Higher availability of LCCs in African American communities and lower prices and greater outdoor advertising in minority and young adult neighborhoods may establish environmental triggers to smoke among groups susceptible to initiation, addiction, and long-term negative health consequences.

Aims This study examined the impact of tobacco retail outlets on cessation outcomes over time among non-treatment-seeking smokers and assessed differences by neighborhood poverty and individual factors. Design Observational longitudinal cohort study using geospatial data. We used generalized estimating equations to examine cessation outcomes in relation to the proximity and density of tobacco retail outlets near the home. Setting Eight large Designated Media Areas across the U.S. Participants A total of 2,377 baseline smokers followed over 3 waves from 2008 to 2010. Measurements Outlet addresses were identified through North American Industry Classification System codes and proximity and density measures were constructed for each participant at each wave. Outcomes included past 30-day abstinence and pro-cessation attitudes. Findings Smokers in high poverty census tracts living between 500 meters and 1.9 kilometers from an outlet were over 2 times more likely to be abstinent than those living fewer than 500 meters from an outlet (p<.05). Density within 500 meters of home was associated with reduced abstinence (OR: 0.94; CI: 0.90, 0.98) and lower pro-cessation attitudes (Coef: −0.07, CI: −0.10, −0.03) only in high poverty areas. In low poverty areas, density within 500 meters was associated with greater pro-cessation attitudes (OR: 0.06; CI: 0.01, 0.12). Gender, education and heaviness of smoking did not moderate the impact of outlet proximity and density on cessation outcomes. Conclusions In the US, density of tobacco outlets within 500 meters of the home residence appears to be negatively associated with smoking abstinence and pro-cessation attitudes only in poor areas.

Background Little is known about the factors that drive the association between point-of-sale marketing and behavior, because methods that directly link individual-level use outcomes to real-world point-of-sale exposure are only now beginning to be developed. Purpose Daily outcomes during smoking cessation were examined as a function of both real-time geospatial exposure to point-of-sale tobacco (POST) and subjective craving to smoke. Methods Continuous individual geospatial location data collected over the first month of a smoking cessation attempt (N=475) in 2010–2012 were overlaid on a POST outlet geodatabase (N=1060). Participants’ mobility data were used to quantify the number of times they came into contact with a POST outlet. Participants recorded real-time craving levels and smoking status via ecologic momentary assessment (EMA) on cellular telephones. Results The final data set spanned a total of 12,871 days of EMA and geospatial tracking. Lapsing was significantly more likely on days with any POST contact (OR=1.19 [95% CI=1.18, 1.20]), and increasingly likely as the number of daily POST contacts increased (OR=1.07 [95% CI=1.06, 1.08]). Overall, daily POST exposure was significantly associated with lapsing when craving was low (OR=1.22 [95% CI=1.20, 1.23]); high levels of craving were more directly associated with lapse outcomes. Conclusions These data shed light on the way mobility patterns drive a dynamic interaction between individuals and the POST environment, demonstrating that quantification of individuals’ exposure to POST marketing can be used to identify previously unrecognized patterns of association among individual mobility, the built environment, and behavioral outcomes.