Tobacco addiction is the most important preventable cause of morbidity and mortality in Canada. Family physicians, nurse practitioners and other front-line health care professionals are well positioned to influence and assist their patients in quitting, thereby reducing the burden on both personal health and the public health care system.

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A three-stage study was conducted to investigate the community health impacts of the Petro Canada petroleum refinery in Oakville, Ontario. A feasibility study was the basis for a stage 2 health survey in 1992 designed to examine the association between self-reported somatic and/or psychosocial symptoms and exposure to odorous refinery emissions in families living near the refinery. In stage 3, a qualitative investigation of residents' experiences of the refinery was conducted in 1994 by means of depth interviews of a subsample of the survey respondents. The focus of this article is the results of the stage 2 and 3 studies. The survey results (n ϭ 391) showed strong association between zone of residence and odor perception and annoyance, which, in turn, were strongly associated with the reporting of cardinal and general symptoms in adults and children. The strong mediating effect of odors on the refinery exposure-symptom reporting relationship was confirmed by the results of path analyses. The survey findings are consistent with the results of several previous studies of health effects due to environmental odor exposures, which suggest a psychosomatic reaction to the environmental stress associated with odorous emissions. The analysis of the depth interviews (n ϭ 40) revealed the effects of social and community factors on residents' experiences of the refinery emissions and served to elucidate the relationship between exposure, odor annoyance, and symptom reporting. Ten emergent themes were identified, and these were integrated in terms of three profiles of "typical" resident reactions to the refinery. Follow-up quantitative and qualitative studies are planned to determine whether the ongoing odor reduction plan at the refinery results in reduced levels of symptom reporting.

Debt and financial insecurity are associated with stress, low self-worth and poor health. Joining and identifying with social groups (social identification) promotes better health and higher self-esteem. Here, we examined whether identifying with one's local neighbourhood protected people from developing mental health symptoms associated with financial stress. We analysed data from a general population survey (Study 1, N= 4319) and a student mental health survey (Study 2, N= 612) conducted in the North West of England. We administered measures of financial stress, self-esteem, neighbourhood identity and mental health, and conducted moderated mediation analyzes to test our predictions. Study 1 (population survey) demonstrated that stronger identification with one's local neighbourhood attenuated the adverse effects of financial stress on self-esteem and subsequent mental health. Study 2 (student survey) showed that strong host town identities buffered students from mental health symptoms related to financial stress. Strong hometown identities, however, showed no buffering effect. The findings suggest that one way financial stress impacts mental health is by eroding self-esteem. Identifying with one's current place of residence appears to disrupt this pathway, whilst identifying with one's previous place of residence does not provide the same psychological protection.

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