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Martin-Gall V, Neil A, Macintyre K, Rehman S, Nguyen TP, Harding B, Gall S. Tobacco retail availability and smoking-A systematic review and meta-analysis. Drug Alcohol Rev 2024. [PMID: 39228169 DOI: 10.1111/dar.13936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Revised: 07/23/2024] [Accepted: 08/05/2024] [Indexed: 09/05/2024]
Abstract
ISSUES Health policy makers worldwide have adopted evidence-based legislation, largely directed at consumers, to reduce tobacco-related harm. It is suggested that limiting supply by decreasing retail availability can also reduce cigarette smoking. To inform policy makers this systematic literature review assesses whether reducing availability is associated with smoking behaviours. APPROACH Systematic literature searches of five databases were carried out up to January 2023. Included studies had at least one exposure (tobacco retail density, proximity or mixed measures thereof) and outcomes of smoking behaviour. Meta-analysis of effect estimates were undertaken if there were at least three studies with similar population, exposure and outcome measures. KEY FINDINGS Sixty-two studies were included, and positive associations were found between tobacco outlet density and cigarette smoking in pregnancy, youth, adults and cessation. Meta-analyses were undertaken for retail density and ever smoking (odds ratio [OR] 1.20; 95% confidence interval [CI] 1.04, 1.37; I2 = 87.3%), and current youth smoking (OR 1.23; 95% CI 1.08, 1.40; I2 = 0.0%), adult smoking (OR 1.11; 95% CI 1.01, 1.22; I2 = 74.8%); and mixed measures of retail availability near schools and current youth smoking (OR 1.03; 95% CI 1.01, 1.05; I2 = 0.0%). IMPLICATIONS AND CONCLUSION There is evidence higher tobacco retail density is consistently associated with cigarette smoking in pregnant women, young people and adults when ecological studies are included in meta-analysis. Meanwhile, evidence synthesis reveals restrictive tobacco retail laws based on proximity or mixed measures near home or very near school may not reduce smoking except in men who smoke heavily. Mechanisms to reduce retailer density should be thus considered part of tobacco control strategies.
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Affiliation(s)
- Veronica Martin-Gall
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
- Public Health Services, Department of Health, Hobart, Australia
| | - Amanda Neil
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Kate Macintyre
- Tasmanian School of Medicine, University of Tasmania, Hobart, Australia
| | - Sabah Rehman
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Thuy Phuong Nguyen
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Ben Harding
- Public Health Services, Department of Health, Hobart, Australia
| | - Seana Gall
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
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Bendotti H, Gartner CE, Marshall HM, Ireland D, Garvey G, Lawler S. Exploring associations of population characteristics and tobacco and vape retailer density and proximity in Australia: a scoping review. Tob Control 2024:tc-2024-058760. [PMID: 38969498 DOI: 10.1136/tc-2024-058760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Accepted: 06/19/2024] [Indexed: 07/07/2024]
Abstract
OBJECTIVE This scoping review synthesises Australian evidence on associations between tobacco and vape retailer density/proximity and various population measures and smoking behaviour to identify research gaps and inform future policy and strategies. DATA SOURCES Following Joanna Briggs Institute methodology, relevant studies published in English since 2003 were identified via searches of eight databases in March and August 2023. STUDY SELECTION Two reviewers independently completed screening procedures. Eligible studies were from Australia and described associations between tobacco or vape retailer density/proximity and adult or youth smoking/vaping prevalence or behaviours, neighbourhood socioeconomic status, geographic location, school locations and/or Indigenous status. DATA EXTRACTION Results are reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist. DATA SYNTHESIS Of 794 publications screened, 12 studies from 6 Australian states were included. Six studies from five states reported statistically significant associations between neighbourhood-level socioeconomic disadvantage and tobacco retailer density, yet only two studies from two states found a significant relationship between retailer density and adult smoking prevalence. Increasing retailer density was consistently significantly associated with increasing geographical remoteness in three states. No studies explored associations with tobacco retailer proximity or vape retailer density/proximity. CONCLUSIONS Despite a moderate number of studies overall, state-level evidence is limited, and unknown for Australian territories. Evidence from five Australian states reflects the international evidence that increasing retailer density is significantly associated with increasing socioeconomic disadvantage and remoteness, supporting the need for tobacco supply-based policies. Further research is required to understand the impact of retailer density and adult and youth smoking prevalence in Australia.
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Affiliation(s)
- Hollie Bendotti
- School of Public Health, Faculty of Medicine, The University of Queensland, Herston, Queensland, Australia
- Thoracic Research Centre, Faculty of Medicine, The University of Queensland, Chermside, Queensland, Australia
| | - Coral E Gartner
- NHMRC Centre of Research Excellence on Achieving the Tobacco Endgame, School of Public Health, The University of Queensland, Herston, Queensland, Australia
| | - Henry M Marshall
- Thoracic Research Centre, Faculty of Medicine, The University of Queensland, Chermside, Queensland, Australia
- Department of Thoracic Medicine, The Prince Charles Hospital, Metro North Hospital and Health Service, Chermside, Queensland, Australia
| | - David Ireland
- Australian eHealth Research Centre, Commonwealth Scientific and Industrial Research Organisation, Herston, Queensland, Australia
| | - Gail Garvey
- School of Public Health, Faculty of Medicine, The University of Queensland, Herston, Queensland, Australia
| | - Sheleigh Lawler
- School of Public Health, Faculty of Medicine, The University of Queensland, Herston, Queensland, Australia
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Smith EA, McDaniel PA, Malone RE. Should tobacco sales be restricted to state-run alcohol outlets? Perspectives from 10 US alcohol control states. Addiction 2024; 119:1048-1058. [PMID: 38454636 PMCID: PMC11131590 DOI: 10.1111/add.16467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 02/01/2024] [Indexed: 03/09/2024]
Abstract
BACKGROUND AND AIMS The ubiquity of tobacco retailers helps to sustain the tobacco epidemic. A tobacco retail reduction approach that has not been tried is transitioning tobacco sales to state-controlled alcohol stores (TTS), which are limited in number and operate under some restrictions, e.g. regarding opening hours or marketing materials. This study summarizes policy experts' and advocates' views of TTS, including (1) advantages and disadvantages; (2) feasibility; and (3) potential implementation obstacles. DESIGN This study was a qualitative content analysis of semi-structured interviews. SETTING Ten US states with alcoholic beverage control systems were included. PARTICIPANTS The participants comprised a total of 103 tobacco control advocates and professionals, public health officials, alcohol policy experts and alcohol control system representatives, including two tribal community representatives. MEASUREMENTS Interviewees' perspectives on their state's alcoholic beverage control agency (ABC, the agency that oversees or operates a state alcohol monopoly) and on TTS were assessed. FINDINGS Interviewees thought TTS offered potential advantages, including reduced access to tobacco products, less exposure to tobacco advertising and a greater likelihood of successful smoking cessation. Some saw potential long-term health benefits for communities of color, due to the smaller number of state alcohol stores in those communities. Interviewees also raised concerns regarding TTS, including ABCs' limited focus on public health and emphasis on revenue generation, which could conflict with tobacco use reduction efforts. Some interviewees thought TTS could enhance the power of the tobacco and alcohol industries, increase calls for alcohol system privatization or create difficulties for those in recovery. CONCLUSIONS In the United States, transitioning tobacco sales to state-controlled alcohol stores (TTS) could have a positive public health impact by reducing tobacco availability, marketing exposure and, ultimately, tobacco use. However, tensions exist between alcohol control system goals of providing revenue to the state and protecting public health. Should a state decide to pursue TTS, several guardrails should be established, including building into the legislation an explicit goal of reducing tobacco consumption.
