Neighborhood-level factors have also been associated with the risk of substance use. In particular, previous studies have found an inverse relationship between neighborhood social cohesion and substance-use outcomes,26 suggesting that neighborhood social cohesion may act as a protective factor against the risk of smoking initiation. In addition, studies that examined the relationship between neighborhood physical characteristics and substance-use outcomes found that poorer neighborhood quality (dilapidated building structures) was associated with substance-use disorders.27, 28
