The influence of perceived neighborhood disorder on smoking cessation among urban safety net hospital patients

Background: Although research has shown that objective neighborhood characteristics are associated with health behaviors including smoking, little is known about the influence of perceived neighborhood characteristics on a smoking cessation attempt. Methods: Participants (N = 139) enrolled in a Dallas safety-net hospital smoking cessation program were followed from 1 week pre-quit through 4 weeks post-quit. Logistic regression analyses were conducted to evaluate the impact of perceived neighborhood order and disorder on the likelihood of achieving biochemically verified point prevalence and continuous smoking abstinence 4 weeks following a scheduled quit attempt. Analyses were adjusted for demographic characteristics, cigarettes per day, intervention group, and pharmacological treatment. Results: Participants were primarily non-White (72.7%) and female (56.8%) with a mean age of 52.5 (SD = 3.7) years. Most reported an annual household income of <$25,000 (86.3%). Logistic regression analyses indicated that greater neighborhood physical (p = .048) and social order (p = .039) were associated with a greater likelihood of achieving point prevalence smoking abstinence at 4 weeks post-quit. Greater perceived physical (p = .035) and social disorder (p = .039) and total neighborhood disorder (p = .014), were associated with a reduced likelihood of achieving point prevalence abstinence. Social disorder (p =. 040) was associated with a reduced likelihood of achieving continuous abstinence at 4 weeks post-quit, while social order (p =. 020) was associated with an increased likelihood of continuous abstinence. Conclusions: Perceptions of neighborhood order and disorder were associated with the likelihood of smoking cessation among socioeconomically disadvantaged smokers making a quit attempt. Findings highlight the need to address perceptions of the neighborhood environment among disadvantaged smokers seeking treatment. (C) 2015 Elsevier Ireland Ltd. All rights reserved.