Neighbourhood matters: Perceptions of neighbourhood cohesiveness and associations with alcohol, cannabis and tobacco use

Abstract

To examine relationships between perceived neighbourhood cohesion and alcohol, tobacco and cannabis consumption in New Zealand. A two-level random intercept regression model was used to examine the extent to which perception of neighbourhood cohesion (at the individual and area level) was associated with the frequency of substance (alcohol, tobacco and cannabis) consumption, after controlling for demographics and deprivation. This study is based on data from two national Health Behaviours Surveys (Drugs and Alcohol) conducted in 2003 and 2004 in New Zealand. Data were collected by computer-assisted telephone interviewing with two complementary computer-assisted cellphone interviewing samples. The combined sample consists of 6346 men and 8411 women (n = 14,757) distributed across 1572 census area units. Perception of neighbourhood cohesion was significantly associated with the level of alcohol, tobacco and cannabis consumption. Individuals who perceived their neighbourhood as more cohesive had higher annual frequency of alcohol consumption but lower consumption on a typical drinking occasion. Higher perceived neighbourhood cohesion was also associated with a decrease in the probability of tobacco and cannabis use and of the amounts consumed. Area-level analysis suggested that aggregate census area unit-level neighbourhood cohesion exerted a significant additional contextual effect on the frequency of tobacco and cannabis consumption over and above individual perceptions of neighbourhood cohesiveness. This study provides empirical evidence that perceptions of the neighbourhood social environment are associated with people's substance consumption patterns. Increasing residents' sense of neighbourhood cohesion might prove a promising way to decrease health-damaging consumption behaviours.