Evaluating the impact and equity of a tobacco-free pharmacy law on retailer density in New York City neighbourhoods

Giovenco, Daniel P.; Spillane, Torra E.; Mauro, Christine; Hernández, Diana

doi:10.1136/tobaccocontrol-2018-054463

Cited by 25 publications

(15 citation statements)

References 25 publications

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“…We found that there was a lower odds of a tract having a tobacco-selling pharmacy in neighborhoods with a greater percentage of Black or Hispanic or Latino residents in adjusted models, suggesting that policies that restrict the sales of tobacco products in pharmacies may not decrease the number of tobacco retailers equitably across neighborhoods. These findings are consistent with other studies that have investigated the impact of a pharmacy ban on inequities in tobacco retailer density ( Craigmile et al, 2020 ; Giovenco et al, 2019 ; Kulbicki & Leslie, 2015 ; Tucker-Seeley et al, 2016 ). While our study sample was limited to pharmacies that sell tobacco products, our findings are similar to those focused on pharmacy deserts, which find that pharmacies are less available in neighborhoods with a greater proportion of some racially and ethnically minoritized groups ( Qato et al, 2014 ).…”

Section: Discussionsupporting

confidence: 92%

“…Studies in select U.S. cities and states also suggest that the impact of policies that prohibit pharmacies from selling tobacco products may not be equitable ( Craigmile et al, 2020 ; Giovenco et al, 2019 ; Hall et al, 2019 ; Kulbicki & Leslie, 2015 ). Additionally, some places have implemented policies that only allow specialty tobacco shops to sell tobacco products or certain types of tobacco products ( CounterTobacco.org, 2020 ).…”

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confidence: 99%

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Neighborhood Inequities in Tobacco Retailer Density and the Presence of Tobacco-Selling Pharmacies and Tobacco Shops

et al. 2021

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Studies document inequitable tobacco retailer density by neighborhood sociodemographics, but these findings may not be robust to different density measures. Policies to reduce density may be less equitable depending on how the presence of store types differs by neighborhood characteristics. We built a 2018 list of probable tobacco retailers in the United States and calculated four measures of density for all census tracts ( N = 71,495), including total count, and number of retailers per 1,000 people, square mile, and kilometers of roadway. We fit multivariable regression models testing associations between each density measure and tract-level sociodemographics. We fit logistic regression models testing associations between sociodemographics and the presence of a tobacco-selling pharmacy or tobacco shop. Across all measures, tracts with a greater percentage of residents living below 150% of the federal poverty level (FPL) had higher density. A higher percentage of Black residents, Hispanic or Latino residents, and vacant housing was inconsistently associated with density across measures. Neighborhoods with a greater percentage of Black residents had a lower odds of having a pharmacy (adjusted odds ratio [a OR] = 0.96, 95% confidence interval [CI; 0.95, 0.97]) and tobacco shop (a OR = 0.87, CI [0.86, 0.89]), while those with a greater percentage of residents living below 150% FPL had greater odds of having a tobacco shop (a OR = 1.18, CI [1.16, 1.20]). Researchers and policymakers should consider how various measures of retailer density may capture different aspects of the environment. Furthermore, there may be an inequitable impact of retailer-specific policies on tobacco availability.

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Section: Discussionsupporting

confidence: 92%

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confidence: 99%

Neighborhood Inequities in Tobacco Retailer Density and the Presence of Tobacco-Selling Pharmacies and Tobacco Shops

et al. 2021

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“… 63 65–67 69 For the first time, three studies reported on the equity impact of retailer bans, with one covering menthol cigarettes sales near schools 57 and two covering sales of tobacco products by pharmacies. 60 68 The largest shift in intervention type related to population-level cessation support. Where in 2014, two-thirds of studies looked at provision of combined behavioural and pharmacological support (primarily by specialist services), here the focus was on brief interventions within primary care 73–77 82 or access to free or low-cost cessation medication.…”

Section: Resultsmentioning

confidence: 99%

“…Thus—for example—Huang and colleagues 42 noted that the effect of local smoke-free policies may be influenced by both state-level tobacco control programmes and the specific characteristics of the local population. Two studies exploring the equity impact of bans on pharmacies selling tobacco products (one state level 68 and one city level 60 ) found that equity effects were dependent on the socially patterned distribution of pharmacies. Zhang et al , 35 in contrast, evaluated the impact of three different interventions (tobacco tax, smoke-free laws and media campaigns) on home smoking bans, assessing their effects both separately and jointly, and finding that the equity-positive effect of smoke-free laws was no longer apparent in the multi-policy analysis.…”

