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. 2020 Oct 29;22(11):1997-2005.
doi: 10.1093/ntr/ntaa035.

Smoking in Young Adults: A Study of 4-Year Smoking Behavior Patterns and Residential Presence of Features Facilitating Smoking Using Data From the Interdisciplinary Study of Inequalities in Smoking Cohort

Adrian E Ghenadenik  1   2   3 , Lise Gauvin  1   3 , Katherine L Frohlich  1   2
Affiliations

Smoking in Young Adults: A Study of 4-Year Smoking Behavior Patterns and Residential Presence of Features Facilitating Smoking Using Data From the Interdisciplinary Study of Inequalities in Smoking Cohort

Adrian E Ghenadenik et al. Nicotine Tob Res. .

Abstract

Introduction: 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.

Aims and methods: 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.

Results: 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.

Conclusions: 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.

Implications: 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.

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Figures

Figure 1.
Figure 1.
Operationalization of 4-year smoking behavior patterns.
See this image and copyright information in PMC

References

    1. Reid JL, Hammond D, Rynard VL, et al. Tobacco Use in Canada: Patterns and Trends, 2017 Edition. Waterloo, Canada: Propel Centre for Population Health Impact, University of Waterloo; 2017.
    1. Gagné T. Estimation of smoking prevalence in Canada: implications of survey characteristics in the CCHS and CTUMS/CTADS. Can J Public Health. 2017;108(3):e331–e334. - PMC - PubMed
    1. Freedman KS, Nelson NM, Feldman LL. Smoking initiation among young adults in the United States and Canada, 1998–2010: a systematic review. Prev Chronic Dis. 2012;9:110037. doi: 10.5888/pcd9.110037. - DOI - PMC - PubMed
    1. Institute of Medicine and National Research Council. Investing in the Health and Well-Being of Young Adults. Washington, DC: The National Academies Press; 2015.
    1. Barnett R, Moon G, Pearce J, et al. Smoking Geographies: Space, Place and Tobacco. West Sussex, UK: Wiley Blackwell; 2017.

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