1. Environmental and Social Influences on Smoking among urban Hispanic Young Adults: An Observational Study
Jennifer D. McCleary-Sills, MPH, PhD(c)1; Evelyn Rosario2, Lee Bone, MPH, RN1,3 , Frances Stillman, EdD4
1 Johns Hopkins Bloomberg School of Public Health, Department of Health, Behavior and Society; 2 Esperanza Center, Community Outreach Team, Baltimore, MD;
3The Hopkins Center for Health Disparities Solutions, 4Johns Hopkins Bloomberg School of Public Health, Institute for Global Tobacco Control
Background
Methodology
Characteristics of Observed Venues
Conclusions
These findings provide further insight into the environmental influences on smoking behaviors in East Baltimore, including exposure to tobacco advertising and adherence to the city-wide smoking ban. The data indicate that venues outside of the local community should be explored to better understand the environment of social venues frequented by Hispanic young adults.
The knowledge gained from this research will be instrumental in the development of appropriate interventions to eliminate tobacco use among Hispanic young adults in Baltimore and to foster future academic-community partnerships to reduce health disparities experienced by Hispanics in Baltimore City.
The research team conducted a community mapping to identify access points for cigarettes and locations where young Hispanic adults are likely to smoke. This mapping identified a total of 98 merchants as cigarette access points and 24 bars and nightclubs as smoking locations within East Baltimore.
Four observers (2 male, 2 female) were recruited from the local community; they received training on the survey instrument and the use of handheld computers. Each observer completed at least one pilot observation before fielding the checklist.
Observers worked in teams of two (1 male, 1 female) to conduct observations of the 24 bars and nightclubs during the busiest hours on Friday and Saturday nights.
4) The standardized checklist captured detailed information on the environment of each venue, including:
-tobacco-related signage and advertising,
-presence of smoking in front/inside of venue,
-availability of cigarettes and other tobacco products
-patrons’ characteristics.
5) Data were recorded using Pendragon software and analyses of patterns in the observations were conducted using Stata 10.
While national trends in smoking show declining prevalence, this decrease has been less sharp among racial and ethnic minorities.
This disparity is particularly notable among minorities in urban areas, low socioeconomic groups, and with low levels of formal education.
Prior research with urban Hispanic young adults in East Baltimore highlighted a number of social and cultural influences on smoking behaviors and decision making.
The present research aimed to add to this body of knowledge by investigating influences on smoking behaviors in the physical environment.
Photo Source:
The Network Thinker, May 2008
Acknowledgements
Table 1: Characteristics of Observed Venues
(n=44 Observations)
Variable
n (%)
Designated outdoor smoking area in front of venue (Yes)
9 (20.4)
Informal groups of smokers outside (Yes)
10 (22.7)
Signs about not smoking inside venue (Yes)
27 (61.4)
Signs also in Spanish (Yes)
4 (9.1)
Tobacco print ads inside venue (Yes)
Predominant age of patrons (Yes)
Attendees are Hispanic/ Latino (Yes)
43 (97.7)
Tobacco products being used inside (Yes)
3 (6.8)
Designated outdoor smoking area accessible only through the venue (Yes)
2 (4.5)
Evidence of smoking in bathroom (Yes)
This research was supported by grant #P60MD from the National Center on Minority Health and Health Disparities (NCMHD) of the National Institutes of Health (NIH).
The research team is grateful to several community partners for their support of and contributions to this project:
Ms. Sheyla Laviera
Mr. Chris Burgess
Mr. Edgar Juárez
Ms. Aryuna Balzhirova 
The Hopkins Center for Health Disparities Solutions
The Esperanza Center staff and clients
The Latino Providers Network
Ms. Mieka Smart
Research Partnership
The Johns Hopkins School of Public Health research team partnered with Esperanza Center, an community-based organization providing health, legal, literacy, and other social services to immigrants in East Baltimore.
Key staff from Esperanza Center participated in each stage of the research process, including:
-conducting a community mapping of bars and night clubs
-development and tailoring of research instruments;
-identifying and recruiting observers
-reviewing and contributing to relevant presentations and manuscripts
Key Findings
-While cigarette advertising is ubiquitous in the urban landscape, it is more limited in the bars and night clubs of East Baltimore.
-Adherence to the newly enacted (February 2009) indoor smoking ban appears to be high, with incidents of indoor smoking observed in only 3 of the 24 venues.
-The 24 venues appear to cater to patrons older than the target group for this study, as the predominant observed age of patrons in only 77% of the venues was 25 years of or older.
Contact information
Jennifer McCleary-Sills, MPH
PhD Candidate
Department of Health, Behavior, and Society
Johns Hopkins Bloomberg School of Public Health
Esperanza Center, East Baltimore
Photo Source: JHSPH SOURCE web site