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Affiliation(s)
- Elizabeth A Smith
- Department of Social and Behavioral Sciences, School of Nursing, University of California, San Francisco, CA, USA
| | - Patricia A McDaniel
- Department of Social and Behavioral Sciences, School of Nursing, University of California, San Francisco, CA, USA
| | - Ruth E Malone
- Department of Social and Behavioral Sciences, School of Nursing, University of California, San Francisco, CA, USA
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Dadras O. Predictor of smoking cessation among school-going adolescents in Indonesia: a secondary analysis based on the transtheoretical model of behavioral change. Front Psychiatry 2024; 15:1374731. [PMID: 38516262 PMCID: PMC10954880 DOI: 10.3389/fpsyt.2024.1374731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 02/22/2024] [Indexed: 03/23/2024] Open
Abstract
Introduction This study elucidates the complex journey of adolescents toward smoking cessation, investigating the association of relevant demographic factors, advertising, promotion, anti-cigarette messages, and individual knowledge and attitudes with being in different smoking cessation stages. Methods Utilizing data from the 2019 Indonesia Global Youth Tobacco Survey, this secondary analysis included adolescents who reported ever smoking. The Transtheoretical Model (TTM) guided the categorization of the outcome variable into three smoking cessation stages based on the responses to two questions related to the intention and timing of the smoking cessation. This included contemplation, action, and maintenance stages. Multinomial logistic regression analyzed the associations between each independent variable and being in each stage of smoking cessation. The study comprised 3596 Indonesian adolescents from grades 7-12, of which 2484 responded to two questions related to intention and timing of smoking cessation and were included in regression analysis. Results Findings indicate that males and those aged ≥16 were predominantly in contemplation phase. Early smoking initiation, usage of other tobacco products, and exposure to various forms of smoke increased the likelihood of being in contemplation and action phases. Parental smoking, school smoking exposure, and second-hand smoke were significant contemplation phase predictors. Exposure to tobacco advertising was linked to an increased likelihood of being in contemplation and action phases, whereas anti-cigarette messages showed no significant impact. Awareness of cigarette and second-hand smoke harms reduced the odds of being in the contemplation phase, while enjoying smoking and willingness to accept cigarettes from friends increased the odds of being in contemplation and action phases rather than in maintenance phase. Conclusion Addressing age, gender, cultural influences, environmental factors, and attitudes towards smoking through tailored interventions is vital for aiding smoking cessation in Indonesian adolescents. Strengthened tobacco control in schools and public places is recommended to bolster these efforts. Longitudinal studies are required to explore the evolving patterns of smoking cessation behaviors over time, enhancing our understanding of the factors influencing sustained cessation.
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Affiliation(s)
- Omid Dadras
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Bergen Addiction Research, Department of Addiction Medicine, Haukeland University Hospital, Bergen, Norway
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Jenks JD, Prattes J, Wurster S, Sprute R, Seidel D, Oliverio M, Egger M, Del Rio C, Sati H, Cornely OA, Thompson GR, Kontoyiannis DP, Hoenigl M. Social determinants of health as drivers of fungal disease. EClinicalMedicine 2023; 66:102325. [PMID: 38053535 PMCID: PMC10694587 DOI: 10.1016/j.eclinm.2023.102325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 10/27/2023] [Accepted: 11/02/2023] [Indexed: 12/07/2023] Open
Abstract
Disparities in social determinants of health (SDOH) play a significant role in causing health inequities globally. The physical environment, including housing and workplace environment, can increase the prevalence and spread of fungal infections. A number of professions are associated with increased fungal infection risk and are associated with low pay, which may be linked to crowded and sub-optimal living conditions, exposure to fungal organisms, lack of access to quality health care, and risk for fungal infection. Those involved and displaced from areas of armed conflict have an increased risk of invasive fungal infections. Lastly, a number of fungal plant pathogens already threaten food security, which will become more problematic with global climate change. Taken together, disparities in SDOH are associated with increased risk for contracting fungal infections. More emphasis needs to be placed on systematic approaches to better understand the impact and reducing the health inequities associated with these disparities.