Section: Discussionmentioning

confidence: 99%

Impact of population tobacco control interventions on socioeconomic inequalities in smoking: a systematic review and appraisal of future research directions

2020

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BackgroundWhile price increases and targeted cessation support have been found to reduce inequalities in smoking by socioeconomic status (SES), evidence on other measures is mixed. We aimed to update the most recent (2014) previous review by identifying and appraising evidence published since 2013 on the equity impact of population tobacco control measures.MethodsSystematic searching of 10 electronic databases and hand-searching of four key journals identified 68 primary research articles published since 2013 that sought to examine the equity impact of population tobacco control measures in high-income countries with a negative socioeconomic gradient in smoking. Reported equity impacts were categorised as positive (greater impact among lower SES), neutral (no difference by SES), negative (greater impact among higher SES) or mixed/unclear.ResultsThere was substantial growth in research seeking to evaluate the equity impact of tobacco control interventions, but the majority of new studies showed mixed/unclear results. Findings for price increases and targeted cessation support continue to suggest an equity-positive impact, but limitations in the available evidence make further assessment difficult. Substantial differences in the context, scale and implementation of tobacco control policies make straightforward comparison of findings from the previous 2014 and current reviews problematic.ConclusionResearchers need to adopt more sophisticated, multidisciplinary approaches in evaluating the equity impact of tobacco control measures—developing robust measures of equity effect and using frameworks that take account of context, existing systems/processes and the likely mechanisms of action. Socioeconomic differences in intervention impact within low-income and middle-income countries require evaluation.

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“…By March 2018, 171 cities (the majority located in Massachusetts) had enacted tobacco-free pharmacy ordinances, less than 1% of US municipalities,24 25 and in July 2018, Massachusetts prohibited tobacco sales in pharmacies statewide 26. Studies suggest that tobacco-free pharmacies reduce retailer density,27–29 and this reduced density leads to lower smoking initiation and prevalence 30–38. Survey research has shown that both pharmacists and the general community support tobacco-free pharmacies after implementation,2 16 and media coverage has been favourable 39.…”

Section: Introductionmentioning

confidence: 99%

Placement and sales of tobacco products and nicotine replacement therapy in tobacco-free and tobacco-selling pharmacies in Northern California: an observational study

Pimentel

Apollonio

2019

BMJ Open

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ObjectivesAlthough tobacco is the leading preventable cause of death in the USA, it is routinely sold in pharmacies. In 2008, San Francisco became the first city in the USA to pass a tobacco-free pharmacy ordinance. Over the next decade, 171 municipalities enacted similar policies, and in 2018, Massachusetts banned tobacco sales in pharmacies. Our objective was to assess the perceived effects of tobacco-free pharmacy policies on displays, sales, customer visits and counselling.DesignObservational study and survey.SettingIn 2017, we visited Walgreens and CVS stores in San Francisco and nearby San Jose, which allows tobacco sales, to assess placement of tobacco and over-the-counter tobacco cessation products (nicotine replacement therapy or NRT). We surveyed an employee at each site regarding the impact that tobacco-free pharmacy policies had had on customer traffic and sales of NRT.ParticipantsWe obtained display data from 72 pharmacies and collected surveys from 55 employees (76% response rate).ResultsA majority of respondents at tobacco-free pharmacies (55%) reported that the policy had not affected customer visits. In comparison, 70% of respondents at tobacco-selling pharmacies believed that eliminating tobacco sales would reduce the number of customers visiting their stores. Pharmacies that were tobacco free and those that sold tobacco reported comparable displays, sales and counselling for NRT.ConclusionsPharmacies operating under tobacco-free policies did not report reduced customer visits. Greater awareness of this outcome could help pharmacies implement public health recommendations to eliminate tobacco sales.

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Evaluating the impact and equity of a tobacco-free pharmacy law on retailer density in New York City neighbourhoods

Cited by 25 publications

References 25 publications

Neighborhood Inequities in Tobacco Retailer Density and the Presence of Tobacco-Selling Pharmacies and Tobacco Shops

Neighborhood Inequities in Tobacco Retailer Density and the Presence of Tobacco-Selling Pharmacies and Tobacco Shops

Impact of population tobacco control interventions on socioeconomic inequalities in smoking: a systematic review and appraisal of future research directions

Placement and sales of tobacco products and nicotine replacement therapy in tobacco-free and tobacco-selling pharmacies in Northern California: an observational study

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