A Systematic Review of Neighborhood Disparities in Point-of-Sale Tobacco Marketing

Abstract

Objective Tobacco industry documents show systematic targeting by race, ethnicity, and income at the point of sale (POS). We sought to systematically review evidence of disparities in tobacco marketing at tobacco retailers by socio-demographic neighborhood characteristics. Methods We identified 43 relevant papers from 893 results of a systematic search in 10 databases updated on May 28, 2014. We found 148 associations of marketing (price, placement, promotion, or product availability) with a neighborhood demographic of interest (socioeconomic disadvantage, race, ethnicity, and urbanicity). We conducted a narrative review and present results stratified by neighborhood characteristics and types of tobacco product marketing. Results There are disparities in the marketing of tobacco products by neighborhood demographics. Socioeconomic disadvantage is associated with more tobacco marketing. Disparities in menthol marketing are starkly present, with targeting toward more urban neighborhoods and neighborhoods with more black residents. Smokeless tobacco products are targeted toward more rural neighborhoods and neighborhoods with more white residents. Differences in store type partially explain these disparities. Conclusion Geodemographic market targeting, a standard marketing practice across industries, represents an issue of social and environmental injustice for youth exposure to tobacco marketing and for smokers whose quit attempts may be stymied by disproportionate marketing in lower-income neighborhoods and neighborhoods with more black residents.

Differences in Quit Attempts and Cigarette Smoking Abstinence Between Whites and African Americans in the United States: Literature Review and Results From the International Tobacco Control US Survey

“…74,75 Some evidence suggests that retail marketing of cigarettes is higher in African American neighborhoods. 76 Marketing of menthol cigarettes and little cigars and cigarillos are clearly higher in African American neighborhoods. 76 This study is not without limitations.…”

“…76 Marketing of menthol cigarettes and little cigars and cigarillos are clearly higher in African American neighborhoods. 76 This study is not without limitations. For example, it is difficult to make comparisons among studies, even among those of the same study design, as many methodological differences exist in the published literature.…”

The New Vital Sign: Where Do You Live?

“…For example, lower SES areas frequently have a higher per capita burden of stores that sell tobacco products and display tobacco advertising (2). The rural area of Appalachia, Ohio, where I conduct most of my research, has (i) counties without a grocery store to purchase fresh meat, vegetables, and fruit; (ii) fewer sidewalks and health clubs to engage in exercise; (iii) counties with one or no mammography facilities; (iv) fewer colonoscopy facilities; (v) no public transportation; and (vi) poor access to state-of-the-art treatment facilities.…”

Making Neighborhoods Good for Your Health

“…5,6 Measures of having green areas and parks, safe walking spaces such as maintained sidewalks, full-service food stores with fresh fruits and vegetables, recreational sites for sports and physical activity, and reasonable personal safety from crime have all been used to evaluate the quality of neighborhoods. These can be obtained from census data or, more recently, from geospatial data sets that incorporate satellite images.…”

“…3,4 Much of the focus of neighborhood research in chronic disease has been on cardiovascular disease, diabetes mellitus, and obesity, given that poor access to healthy foods and limited opportunities for physical activity are related to potentially health-relevant neighborhood physical and social environments. 5,6 Measures of having green areas and parks, safe walking spaces such as maintained sidewalks, full-service food stores with fresh fruits and vegetables, recreational sites for sports and physical activity, and reasonable personal safety from crime have all been used to evaluate the quality of neighborhoods. These can be obtained from census data or, more recently, from geospatial data sets that incorporate satellite images.…”