may facilitate decreased smoking through psychosocial mechanisms that can result from living in a community with strong interpersonal connections and antismoking values; however, this effect is likely contingent upon social norms within the neighborhood.52 Although previous studies have examined several physical aspects of the neighborhood in relation to health outcomes, including depression53 and substance use,27 no study to our knowledge has explicitly examined the relationship between neighborhood physical disorder and cigarette-smoking frequency. Studies that have examined the relationship between physical disorder and mental health outcomes found that poorer neighborhood conditions (that is, more physical disorders) were related to worse outcomes (that is, more depressive or alcohol use disorder symptoms). The direction of effect was similar for this study's finding in that poorer neighborhood conditions (more physical disorders) were associated with a greater frequency of cigarettes smoked. One key mechanism underlying this relationship has been posited; the stress-reduction hypothesis suggests that substance use may be used to relieve distress.54 Therefore, individuals living in physically deteriorated neighborhoods may use cigarette smoking as a coping mechanism in response to the stressful life experiences that cluster in neighborhoods with high levels of physical disorder.
