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Objective: To investigate whether neighbourhood measures of geographical accessibility to outlets selling tobacco (supermarkets, convenience stores and petrol stations) are associated with individual smoking behaviour in New Zealand. Methods:Using Geographical Information Systems, travel times from the population-weighted centroid of each neighbourhood to the closest outlet selling tobacco were calculated for all 38,350 neighbourhoods across New Zealand. These measures were appended to the 2002/03 New Zealand Health Survey; a national survey of 12,529 adults. Two-level logistic regression models were fitted to examine the effects of neighbourhood locational access upon individual smoking behaviour after controlling for potential individual-and neighbourhood-level confounding factors, including deprivation and urban/rural status.Results: After controlling for individual-level demographic and socioeconomic variables, individuals living in the quartiles of neighbourhoods with the best access to supermarkets (OR 1.23, 95% CI 1.06-1.42) and convenience stores (OR 1.19, 95% CI 1.03-1.38) had a higher odds of smoking compared to individuals in the worst access quartiles. However, the association between neighbourhood accessibility to supermarkets and convenience stores was not apparent once other neighbourhood-level variables (deprivation and rurality) were included. Conclusions:At the national level, there is little evidence to suggest that after adjustment for neighbourhood deprivation better locational access to tobacco retail provision in New Zealand is associated with individual-level smoking behaviour.

There has been a resurgence of interest in how the social, built and cultural environments contribute to shaping health outcomes. The pathways relating place to health behaviour have received less attention. We develop a nuanced understanding of the pathways linking individuals, places and smoking. Two key pathways operate: place-based ‘practices’ and place-based ‘regulation’. Future geographical research should pay attention to the different scale effects, encompass a wider set of influences which affect the liveability and social composition of neighbourhoods, and specify group differences in the impact of the local economic and social environment upon smoking.

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