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Affiliation(s)
- Jeffrey D. Jenks
- Durham County Department of Public Health, Durham, NC, United States of America
- Division of Infectious Diseases, Department of Medicine, Duke University, Durham, NC, United States of America
| | - Juergen Prattes
- Division of Infectious Diseases, ECMM Excellence Center for Medical Mycology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
- BioTechMed, Graz, Austria
| | - Sebastian Wurster
- Division of Internal Medicine, Department of Infectious Diseases, Infection Control and Employee Health, MD Anderson Cancer Center, University of Texas, Houston, TX, United States of America
| | - Rosanne Sprute
- Faculty of Medicine and University Hospital Cologne, University of Cologne, Institute of Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging – Associated Diseases (CECAD), Cologne, Germany
- Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, University of Cologne, Center of Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) and Excellence Center of Medical Mycology (ECMM), Cologne, Germany
- German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany
| | - Danila Seidel
- Faculty of Medicine and University Hospital Cologne, University of Cologne, Institute of Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging – Associated Diseases (CECAD), Cologne, Germany
- Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, University of Cologne, Center of Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) and Excellence Center of Medical Mycology (ECMM), Cologne, Germany
| | - Matteo Oliverio
- Faculty of Medicine and University Hospital Cologne, University of Cologne, Institute of Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging – Associated Diseases (CECAD), Cologne, Germany
- Department I of Internal Medicine, University of Cologne, Cologne, Germany
| | - Matthias Egger
- Division of Infectious Diseases, ECMM Excellence Center for Medical Mycology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
- BioTechMed, Graz, Austria
| | - Carlos Del Rio
- Emory Center for AIDS Research, Emory University School of Medicine, Atlanta, GA, United States of America
| | - Hatim Sati
- Department of Global Coordination and Partnership on Antimicrobial Resistance, World Health Organization, Geneva, Switzerland
| | - Oliver A. Cornely
- Faculty of Medicine and University Hospital Cologne, University of Cologne, Institute of Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging – Associated Diseases (CECAD), Cologne, Germany
- Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, University of Cologne, Center of Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) and Excellence Center of Medical Mycology (ECMM), Cologne, Germany
- German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany
- Faculty of Medicine and University Hospital Cologne, Clinical Trials Centre Cologne (ZKS Koln), University of Cologne, Cologne, Germany
| | - George R. Thompson
- University of California Davis Center for Valley Fever, Sacramento, CA, United States of America
- Division of Infectious Diseases, Department of Internal Medicine, University of California Davis Medical Center, Sacramento, CA, United States of America
- Department of Medical Microbiology and Immunology, University of California Davis, Davis, CA, United States of America
| | - Dimitrios P. Kontoyiannis
- Division of Internal Medicine, Department of Infectious Diseases, Infection Control and Employee Health, MD Anderson Cancer Center, University of Texas, Houston, TX, United States of America
| | - Martin Hoenigl
- Division of Infectious Diseases, ECMM Excellence Center for Medical Mycology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
- BioTechMed, Graz, Austria
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Baker J, Lenz K, Masood M, Rahman MA, Begg S. Tobacco retailer density and smoking behaviour: how are exposure and outcome measures classified? A systematic review. BMC Public Health 2023; 23:2038. [PMID: 37853379 PMCID: PMC10585801 DOI: 10.1186/s12889-023-16914-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Accepted: 10/05/2023] [Indexed: 10/20/2023] Open
Abstract
INTRODUCTION To date only a limited number of reviews have focused on how exposure and outcome measures are defined in the existing literature on associations between tobacco retailer density ('density') and smoking behaviour ('smoking'). Therefore this systematic review classified and summarised how both density and smoking variables are operationalised in the existing literature, and provides several methodological recommendations for future density and smoking research. METHODS Two literature searches between March and April 2018 and April 2022 were conducted across 10 databases. Inclusion and exclusion criteria were developed and keyword database searches were undertaken. Studies were imported into Covidence. Cross-sectional studies that met the inclusion criteria were extracted and a quality assessment was undertaken. Studies were categorised according to the density measure used, and smoking was re-categorised using a modified classification tool. RESULTS Large heterogeneity was found in the operationalisation of both measures in the 47 studies included for analysis. Density was most commonly measured directly from geocoded locations using circular buffers at various distances (n = 14). After smoking was reclassified using a smoking classification tool, past-month smoking was the most common smoking type reported (n = 26). CONCLUSIONS It is recommended that density is measured through length-distance and travel time using the street network and weighted (e.g. by the size of an area), or by using Kernel Density Estimates as these methods provide a more accurate measure of geographical to tobacco and e-cigarette retailer density. The consistent application of a smoking measures classification tool, such as the one developed for this systematic review, would enable better comparisons between studies. Future research should measure exposure and outcome measures in a way that makes them comparable with other studies. IMPLICATIONS This systematic review provides a strong case for improving data collection and analysis methodologies in studies assessing tobacco retailer density and smoking behaviour to ensure that both exposure and outcome measures are clearly defined and captured. As large heterogeneity was found in the operationalisation of both density and smoking behaviour measures in the studies included for analysis, there is a need for future studies to capture, measure and classify exposure measures accurately, and to define outcome measures in a manner that makes them comparable with other studies.
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Affiliation(s)
- John Baker
- Department of Community and Allied Health, La Trobe Rural Health School, La Trobe University, Bendigo, Australia.
| | - Katrin Lenz
- Violet Vines Marshman Centre For Rural Health Research, La Trobe Rural Health School, Melbourne, VIC, Australia
| | - Mohd Masood
- Department of Dentistry and Oral Health, La Trobe Rural Health School, La Trobe University, Bendigo, Australia
- Institute of Dentistry, University of Turku, Turku, Finland
| | - Muhammad Aziz Rahman
- School of Health, Federation University, Berwick, Australia
- Australian Institute for Primary Care and Ageing, La Trobe University, Melbourne, Australia
| | - Stephen Begg
- Violet Vines Marshman Centre For Rural Health Research, La Trobe Rural Health School, Melbourne, VIC, Australia
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Bostean G, Ponicki WR, Padon AA, McCarthy WJ, Unger JB. A statewide study of disparities in local policies and tobacco, vape, and cannabis retail environments. Prev Med Rep 2023; 35:102373. [PMID: 37691887 PMCID: PMC10483047 DOI: 10.1016/j.pmedr.2023.102373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 08/15/2023] [Accepted: 08/16/2023] [Indexed: 09/12/2023] Open
Abstract
The current study: (1) assesses sociodemographic disparities in local policies related to tobacco and cannabis retail, and (2) examines the cross-sectional association between policy strength and retailer densities of tobacco, e-cigarette (vape), and cannabis retailers within California cities and county unincorporated areas (N = 539). We combined (a) American Community Survey data (2019 5-year estimates), (b) 2018 tobacco, vape, and cannabis retailer locations from a commercial data provider, (c) 2017 tobacco and vape retail environment policy data from American Lung Association, and (d) 2018 cannabis policy data from California Cannabis Local Laws Database. Conditional autoregressive models examined policy strength associations with sociodemographic composition and retailer density in California jurisdictions. Jurisdictions with larger percentages of Black and foreign-born residents had stronger tobacco and vape policies. For cannabis policy, only income had a small, significant positive association with policy strength. Contrary to hypothesis, tobacco/vape policies were not significantly associated with retailer density, but cannabis policy strength was associated with lower cannabis retailer density (relative rate = 0.58, 95% Uncertainty Interval 0.47-0.70)-this effect was completely driven by storefront bans. Thus, storefront cannabis bans were the only policy studied that was associated with lower cannabis retailer density. Further research is needed to understand policies and disparities in retail environments for tobacco, vape, and cannabis, including data on the prospective association between policy implementation and subsequent retailer density, and the role of enforcement.
