The impact of the tobacco retail outlet environment on adult cessation and differences by neighborhood poverty

Abstract

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.

Tobacco Retail Outlet Density and Young Adult Tobacco Initiation

“…The NAICS list has been used previously for similar studies. 15 Third, these analyses were not able to distinguish between the impact of tobacco product availability in outlets and outlet advertising on young adult behaviors. However, this is a limitation for all studies of outlet density and proximity in countries and geographic areas where point-of-sale advertising is allowed.…”

“…8 Recent years have seen a growing interest in reducing tobacco availability via retail outlets, 9 along with growing evidence that the distribution of outlets may impact tobacco use behavior. Studies have found that outlet density is associated with increased cigarette smoking among youth, [10][11][12][13][14] while outlet proximity [15][16][17][18] is associated with reduced smoking cessation among adults. However, evidence examining the impact of outlets on cigarette smoking or use of other tobacco products among young adults is scarce.…”

Is There a Relationship Between the Concentration of Same-Sex Couples and Tobacco Retailer Density?

“…[16][17][18][19] Proximity to tobacco retailers is associated with decreased success in tobacco use cessation, 20,21 although this may be true only in lower socioeconomic status neighborhoods. 22 Tobacco retailer density has been associated with smoking behaviors [23][24][25] and with youth initiation; 26 however, some findings are mixed. 21,25,27 There are both regional and local patterns of same-sex couple migration and neighborhood selection in the United States.…”

Exposure to and Use of Electronic Cigarettes: Does Language Matter?

“…This is especially pertinent in our low-income, urban, safety-net Hispanic population -one historically susceptible to tobacco use. 32 Even as full regulations on advertising begin to take effect, continued exposure to e-cigarette marketing tactics may adversely influence perceptions of product safety and efficacy in smoking cessation. By providing culturally sensitive interventions that more effectively target vulnerable populations, we can increase education on safety and mitigate harmful usage.…”