Earls, 2003), few neighborhood studies of pregnant women are designed to focus on maternal smoking behavior as a risk factor in their own health profiles.…”