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Affiliation(s)
- Georgiana Bostean
- Sociology Department, Environmental Science & Policy Program, Chapman University, One University Drive, Orange, CA 92866, USA
| | - William R. Ponicki
- Prevention Research Center, Pacific Institute for Research and Evaluation, Berkeley, CA, USA
| | | | - William J. McCarthy
- Department of Health Policy & Management, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA
| | - Jennifer B. Unger
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
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Seale E, Sturrock SL, Widener MJ, Myran DT. The availability and distribution of vaping retailers across Ontario neighbourhoods, 2016-2019. CANADIAN JOURNAL OF PUBLIC HEALTH = REVUE CANADIENNE DE SANTE PUBLIQUE 2023; 114:493-501. [PMID: 36574202 PMCID: PMC10283501 DOI: 10.17269/s41997-022-00718-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 11/03/2022] [Indexed: 12/28/2022]
Abstract
OBJECTIVES To characterize the distribution of vaping retailers and examine the association between neighbourhood income and vaping retailer availability in Ontario prior to and after regulatory changes to the vaping market in 2018. METHODS We quantified vaping access by number of vaping retailers for 19,964 dissemination areas (DAs) in Ontario and percentage of schools near a vaping retailer. We used mixed-effects regression models to examine the associations between vaping access and neighbourhood income in 2018 and 2019. RESULTS Between 2016 and 2019, the number of vaping retailers in Ontario increased by 22.6% (5999 to 7355), despite a mild drop from 2016 to 2018. In 2019, 59.7% of urban neighbourhoods had one or more vaping retailers within 1000 m of their geographic centre, and 79.4% of elementary, 82.8% of secondary, and 84.2% of post-secondary schools had at least one within 1000 m. Neighbourhood income was associated with access to vaping retailers, with a greater number in low-income regions. In 2019, neighbourhoods in the lowest income quintile had over twice the number of vaping retailers per capita within 1000 m compared to the highest income quintile (adjusted incidence rate ratio 2.40; 95% CI 2.24-2.58). Increases over time in access to vaping retailers did not differ by geographic region, neighbourhood income quintile, or school type. CONCLUSION We observed a substantial increase in access to vaping retailers in Ontario including proximity to elementary and secondary schools following the 2018 provincial marketing regulations and federal nicotine regulations. Access to vaping was greatest in low-income neighbourhoods and may contribute to established inequities in vaping-related adverse events.
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Affiliation(s)
- Emily Seale
- Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
- Bruyère Research Institute, Ottawa, ON, Canada
| | - Shelby L Sturrock
- Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Michael J Widener
- Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Department of Geography and Planning, University of Toronto, Toronto, ON, Canada
| | - Daniel T Myran
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada.
- Department of Family Medicine, University of Ottawa, Ottawa, ON, Canada.
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Croker JA, Werts M, Couch ET, Chaffee BW. Cannabis use among adolescents and emerging adults who use e-cigarettes: Findings from an online, national U.S. Sample. Addict Behav 2023; 140:107620. [PMID: 36724700 PMCID: PMC9984189 DOI: 10.1016/j.addbeh.2023.107620] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 11/17/2022] [Accepted: 01/09/2023] [Indexed: 01/21/2023]
Abstract
Concurrent use of e-cigarettes and cannabis among adolescents and emerging adults is a growing public health concern. More research is needed describing cannabis use among adolescents and emerging adults who vape. The objective of this study was to characterize cannabis use among adolescents and emerging adults (age 14-20) who reported e-cigarette ever-use, particularly their use of blunts and liquid cannabis vape (LCV) products. Using cross-sectional data from a national online survey, we describe their patterns of cannabis use, detail their use of flavored cannabis and tobacco products, and estimate associations of demographic factors and other current substance use behaviors with levels of blunt and LCV use. Of the 2253 respondents in the sample, 1379 (61 %) reported some form of cannabis use in the past 30 days, among whom 80 % used flavored cannabis (including edibles). Significant associations with current cannabis use were observed on several demographic measures, with current cannabis blunt use more frequent among participants not in school, non-Hispanic Blacks, multiracial respondents, and those whose incomes do not meet their expenses. Other than income, demographic characteristics were generally not associated with LCV use frequency. Use of other substances was associated with more frequent use of both blunts and LCV in the past 30 days, and enrollment in college or the military seems somewhat protective for emerging adults. These findings suggest a need for tailored prevention efforts among high-risk adolescents and emerging adults, potential regulation of added flavors in commercialized cannabis products, and stronger enforcement of retail restrictions for individuals under age 21 more broadly.
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Affiliation(s)
- James A Croker
- Center for Tobacco Control Research and Education, Cardiovascular Research Institute, University of California San Francisco, San Francisco, CA, USA.
| | - Miranda Werts
- Division of Oral Epidemiology and Dental Public Health, School of Dentistry, University of California San Francisco, San Francisco, CA, USA.
| | - Elizabeth T Couch
- Division of Oral Epidemiology and Dental Public Health, School of Dentistry, University of California San Francisco, San Francisco, CA, USA.
| | - Benjamin W Chaffee
- Center for Tobacco Control Research and Education, Cardiovascular Research Institute, University of California San Francisco, San Francisco, CA, USA; Division of Oral Epidemiology and Dental Public Health, School of Dentistry, University of California San Francisco, San Francisco, CA, USA.
