District Wards, Health Care Coverage, Perceived Health Status, and Educational Levels that Affect Differences in Cigarette Smoking in the Washington, D.C. Population of Men and Women

The purpose of this study is to assess the degree to which the health lifestyle theory can explain cigarette smoking in the Washington, D.C. population of men and women. The focus of this study is to assess the effect of district wards (residential area), health care coverage, perceived health status, and educational levels on cigarette smoking among men (N = 1,505) and women (N = 2,398). Several research questions were formulated from the theory and related research, and several hypotheses were developed to test the research questions. This study seeks to answer two research questions: (1) Is cigarette smoking in Washington, D.C. better explained by gender, ward, perceived health status, health care coverage, or education level, and (2) Is cigarette smoking in Washington, D.C. predicted by ward? Data from the Behavioral Risk Factor Surveillance System (BRFSS) 2009 Study on 3,904 residents of the District of Columbia, aged 18 years and over were used. Univariate, bivariate, and multivariate analyses were used to address the research questions.;The health lifestyle theory conceptual model for this study made a statistically significant (p ≤ .05) contribution to explain health lifestyle practices and cigarette smoking in the Washington, D.C. population of men and women. A logistic regression shows that variance (R2 = 11.5%) in cigarette smoking is explained by district ward, perceived health status, health care coverage, and education level. District wards make a statistically significant (p ≤ .05) contribution to the log of the odds (e beta) of an adult in the District of Columbia being a cigarette smoker. In order of highest to lowest, residents who live in Wards Eight, Five, Seven, and Six are at least more than two times (e beta = 2.13) more likely to smoke cigarettes than residents in Wards Four, One, Two, and Three who are at least 52 percent (e beta = 1.52) more likely to smoke cigarettes. In the District of Columbia, adults who are nonsmokers are 71 percent (e beta = 1.71) more likely to have health care coverage than the adult cigarette smoker in the District without it. A fair-to-poor perceived health status is 13 percent (e beta = 1.13) more likely to be expressed by an adult resident in the District who smokes cigarettes than by a nonsmoker in the adult population. The adult cigarette smoker in the District is 6 percent (e beta = .625) more likely to have little-to-no education compared to nonsmoker, in the adult population of residents, with at least some college education. The gender predictor was not significant (p = .438) and had no effect on whether an adult resident of the District smoked cigarettes or not. Being a male or female was not statistically significant (p ≤ .05) in explaining cigarette smoking in the adult population of the District.