Academic Medical Center, University of Amsterdam, Department: Public Health, Amsterdam Public Health research institute, Amsterdam, The Netherlands.
Department of Geography, Planning & International Development Studies, University of Amsterdam, Amsterdam, The Netherlands.
Prev Med. 2018 Jul;112:111-118. doi: 10.1016/j.ypmed.2018.04.012. Epub 2018 Apr 12.
This study examines the associations between neighbourhood safety and three types of smoking behaviour, and whether these associations differ by sex, age, ethnicity and individual-level socio-economic position. Baseline data (2011-2015) from the The HEalthy LIfe in an Urban Setting (HELIUS) study (Amsterdam, the Netherlands) were used. Smoking behaviour was based on self-report. Heavy smoking was defined as smoking ≥10 cigarettes per day. Nicotine dependence was assessed using the Fagerström questionnaire. Geographic Information System techniques were used to construct local residential areas and to examine neighbourhood safety for these areas using micro-scale environmental data. Multilevel logistic regression analyses with 6-digit zip code area as a second level were used to assess the association between neighbourhood safety and smoking. In our study sample of 22,728 participants (18-70 years), 24.0% were current smokers, 13.7% were heavy smokers and 8.1% were nicotine dependent individuals. Higher levels of neighbourhood safety were significantly associated with less heavy smoking (OR = 0.88, 95% CI = 0.78-0.99) and less nicotine dependence (OR = 0.81, 95% CI = 0.69-0.95), but not with less current smoking (OR = 1.01, 95% CI = 0.91-1.11). The associations between neighbourhood safety and the three types of smoking behaviour varied by ethnicity. For instance, higher levels of neighbourhood safety were associated with less current smoking in participants of African Surinamese origin (OR = 0.71, 95% CI = 0.57-0.89), but not in those of Dutch (OR = 1.13, 95% CI = 0.91-1.39), South-Asian Surinamese (OR = 1.22, 95% CI = 0.95-1.55), Turkish (OR = 1.08, 95% CI = 0.84-1.38), Moroccan (OR = 1.53, 95% CI = 1.12-2.10) or Ghanaian (OR = 1.18, 95% CI = 0.47-2.94) origin. Policies that improve neighbourhood safety potentially contribute to less heavy smoking and nicotine dependence.
本研究考察了邻里安全与三种吸烟行为之间的关联，以及这些关联是否因性别、年龄、种族和个体社会经济地位的不同而有所不同。本研究使用了来自“城市环境中的健康生活（HELIUS）”研究（荷兰阿姆斯特丹）的基线数据（2011-2015 年）。吸烟行为基于自我报告。重度吸烟定义为每天吸烟≥10 支。尼古丁依赖程度使用 Fagerström 问卷进行评估。使用地理信息系统技术构建了当地居住区域，并使用微观环境数据来检查这些区域的邻里安全情况。使用六位数邮政编码区域作为二级的多水平逻辑回归分析用于评估邻里安全与吸烟之间的关联。在我们的研究样本中，共有 22728 名参与者（18-70 岁），其中 24.0%为当前吸烟者，13.7%为重度吸烟者，8.1%为尼古丁依赖者。较高的邻里安全水平与较少的重度吸烟（OR=0.88，95%CI=0.78-0.99）和较少的尼古丁依赖（OR=0.81，95%CI=0.69-0.95）显著相关，但与当前吸烟量减少无关（OR=1.01，95%CI=0.91-1.11）。邻里安全与三种吸烟行为之间的关联因种族而异。例如，较高的邻里安全水平与非洲苏里南裔参与者的当前吸烟量减少有关（OR=0.71，95%CI=0.57-0.89），但与荷兰裔参与者无关（OR=1.13，95%CI=0.91-1.39）、南亚苏里南裔（OR=1.22，95%CI=0.95-1.55）、土耳其裔（OR=1.08，95%CI=0.84-1.38）、摩洛哥裔（OR=1.53，95%CI=1.12-2.10）或加纳裔（OR=1.18，95%CI=0.47-2.94）。改善邻里安全的政策可能有助于减少重度吸烟和尼古丁依赖。