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10
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Lin SY, Zhou W, Koch JR, Barnes AJ, Yang R, Xue H. The Association Between Tobacco Retailer Outlet Density and Prevalence of Cigarette Smoking in Virginia. Nicotine Tob Res 2023; 25:36-42. [PMID: 35752162 DOI: 10.1093/ntr/ntac154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 05/22/2022] [Accepted: 06/23/2022] [Indexed: 01/03/2023]
Abstract
OBJECTIVE We examine the association between tobacco retail outlet density and adult smoking prevalence at the county level in Virginia, controlling for spatial autocorrelations. AIMS AND METHODS Pooling data from 2020 County Health Rankings (compiled data from various sources including, but not limited to, the National Center for Health Statistics-Mortality Files, the Behavioral Risk Factor Surveillance System (BRFSS), and the American Community Survey) and Counter Tools, we conducted regression analyses that accounted for spatial autocorrelation (spatial lag models, LMlag) and adjusted for county-level access to healthcare, demographics, SES, environmental factors, risk conditions or behaviors, and population health measures. RESULTS Our estimates provide evidence that every increase of one tobacco retail outlet per 1000 persons was associated with 1.16 percentage points (95% CI: 0.80-1.52) higher smoking prevalence at the county level in Virginia after controlling for spatial autocorrelation. The effect of outlet density was largely explained by social determinants of health such as SES, risky conditions or behaviors, and environmental factors. We further noticed that the impact of social determinants of health were closely related and can be explained by indicators of population health (rates of mental distress (β = 1.49, 95% CI: 1.31-1.67) and physical inactivity (β = 0.07, 95% CI: 0.04-0.10). CONCLUSIONS Although higher tobacco outlet density was associated with an increase in county-level smoking prevalence, the impact of outlet density was largely explained by social determinants of health and mental illness. Improving well-being at the community level could be a promising strategy in future tobacco control policies. IMPLICATION The influence of tobacco outlet density seems to be explained by other social determinants of health and population level of mental or physical health. Thus, efforts to reduce tobacco use and consequent negative health effects should explore the impact of improving regional living standards. However, a sole focus on economic growth may not be sufficient, whereas a focus on such things as promoting work-life balance and improving overall well-being at the community level may be more.
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Affiliation(s)
- Shuo-Yu Lin
- Department of Health Administration and Policy, College of Health and Human Services, George Mason University, Fairfax, VA, USA
| | - Weiyu Zhou
- Department of Statistics, Volgenau School of Engineering, George Mason University, Fairfax, VA, USA
| | - J Randy Koch
- Department of Psychology and the Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, VA, USA
| | - Andrew J Barnes
- Department of Health Behavior and Policy, School of Medicine, Virginia Commonwealth University, Richmond, VA, USA
| | - Ruixin Yang
- Department of Geography and Geoinformation Science, College of Science, George Mason University, Fairfax, VA, USA
| | - Hong Xue
- Department of Health Administration and Policy, College of Health and Human Services, George Mason University, Fairfax, VA, USA
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11
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Raskind IG, Vishwakarma M, Schleicher NC, Andersen-Rodgers E, Henriksen L. The changing retail landscape for tobacco: dollar stores and the availability of cheap cigarettes among tobacco-related priority populations. Tob Control 2022; 31:e140-e147. [PMID: 34607887 PMCID: PMC8977398 DOI: 10.1136/tobaccocontrol-2020-056389] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Accepted: 08/10/2021] [Indexed: 12/14/2022]
Abstract
INTRODUCTION Dollar stores are rapidly altering the retail landscape for tobacco. Two of the three largest chains sell tobacco products in more than 24 000 stores across the USA. We sought to examine whether dollar stores are more likely to be located in disadvantaged neighbourhoods and whether dollar stores charge less for cigarettes than other tobacco retailers. METHODS Data were collected from a statewide random sample of licensed tobacco retailers in California (n=7678) in 2019. Logistic regression modelled odds of a census tract containing at least one dollar store as a function of tract demographics. Linear mixed models compared price of the cheapest cigarette pack by store type, controlling for tract demographics. RESULTS Census tracts with lower median household income, rural status and higher proportions of school-age youth were more likely to contain at least one dollar store. The cheapest cigarette pack cost less in dollar stores compared with all store types examined except tobacco shops. Estimated price differences ranged from $0.32 (95% CI: 0.14 to 0.51) more in liquor stores and $0.39 (95% CI: 0.22 to 0.57) more in convenience stores, to $0.82 (95% CI: 0.64 to 1.01) more in small markets and $1.86 (95% CI: 1.61 to 2.11) more in stores classified as 'other'. CONCLUSIONS Dollar stores may exacerbate smoking-related inequities by contributing to the availability of cheaper cigarettes in neighbourhoods that are lower income, rural and have greater proportions of youth. Pro-equity retail policies, such as minimum price laws and density reduction policies, could mitigate the health consequences of dollar stores' rapid expansion.
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Affiliation(s)
- Ilana G Raskind
- Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, California, USA
| | - Monika Vishwakarma
- Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, California, USA
| | - Nina C Schleicher
- Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, California, USA
| | | | - Lisa Henriksen
- Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, California, USA
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12
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Travis N, Levy DT, McDaniel PA, Henriksen L. Tobacco retail availability and cigarette and e-cigarette use among youth and adults: a scoping review. Tob Control 2022; 31:e175-e188. [PMID: 34301839 PMCID: PMC9126034 DOI: 10.1136/tobaccocontrol-2020-056376] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 06/28/2021] [Indexed: 12/18/2022]
Abstract
OBJECTIVE States and localities are formulating strategies to reduce the widespread retail availability of tobacco products. Evidence of associations between retailer density/proximity and tobacco use outcomes can help inform those strategies. We conducted a scoping review on tobacco retail availability and cigarette/e-cigarette use in adults and youth, and considered variations in spatial units, measures of retailer exposure and outcomes across studies. METHODS A systematic search for studies examining the association between retailer density/proximity and youth and adult cigarette/e-cigarette use was conducted across MEDLINE (PubMed), Web of Science and Google Scholar through 27 August 2020 with no restrictions. RESULTS Thirty-five studies were included in our qualitative synthesis. While there were differences in neighbourhood definitions (eg, egocentric vs administrative), there is evidence for a positive association between higher retailer density in egocentric neighbourhoods around homes and current smoking in adults and adolescents. Administrative unit measures in some studies showed associations with adult current smoking, and adolescent lifetime and current smoking. Studies on tobacco outlet proximity to homes obtained mixed results. Density/proximity of tobacco outlets around schools showed no or inverse association with adolescent smoking, but suggests higher susceptibility to smoking. Evidence of an association between e-cigarette retail availability and e-cigarette use is limited due to a small number of studies. CONCLUSION The current literature provides limited empirical evidence of the association between tobacco retailer availability and smoking or e-cigarette use. More research with uniform measures of environmental exposure to tobacco retailers is needed to allow for greater comparability between studies.
