Tobacco retailer density surrounding schools and youth smoking behaviour: a multi-level analysis

Abstract

BackgroundYouth smoking prevention should be a public health priority. It is not only vital to prevent youth from smoking but also to prevent non-smoking youth from becoming susceptible to smoking. Past research has examined factors associated with youth's susceptibility to become a future smoker, but research has yet to examine tobacco retailer density and susceptibility to smoking among never smokers. The objectives of this study are to examine how tobacco retailer density surrounding schools and social smoking influences are associated with smoking susceptibility among youth of never smokers, and occasional and daily smoking among youth of current smokers.MethodsData were collected in 2005-2006 from grade 9 to 12 students attending 76 secondary schools in Ontario, Canada, as part of the SHAPES-On study. A series of multi-level logistic regression analyses were performed to understand how student- and school-level factors are associated with three smoking behaviour outcomes: smoking susceptibility among never smokers, occasional smoking, and daily smoking.ResultsThe number of tobacco retailers surrounding a school was found to be associated with the likelihood of a never smoker being susceptible to future smoking (OR 1.03, 95CI% 1.01, 1.05). We also identified that being surrounded by smoking social influences, specifically family and close friends, can substantially increase the likelihood that never smokers are at risk for future smoking or that youth are already occasional or daily smokers.ConclusionsWe identified that the number of tobacco retailers surrounding a school was associated with an increased odds of being susceptible to future smoking among male never smokers. Smoking social models surrounding youth also appears to have an important impact on their smoking behaviour regardless of their smoking status. It is important for youth smoking prevention programs to begin early, interrupt youths' susceptibility to future smoking, and focus on subgroups that are at higher risk of smoking. The government should consider the impact of tobacco retailer density on youth smoking behaviour, and be cautious when granting licenses for establishments to sell tobacco products.

Correlates of Susceptibility to Smoking among Secondary School Students in Kota Tinggi District, Johor, Malaysia

“…This finding contradicts the study by Wilkinson et al (2008), Ertas (2007), Chan and Leatherdale (2011) and Huang et al (2012) that says respondents with a brother or parent who smoke were more likely to be susceptible to smoking (OR 2.65; 95%CI 1.48-4.76; 1.17; 95%CI 1.04-1.31; 1.35; 95%CI 1.16-1.58); this could be due to the older age of respondents in the current study compared to the other studies which show that parents' influence would gradually decline as their children grew older because parental control naturally slips with the increasing age of their offspring (Baumrind, 1991). Older adolescents were more likely to obtain autonomy from the family as they seek self-identity through increasing time spent on school activities and also becoming less involved with their parents.…”

Youth activity spaces and daily exposure to tobacco outlets

“…Results of these studies are mixed. Some studies have found no or small effects (Leatherdale & Strath, 2007; Lovato et al, 2007;McCarthy et al, 2009;Pokorny et al, 2003) and others have shown stronger associations with youth smoking (Chan & Leatherdale, 2011;Henriksen et al, 2008; Lipperman-Kreda et al, 2014b;Novak et al, 2006;West et al, 2010).…”

“…A modest body of cross-sectional research has investigated the association between exposure to tobacco outlets around schools or residential areas and tobacco use among youths (Chan & Leatherdale, 2011;Henriksen et al, 2008;Leatherdale & Strath, 2007;LippermanKreda et al, 2014b;Lovato, Hsu, Sabiston, Hadd, & Nykiforuk, 2007;McCarthy et al, 2009;Novak, Reardon, Raudenbush, & Buka, 2006;Pokorny, Jason, & Schoeny, 2003;West et al, 2010). Results of these studies are mixed.…”

“…All of these factors are related to youth tobacco use (Botello-Harbaum et al, 2009;Carpenter & Cook, 2008;DiFranza, Savageau, & Fletcher, 2009;Ding, 2003;Henriksen, Feighery, Wang, & Fortmann, 2004;Henriksen, Schleicher, Feighery, & Fortmann, 2010;Lipperman-Kreda, Grube, & Friend, 2012;Wakefield & Chaloupka, 2000). Controls over the number of tobacco outlets and their distance from residential areas or schools are frequently advocated approaches to reduce youth exposure and access to tobacco products and thus their tobacco use.A modest body of cross-sectional research has investigated the association between exposure to tobacco outlets around schools or residential areas and tobacco use among youths (Chan & Leatherdale, 2011;Henriksen et al, 2008;Leatherdale & Strath, 2007; LippermanKreda et al, 2014b; Lovato, Hsu, Sabiston, Hadd, & Nykiforuk, 2007;McCarthy et al, 2009;Novak, Reardon, Raudenbush, & Buka, 2006;Pokorny, Jason, & Schoeny, 2003;West et al, 2010). Results of these studies are mixed.…”

“…Results of these studies are mixed. Some studies have found no or small effects (Leatherdale & Strath, 2007; Lovato et al, 2007;McCarthy et al, 2009;Pokorny et al, 2003) and others have shown stronger associations with youth smoking (Chan & Leatherdale, 2011;Henriksen et al, 2008; Lipperman-Kreda et al, 2014b;Novak et al, 2006;West et al, 2010).The existing research, however, has considered exposure to tobacco outlets based on defined administrative units (e.g., census tract or ZIP code) or buffers (typically 0.5 to 1 mile) surrounding youths' homes or schools. These approaches fail to capture exposure to tobacco outlets in the broader environment where youths spend their time (i.e., activity spaces).…”