The Role of Perceived Neighborhood Cohesion in the Association between Depressive Symptoms and Cigarette Smoking

Abstract

Background

Greater depression has been linked to increased smoking rates. However, the mechanisms underlying this association are not fully understood. It is possible that high perceived neighborhood cohesion may serve as one such mechanism given its associations with decreased depression and smoking. Having increased levels of depression likely impacts one’s perceptions of neighborhood cohesion, which could lead to further increases in depression and a need to manage these symptoms via cigarette smoking. As a first test of this theory, the current study examined the effect of neighborhood cohesion on the association between depressive symptoms and smoking frequency and quantity among past 30-day cigarette smokers.

Methods

Participants were 201 combustible cigarette smokers (M_age = 48.33, SD = 11.64; 63.2% female; 68.2% White) who completed self-report measures as part of a larger study of environmental influences on cardiac health.

Results

Greater depressive symptoms were associated with lower levels of perceived neighborhood cohesion, and there was a significant indirect effect of greater depressive symptoms on heavier smoking through decreased neighborhood cohesion (b = .07, SE = .04, 95% CI [.003, .15]). There was no significant indirect effect for daily smoking.

Conclusion

These results suggest that neighborhood cohesion is an important contextual factor that serves as one explanatory mechanism for the well-established relationship between depression and smoking quantity. Thus, there may be utility in implementing interventions focused on increasing neighborhood cohesion as a way to decrease smoking behavior.

Keywords:

• Cigarettes
• depression
• perceived neighborhood cohesion
• smoking
• social cohesion

Disclosure statement

The authors report there no conflict of interest.

Data availability statement

The data that support the findings of this study are available from the corresponding author, A.C.M., upon reasonable request.

Additional information

Funding

This work was supported, in part, by grants from the National Institute of Environmental Health Sciences (Award Numbers R01 ES 029846 and P42 ES023716) as well as the National Heart, Lung, and Blood Institute (NHLBI) and the FDA Center for Tobacco Products (Award Number U54HL120163). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health, the Food and Drug Administration, or the University of Louisville. The funding sponsors had no role in study design; data collection, analyses, or interpretation; manuscript preparation; or the decision to publish the results.