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Affiliation(s)
- Nargiz Travis
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, USA
| | - David T Levy
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, USA
| | - Patricia A McDaniel
- Department of Social and Behavioral Sciences, University of California, San Francisco, California, USA
| | - Lisa Henriksen
- Stanford Prevention Research Center, Stanford University School of Medicine, Palo Alto, California, USA
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13
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Chaffee BW, Halpern-Felsher B, Croker JA, Werts M, Couch ET, Cheng J. Preferences, use, and perceived access to flavored e-cigarettes among United States adolescents and young adults. DRUG AND ALCOHOL DEPENDENCE REPORTS 2022; 3. [PMID: 35757567 PMCID: PMC9224229 DOI: 10.1016/j.dadr.2022.100068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Background: Citing concern over youth use, the Food and Drug Administration announced a prioritized enforcement policy against cartridge-based (reusable pod) e-cigarettes in non-menthol, non-tobacco flavors, effective February 2020. Data are needed regarding youth e-cigarette access and use behaviors following this policy. Methods: This cross-sectional national (USA) online panel survey, conducted March/April 2021, included 2253 participants ages 14–20 who ever used e-cigarettes ≥3 times (73% past 30-day users). Participants reported their flavor preferences, use reasons, and perceived ease of access. Latent class analysis categorized participants according to their preferred e-cigarette flavors, and multinominal logistic regression identified sociodemographic and behavioral correlates of class membership. Results: Most past 30-day e-cigarette users used reusable pod (77%) or modern disposable (68%) devices, ≥1 non-tobacco (92%), sweet (76%), and/or menthol flavors including fruit-ice (70%) (flavor and device categories not mutually exclusive). Most past 30-day users (70%) and non-users (63%) perceived it would be somewhat or very easy to acquire e-cigarettes in flavors they like. Latent class analysis identified four e-cigarette flavor preference classes: mint (34% of sample), no preference (29%), fruit/sweet (28%), and dislikes ≥1 flavor (10%). Relative to no preference, membership in fruit/sweet (RRR: 1.87; 95% CI: 1.37, 2.57) and mint (RRR: 3.85; 95% CI: 2.77, 5.36) classes was associated with using e-cigarettes ≥50 times. Fruit/sweet membership was inversely associated with combustible tobacco use (RRR: 0.50; 95% CI: 0.38, 0.66). Conclusion: Young e-cigarette users maintained ample access to flavored and cartridge-based products. Stronger access restrictions and enforcement are required to reduce youth e-cigarette use.
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Affiliation(s)
- Benjamin W. Chaffee
- University of California San Francisco, San Francisco, CA, United States
- Corresponding author: 707 Parnassus Ave. Room D3214, Box 0758, San Francisco, CA, 94143 United States.
| | | | - James Alton Croker
- University of California San Francisco, San Francisco, CA, United States
| | - Miranda Werts
- University of California San Francisco, San Francisco, CA, United States
| | - Elizabeth T. Couch
- University of California San Francisco, San Francisco, CA, United States
| | - Jing Cheng
- University of California San Francisco, San Francisco, CA, United States
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14
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Dewi DMSK, Puspikawati SI, Astutik E, Kusuma D, Melaniani S, Sebayang SK. Density of Cigarette Retailers Near Facilities for Children and Adolescents in Urban and Rural Areas in Indonesia: A Geospatial Analysis. Asia Pac J Public Health 2022; 34:384-391. [PMID: 35392672 DOI: 10.1177/10105395221085067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The lack of regulation banning cigarette retailers near facilities for children and adolescents has made cigarettes easily accessible to youth in Indonesia. This study aimed to investigate the density of cigarette retailer near children and adolescent facilities in urban and rural areas in the country. We mapped all cigarette retailers and facilities for children and adolescents in Surabaya city (urban) and Banyuwangi district (rural) in East Java province. All types of facilities for children and adolescents and retailers visible from the streets in the study areas were mapped. We conducted geospatial analysis of the density of retailers to the facilities for children and adolescents in QGIS 2.8 and STATA 14. We found that the density of cigarette retailers was 81% higher in the areas within 100 m from the facilities for children and adolescents, compared with the areas within 100 to 250 m from facilities. We also found that the density of cigarette retailers within 100 m from facilities was 2.35 times higher in the rural setting, compared with the urban setting. Controlling cigarette retailers through zoning and licensing is urgently needed in Indonesia.
