Future research should explore how best to alter the sellekchem contextual environment to affect reductions in tobacco dependence among smokers living in less desirable neighborhoods. Although we hypothesized that troubled neighborhoods affect tobacco dependence in this study, it is also important to acknowledge the potential for a reversed model whereby tobacco dependence contributed to residence in troubled neighborhoods. Tobacco dependence might affect neighborhood selection directly (more dependent people may choose to live in areas with greater access to tobacco, and these areas may be more likely to have problems or engender more vigilance). Or, alternatively, tobacco dependence might be a proxy for other factors that contributed to residence in troubled neighborhoods.
These possibilities might limit the effects that environmental manipulations could have on tobacco dependence. Future studies should make use of longitudinal designs to enhance our understanding of the directionality of effects, which will also help to inform the utility of place-based interventions. This study relied entirely on self-reported data. Therefore, the same-source reporting bias might have affected the significance of our results. To address this possibility, we conducted additional analyses that aggregated participant��s neighborhood perceptions to the tract level (see Echeverria et al., 2008, for precedent). Both area-level neighborhood problems and area-level neighborhood vigilance remained significantly associated with tobacco dependence in these adjusted analyses, with relations driven by secondary dependence motives (results are available upon request).
These results help to minimize concerns about the potential influence of same-source reporting bias in our data. However, although the aggregation of individual-level perceptions is helpful to address concerns about biases in self-reported data, the inclusion of mental health data (e.g., depression measures) in future research would also be helpful to rule out potential confounding. Strengths of the current work include the use of a multidimensional measure of tobacco dependence, which has several advantages over traditional single-item tobacco dependence questions (e.g., cigarettes per day), especially among AA smokers (Barondess, Meyer, Boinapally, Fairman, & Anthony, 2010; Benowitz & Jacob, 2011).
This work also has limitations. For example, neighborhood characteristics were based on individual perceptions and may not reflect objective neighborhood conditions. To the extent to which the two diverge, place-based interventions may be ineffective for altering residents�� tobacco dependence. Future studies in this area might include both self-reported and objective neighborhood data (e.g., crime statistics) Cilengitide to assess whether key findings replicate across data sources. Additional limitations of the current research include that participants were self-selected, treatment-seeking AA smokers.