Tobacco retailer density and adult smoking in California

Audience:

Tobacco control program staff, policy makers, and researchers interested in environmental influences on tobacco use or regulating retail marketing

Key Points:

1.  The greater availability of cigarettes and visibility of cigarette marketing in environments with a higher concentration (density) of tobacco retailers may promote tobacco use.

2. Higher retailer density is associated with a greater likelihood and prevalence of smoking by adolescents.  However, studies that address adult smoking are few and limited to small geographic areas.

3. Combining data from state retailer licensing records and the California Health Interview Survey (n=51,048 adults), this study used multilevel modeling to examine the association of tobacco retailer density with smoking status and frequency, adjusting for other risk factors measured at both the individual and neighborhood levels. 

 4. Living in neighborhoods with higher tobacco retailer density was associated with a greater likelihood of being a smoker in rural (OR=1.37, p<.01) and suburban areas (OR=1.20, p<.05), but not in urban areas.  Secondary analyses examined proximity as well as smoking frequency. 

5. Limiting tobacco retailer density is a plausible strategy to reduce adult tobacco use, particularly in rural and suburban areas.  

Educational Experience:

Presentation includes maps illustrating different measures of retailer density; suggested resources to accomplish similar research with limited access to GIS tools. 

Benefits:

1. This study reports an association of tobacco retailer density with adult smoking from the largest statewide health survey in the US.

2. Study findings suggest that policies to limit tobacco retailer density could benefit smoking cessation efforts.