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Affiliation(s)
- Desak Made Sintha Kurnia Dewi
- Department of Epidemiology, Biostatistics, Population Studies, and Health Promotion, Universitas Airlangga, Banyuwangi, Indonesia.,Research Group for Health & Well-Being of Women and Children, Universitas Airlangga, Banyuwangi, Indonesia
| | - Septa Indra Puspikawati
- Research Group for Health & Well-Being of Women and Children, Universitas Airlangga, Banyuwangi, Indonesia.,Department of Nutrition, Universitas Airlangga, Banyuwangi, Indonesia
| | - Erni Astutik
- Research Group for Health & Well-Being of Women and Children, Universitas Airlangga, Banyuwangi, Indonesia.,Department of Epidemiology, Biostatistics, Population Studies, and Health Promotion, Universitas Airlangga, Surabaya, Indonesia
| | - Dian Kusuma
- Centre for Health Economics & Policy Innovation, Imperial College Business School, London, UK
| | - Soenarnatalina Melaniani
- Research Group for Health & Well-Being of Women and Children, Universitas Airlangga, Banyuwangi, Indonesia.,Department of Epidemiology, Biostatistics, Population Studies, and Health Promotion, Universitas Airlangga, Surabaya, Indonesia
| | - Susy Katikana Sebayang
- Department of Epidemiology, Biostatistics, Population Studies, and Health Promotion, Universitas Airlangga, Banyuwangi, Indonesia.,Research Group for Health & Well-Being of Women and Children, Universitas Airlangga, Banyuwangi, Indonesia
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15
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Feltmann K, Gripenberg J, Elgán TH. Sales of cigarettes to pseudo-underage mystery shoppers: Experiences from Stockholm County. NORDIC STUDIES ON ALCOHOL AND DRUGS 2022; 38:573-585. [PMID: 35309850 PMCID: PMC8900174 DOI: 10.1177/14550725211003423] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Accepted: 03/01/2021] [Indexed: 12/30/2022] Open
Abstract
Aims There is an 18 years age limit for cigarette purchase in Sweden and in order to implement this law outlets need to perform ID checks. This study investigates the rate of cigarette sales and ID checks when pseudo-underage mystery shoppers attempted to purchase cigarettes. It explores possible factors associated with sales outcomes. Design Nine mystery shoppers (6 females and 3 males) attempted to purchase cigarettes without providing ID. The mystery shoppers were 18 years old but had a younger appearance as judged by an expert panel. During each attempt, the adolescents worked in pairs (shopper and observer). A total of 320 outlets in 13 municipalities in Stockholm County were randomly selected based on an outlet type stratum (i.e., gas station, convenience store, kiosk, grocery store). Effects of variables on sales outcomes were analysed using Pearson's chi-square and binominal regression analysis. Results In 25.4% of the purchase attempts (total n = 287), cigarettes were sold although the pseudo-underage mystery shopper did not provide a valid ID. In 82.6% of the attempts, the shopper was asked to provide ID, and cigarettes were sold in 9.7% of these cases. The rate of sales was significantly higher among female mystery shoppers (29.5%) compared to male (15.0%). Age limit signs were observed in 89.5% of the outlets but they were not significantly associated with the success rate in a regression analysis. Conclusions The results of the present study indicate that cigarettes could potentially and frequently be sold to underage adolescents by outlets within Stockholm County. Therefore, routines established for checking IDs clearly need to be improved. For example, strategies to improve adherence to the legal age limit on the purchase of cigarettes, such as compliance checks using mystery shopping with feedback to retailers, are needed.
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Affiliation(s)
- Kristin Feltmann
- STAD, Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Stockholm, Sweden
| | - Johanna Gripenberg
- STAD, Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Stockholm, Sweden
| | - Tobias H Elgán
- STAD, Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Stockholm, Sweden
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16
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Rhew IC, Guttmannova K, Kilmer JR, Fleming CB, Hultgren BA, Hurvitz PM, Dilley JA, Larimer ME. Associations of cannabis retail outlet availability and neighborhood disadvantage with cannabis use and related risk factors among young adults in Washington State. Drug Alcohol Depend 2022; 232:109332. [PMID: 35123361 PMCID: PMC8890768 DOI: 10.1016/j.drugalcdep.2022.109332] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 01/20/2022] [Accepted: 01/22/2022] [Indexed: 12/13/2022]
Abstract
BACKGROUND This study examined associations of local cannabis retail outlet availability and neighborhood disadvantage with cannabis use and related risk factors among young adults. METHODS Data were from annual cross-sectional surveys administered from 2015 to 2019 to individuals ages 18-25 residing in Washington State (N = 10,009). As outcomes, this study assessed self-reported cannabis use at different margins/frequencies (any past year, at least monthly, at least weekly, at least daily) and perceived ease of access to cannabis and acceptability of cannabis use in the community. Cannabis retail outlet availability was defined as the presence of at least one retail outlet within a 1-kilometer road network buffer of one's residence. Sensitivity analyses explored four other spatial metrics to define outlet availability (any outlet within 0.5-km, 2-km, and the census tract; and census tract density per 1000 residents). Census tract level disadvantage was a composite of five US census variables. RESULTS Adjusting for individual- and area-level covariates, living within 1-kilometer of at least one cannabis retail outlet was statistically significantly associated with any past year and at least monthly cannabis use as well as high perceived access to cannabis. Results using a 2-km buffer and census tract-level metrics for retail outlet availability showed similar findings. Neighborhood disadvantage was statistically significantly associated with at least weekly and at least daily cannabis use and with greater perceived acceptability of cannabis use. CONCLUSIONS Results may have implications for regulatory and prevention strategies to reduce the population burden of cannabis use and related harms.
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Affiliation(s)
- Isaac C Rhew
- Department of Psychiatry and Behavioral Sciences, Center for the Study of Health and Risk Behaviors, University of Washington, Box 357238, Seattle, WA 98195-7238, USA.
| | - Katarina Guttmannova
- Department of Psychiatry and Behavioral Sciences, Center for the Study of Health and Risk Behaviors, University of Washington, Box 357238, Seattle, WA 98195-7238, USA.
| | - Jason R Kilmer
- Department of Psychiatry and Behavioral Sciences, Center for the Study of Health and Risk Behaviors, University of Washington, Box 357238, Seattle, WA 98195-7238, USA.
| | - Charles B Fleming
- Department of Psychiatry and Behavioral Sciences, Center for the Study of Health and Risk Behaviors, University of Washington, Box 357238, Seattle, WA 98195-7238, USA.
| | - Brittney A Hultgren
- Department of Psychiatry and Behavioral Sciences, Center for the Study of Health and Risk Behaviors, University of Washington, Box 357238, Seattle, WA 98195-7238, USA.
| | - Philip M Hurvitz
- Center for the Studies in Demography and Ecology, University of Washington, Seattle, WA, USA; Department of Urban Design and Planning, University of Washington, Seattle, WA, USA.
| | - Julia A Dilley
- Oregon Public Health Division, 800 NE Oregon Street, #260, Portland, OR 97232, USA.
| | - Mary E Larimer
- Department of Psychiatry and Behavioral Sciences, Center for the Study of Health and Risk Behaviors, University of Washington, Box 357238, Seattle, WA 98195-7238, USA.
