Perceived neighborhood cohesion (NC) and education: individual and combined effects on daily smoking and heavier drinking in Hong Kong Chinese

Abstract

OBJECTIVES: The effect of perceived neighborhood cohesion (NC) on daily smoking/heavier drinking has not been previously examined among Chinese. This study examines the association between perceived NC, education, and daily smoking/heavier drinking, and assesses interaction between low NC and lower education on smoking/drinking. METHODS: A randomly selected representative sample of 12,302 participants aged over 15 from the Hong Kong Jockey Club FAMILY Project was used. Perceived NC was defined as the perception of bonds among neighbors and measured using Sampson et al.’s five-item scale (1997). Heavier drinking was defined as alcohol consumption of more than 168 grams (for males) and 120 grams (for females) per week, or engagement in binge drinking in the past month. Synergy indices (SI) were used to examine the interaction effect between NC and education on smoking/drinking. RESULTS: Low NC was associated with daily smoking (adjusted odds ratio (AOR) =1.51; 95% confidence interval (CI):1.18-1.92) and heavier drinking (AOR = 1.64; 95% CI = 1.13-2.38) among females only. Studying their combined effect, low NC was associated with smoking (AOR = 1.75; 95% CI: 1.35-2.26) and drinking (AOR = 1.66; 95% CI: 1.15-2.39) among females with secondary education only. The proportions of smoking/drinking were the largest among females with low NC and secondary education. This group also reported the largest odds to smoke (AOR = 5.49; 95% CI = 3.25-9.26) or drink (AOR = 1.77; 95% CI = 1.08-2.91). SI between low NC and secondary education were larger than 1, indicating that their combined effect is larger than the addition of their individual effects. Interaction accounted for 43% and 28% of the combined effect of low NC and secondary education on smoking and drinking, respectively. CONCLUSION: Females characterized by low perceived NC and lower education level are associated with higher odds of daily smoking or heavier drinking and may benefit from targeted prevention programs.