Short Report Neighborhood contextual factors for smoking among middle-aged Japanese: A multilevel analysis Tomoya Hanibuchi a , Tomoki Nakaya b , Kaori Honjo c , Ai Ikeda d , Hiroyasu Iso e,n , Manami Inoue d,f , Norie Sawada d , Shoichiro Tsugane d , the Japan Public Health Center-based Prospective Study Group a School of International Liberal Studies, Chukyo University,101 Tokodachi, Kaizu-cho, Toyota, Aichi, 470-0393 Japan b Department of Geography and Research Institute for Disaster Mitigation of Urban Cultural Heritage, Ritsumeikan University, 58 Komatsubara Kitamachi, Kita-ku, Kyoto, 603–8341 Japan c Global Collaboration Center, Osaka University, 2–7 Yamadaoka, Suita, Osaka, 565–0871 Japan d Epidemiology and Prevention Group, Research Center for Cancer Prevention and Screening, National Cancer Center, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045 Japan e Public Health Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita, Osaka, Japan f Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033 Japan article info Article history: Received 18 June 2014 Received in revised form 16 October 2014 Accepted 21 October 2014 Keywords: Neighborhoods Smoking Multilevel analysis Japan abstract The purpose of this study is to explore neighborhood contextual factors in terms of smoking behaviors among middle-aged Japanese, by using a multilevel analysis. Subjects were Japanese men and women, between 40 and 59 years of age (40,961 for the cross-sectional analysis, and 9,177 for the longitudinal analysis), nested in 39 neighborhoods (Kyuson). The results showed that women in a less residentially stable neighborhood were more likely to be smokers. No associations were seen between current smoking and neighborhood deprivation; however, women in the most deprived neighborhood were more likely to quit smoking. This study is the first to demonstrate the associations between neighborhood environment and current smoking or smoking cessation, in a Japanese setting. The findings imply that policy makers should consider targeting neighborhood conditions in order to help reduce smoking prevalence, especially among women. & 2014 Elsevier Ltd. All rights reserved. 1. Introduction “Neighborhood” has become a significant keyword in recent studies of social epidemiology and health geography. Researchers have explored whether or not neighborhood contextual factors affect the health of individuals, even after considering individual composition (Diez Roux and Mair, 2010; Kawachi and Berkman, 2003). This is also the case for health behaviors, including tobacco smoking. Neighborhood-level factors, as well as individual- and household-level factors, have been considered to relate to smoking (Lindström, 2008; Wilcox, 2003). Although the possible neighborhood factors that affect smoking are considered to be multiple and diverse, it is obvious that area- level deprivation has attracted a lot of interest from researchers (Pearce et al., 2012). This is because the residents living in socio- economically deprived areas are assumed more likely to become smokers, through the mechanisms such as; availability of tobacco, exposure to tobacco advertising, or psychosocial stress related to living in a disadvantaged neighborhood (Diez Roux et al., 2003). To date, the direct and indirect effects of neighborhood deprivation or socioeconomic status (SES) on smoking have been well documen- ted (Datta et al., 2006; Mathur et al., 2013; Matheson et al., 2011; Chuang et al., 2005; Kendzor et al., 2012; Cohen et al., 2011; Karvonen et al., 2008). Social environment is another one of the important neighbor- hood factors related to smoking behavior, and it has been found to be associated with smoking prevalence. For example, the places or communities where many people smoke cigarettes may increase the probability of smoking, by creating social norms that accept smoking behavior (Ahern et al., 2009; Harbour, 2012; Karasek et al., 2012; Corsi et al., 2012). Social capital or social cohesion have also been considered to relate to health behaviors, such as smoking (Lindström, 2008; Brown et al., 2006; Poortinga, 2006). In addition, researchers have focused on residential stability in neighborhood community as a possible basis for building Contents lists available at ScienceDirect journal homepage: www.elsevier.com/locate/healthplace Health & Place http://dx.doi.org/10.1016/j.healthplace.2014.10.010 1353-8292/& 2014 Elsevier Ltd. All rights reserved. n Corresponding author. Tel.: þ81 6 6879 3911. E-mail addresses: info@hanibuchi.com (T. Hanibuchi), nakaya@lt.ritsumei.ac.jp (T. Nakaya), khonjo@glocol.osaka-u.ac.jp (K. Honjo), ai-ikeda@umin.ac.jp (A. Ikeda), iso@pbhel.med.osaka-u.ac.jp (H. Iso), mnminoue@ncc.go.jp (M. Inoue), nsawada@ncc.go.jp (N. Sawada), stsugane@ncc.go.jp (S. Tsugane). Health & Place 31 (2015) 17–23