Département de médecine sociale et préventive, École de santé publique (ESPUM), Université de Montréal, Montreal, Canada.
Institut de recherche en santé publique de l'Université de Montréal (IRSPUM), Montreal, Canada.
Nicotine Tob Res. 2020 Oct 29;22(11):1997-2005. doi: 10.1093/ntr/ntaa035.
Young adults have the highest prevalence of smoking among all age groups in most industrialized countries and exhibit great variability in smoking behavior. Differences in associations between features in residential environments and smoking initiation, prevalence, and cessation have been extensively examined in the literature. Nonetheless, in many cases, findings remain inconsistent. This paper proposes that a potential driver of these inconsistencies is an almost exclusive focus on point-specific smoking outcomes, without consideration for the different behavior patterns that this age group may experience over time.
Based on data from the Interdisciplinary Study of Inequalities in Smoking cohort of 18- to 25-year-old Montreal residents (n = 1025), we examined associations between 4-year smoking patterns measured at three timepoints and proximal presence/density of tobacco retail outlets and presence of smoker accommodation facilities in Montreal, Canada. Associations were tested using two-level multinomial and logistic models.
In fully adjusted models, compared to never-smokers, residents of areas with a higher density of tobacco retail were more likely to (1) be characterized as established smokers, (2) have experienced repeated changes in smoking status (being "switchers") during the 4-year study period, and (3) be former smokers.
From a conceptual standpoint, these findings highlight the importance of acknowledging and examining smoking behavior patterns among young adults. Furthermore, specific pattern-feature associations may point to unique mechanisms by which features could influence smoking behavior patterns. These findings require replication and extension, including testing hypotheses regarding tobacco retail density's role in sustaining smoking and in influencing changes in smoking status.
Results from this study highlight the importance of describing and examining different young adult smoking behavior patterns and how they may be influenced by residential environment features such as the density of tobacco retail. Findings suggest that young adults residing in areas with a higher density of tobacco retailers are more likely to have experienced repeated changes in smoking status and to be established smokers. Further research in this area is needed to advance knowledge of the putative mechanisms by which residential features may influence smoking behavior patterns and to ultimately orient policy and interventions seeking to curb smoking at the local level.
在大多数工业化国家，年轻人在所有年龄段中吸烟率最高，且吸烟行为差异较大。文献中广泛研究了居住环境特征与吸烟起始、流行和戒烟之间的关联差异。尽管如此，在许多情况下，研究结果仍然不一致。本文提出，造成这种不一致的一个潜在原因是几乎完全关注特定时间点的吸烟结果，而没有考虑到该年龄段随时间推移可能经历的不同行为模式。
基于来自蒙特利尔 18 至 25 岁居民的跨学科吸烟不平等研究队列（n=1025）的数据，我们检验了在三个时间点测量的四年吸烟模式与加拿大蒙特利尔烟草零售点的近距存在/密度以及吸烟者住宿设施的存在之间的关联。使用两水平多项和逻辑模型检验关联。
在完全调整的模型中，与从不吸烟者相比，居住在烟草零售密度较高地区的居民更有可能（1）被归类为已确立的吸烟者，（2）在四年的研究期间经历过吸烟状态的反复变化（成为“转换者”），以及（3）曾经是吸烟者。
从概念角度来看，这些发现强调了承认和检验年轻人吸烟行为模式的重要性。此外，特定模式特征关联可能指向特征影响吸烟行为模式的独特机制。这些发现需要复制和扩展，包括检验烟草零售密度在维持吸烟和影响吸烟状态变化中的作用的假设。
本研究结果强调了描述和检验不同的年轻成人吸烟行为模式以及它们如何受居住环境特征（如烟草零售密度）影响的重要性。研究结果表明，居住在烟草零售商密度较高地区的年轻人更有可能经历过吸烟状态的反复变化，并且成为已确立的吸烟者。需要在这一领域进行进一步研究，以增进对居住特征可能影响吸烟行为模式的潜在机制的了解，并最终为在地方一级遏制吸烟的政策和干预措施提供指导。
