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Rethinking Exposure in Area Studies on Social Inequities in Smoking in Youth and Young Adults

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Neighbourhood Structure and Health Promotion

Abstract

Smoking is the main modifiable cause of premature death worldwide. It is also increasingly concentrated in younger age groups, lower social classes and deprived geographic areas. These social inequities in smoking are intrinsically unfair and have major implications for public health. As such, they must be addressed, but a better understanding of how social inequities in smoking in youth and young adults come about and could be reduced must first be sought. Part of the answer could lie in characteristics of the areas to which people are exposed. In this chapter, we review the literature on area effects and social inequities in smoking in youth and young adults. We highlight two main limitations of contemporary research and interventions: (1) the narrow focus on single, mainly residential areas, rather than multiple life environments and (2) the lack of research on the differential effect of area-level interventions on smoking across social groups. We conclude by introducing a health promotion perspective which could contribute to furthering the study of area-level influences on social inequities in smoking in youth and young adults. This perspective involves two key principles: the view that health is produced in everyday life environments, where people live, work, study and play, and the explicit focus on equity. This perspective is integrated in an ongoing research project which will be presented for illustrative purposes. As a subcomponent of the Interdisciplinary Study on Inequalities in Smoking (ISIS), the ISIS-Activity Space project explores the influence of area-level exposures measured within multiple life environments, which together form the “activity space”, on social inequities in smoking in a sample of young adults residing in areas of varied deprivation levels in Montreal, Canada.

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Notes

  1. 1.

    A detailed discussion of the many ways “neighbourhoods” have been defined throughout history and in different fields of research is beyond the scope of this chapter. Here, we use the terms neighbourhood and area interchangeably to refer to a local, spatially defined area in which health-­relevant attributes are measured. The size and shape of this area can vary between studies and so do the life environments (residential, school, etc.) encompassed by the area. Neighbourhood or area-level features and resources are those measured within a given area.

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  1. Département de médecine sociale et préventive, Université de Montréal (IRSPUM), C.P. 6128, succ. Centre-ville, Montréal, QC, H3C 3J7, Canada

    Martine Shareck & Katherine L. Frohlich

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  1. Martine Shareck
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  2. Katherine L. Frohlich
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Correspondence to Martine Shareck .

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  1. , Unit for Health Promotion Research, University of Southern Denmark, Niels Bohrs Vej 9-10, Esbjerg, 6700, Denmark

    Christiane Stock

  2. , MRC Social & Public Health Sciences Unit, University of Glasgow, Lilybank Gardens 4, Glasgow, G12 8RZ, United Kingdom

    Anne Ellaway

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Shareck, M., Frohlich, K.L. (2013). Rethinking Exposure in Area Studies on Social Inequities in Smoking in Youth and Young Adults. In: Stock, C., Ellaway, A. (eds) Neighbourhood Structure and Health Promotion. Springer, Boston, MA. https://doi.org/10.1007/978-1-4614-6672-7_14

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