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17
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Trapl E, Anesetti-Rothermel A, Pike Moore S, Gittleman H. Association between school-based tobacco retailer exposures and young adolescent cigarette, cigar and e-cigarette use. Tob Control 2021; 30:e104-e110. [PMID: 32817573 DOI: 10.1136/tobaccocontrol-2020-055764] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 06/22/2020] [Accepted: 07/15/2020] [Indexed: 11/04/2022]
Abstract
BACKGROUND Associations between retail tobacco availability and tobacco use have been mixed. This study examined associations between school-based retail environment exposures and current use of cigarettes, cigar products and e-cigarettes among middle school youth in Cleveland, OH. METHODS Retailers selling tobacco products were identified using the 2015 Cleveland Food Retail Database (n=639 stores). Youth survey data were drawn from the 2016 Cleveland Youth Risk Behavior Survey, administered to all 7th/8th graders across the Cleveland Metropolitan School District (n=3778, response rate=83.0%). Past 30-day cigarette, cigar product and e-cigarette use were assessed. Student demographics, number of days walking to/from school each week and number of times youth stopped at a retailer to/from school each week were included. For each school (n=63), tobacco retail density (TRD) and proximity (TRP) to nearest retailer were calculated for each product. Multiple regression analysis assessed associations between retail exposures and youth tobacco use. RESULTS Across all schools, 3.9%, 10.2% and 8.6% of students currently use cigarettes, cigar products and e-cigarettes, respectively, and 15.2% currently use at least one tobacco product. TRD and TRP were not associated with current use; frequency of walking to school and stopping at retailers were strongly associated with current use. CONCLUSIONS Although TRD and TRP were not significantly associated with tobacco product use, youth who reported regularly walking to/from school or who reported stopping at a retail store before/after school were significantly more likely to be a current tobacco product user. This may be due to increased exposure to exterior and point-of-sale marketing.
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Affiliation(s)
- Erika Trapl
- Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, Ohio, USA
| | - Andrew Anesetti-Rothermel
- PATH Branch, Center for Tobacco Products, Office of Science, US Food and Drug Administration, Silver Spring, Maryland, USA
| | - Stephanie Pike Moore
- Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, Ohio, USA
| | - Haley Gittleman
- Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, Ohio, USA
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18
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Valiente R, Escobar F, Urtasun M, Franco M, Shortt NK, Sureda X. Tobacco Retail Environment and Smoking: A Systematic Review of Geographic Exposure Measures and Implications for Future Studies. Nicotine Tob Res 2021; 23:1263-1273. [PMID: 33155040 DOI: 10.1093/ntr/ntaa223] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 10/29/2020] [Indexed: 11/13/2022]
Abstract
INTRODUCTION To review the geographic exposure measures used to characterize the tobacco environment in terms of density of tobacco outlets and proximity to tobacco outlets, and its association with smoking-related outcomes. METHODS We used PubMed and Google Scholar to find articles published until December 2019. The search was restricted to studies that (1) measured the density of and/or proximity to tobacco outlets and (2) included associations with smoking outcomes. The extraction was coordinated by several observers. We gathered data on the place of exposure, methodological approaches, and smoking outcomes. RESULTS Forty articles were eligible out of 3002 screened papers. Different density and proximity measures were described. 47.4% density calculations were based on simple counts (number of outlets within an area). Kernel density estimations and other measures weighted by the size of the area (outlets per square kilometer), population, and road length were identified. 81.3% of the articles which assessed proximity to tobacco outlets used length distances estimated through the street network. Higher density values were mostly associated with higher smoking prevalence (76.2%), greater tobacco use and smoking initiation (64.3%), and lower cessation outcomes (84.6%). Proximity measures were not associated with any smoking outcome except with cessation (62.5%). CONCLUSION Associations between the density of tobacco outlets and smoking outcomes were found regardless of the exposure measure applied. Further research is warranted to better understand how proximity to tobacco outlets may influence the smoking outcomes. This systematic review discusses methodological gaps in the literature and provides insights for future studies exploring the tobacco environment. IMPLICATIONS Our findings pose some methodological lessons to improve the exposure measures on the tobacco outlet environment. Solving these methodological gaps is crucial to understand the influence of the tobacco environment on the smoking outcomes. Activity spaces should be considered in further analyses because individuals are exposed to tobacco beyond their residence or school neighborhood. Further studies in this research area demand density estimations weighted by the size of the area, population, or road length, or measured using Kernel density estimations. Proximity calculations should be measured through the street network and should consider travel times apart from the length distance.
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Affiliation(s)
- Roberto Valiente
- Department of Geology, Geography and Environmental Sciences, University of Alcalá, Alcalá de Henares, Madrid, Spain
- Public Health and Epidemiology Research Group, School of Medicine, University of Alcalá, Alcalá de Henares, Madrid, Spain
| | - Francisco Escobar
- Department of Geology, Geography and Environmental Sciences, University of Alcalá, Alcalá de Henares, Madrid, Spain
| | - María Urtasun
- Public Health and Epidemiology Research Group, School of Medicine, University of Alcalá, Alcalá de Henares, Madrid, Spain
- Cooperativa APLICA, Madrid, Spain
| | - Manuel Franco
- Public Health and Epidemiology Research Group, School of Medicine, University of Alcalá, Alcalá de Henares, Madrid, Spain
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
- Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, City University of New York, New York, NY
| | - Niamh K Shortt
- Centre for Research on Environment, Society and Health, School of Geosciences, University of Edinburgh, Edinburgh, UK
| | - Xisca Sureda
- Public Health and Epidemiology Research Group, School of Medicine, University of Alcalá, Alcalá de Henares, Madrid, Spain
- Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, City University of New York, New York, NY
- Tobacco Control Research Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, l'Hospitalet de Llobregat, Barcelona, Spain
- Consortium for Biomedical Research in Respiratory Diseases (CIBER en Enfermedades Respiratorias, CIBERES), Madrid, Spain
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19
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Nuyts PAW, Davies LEM, Kunst AE, Kuipers MAG. The Association Between Tobacco Outlet Density and Smoking Among Young People: A Systematic Methodological Review. Nicotine Tob Res 2021; 23:239-248. [PMID: 31433835 PMCID: PMC7822097 DOI: 10.1093/ntr/ntz153] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Accepted: 08/19/2019] [Indexed: 11/29/2022]
Abstract
Aim Evidence on the association between tobacco outlet density and proximity and smoking behavior among youth is inconsistent, which may be due to methodological problems in some studies. We assessed the association of outlet density or proximity with smoking behavior among young people while taking into account the methodological quality of studies. Methods MEDLINE, EMBASE, and Google Scholar were systematically searched for studies on the relationship between outlet density or proximity and smoking behavior among 12- to 25-year-olds, published between 1997 and 2017. Methodological quality of the included studies was evaluated independently by two reviewers. Results Twenty studies were included in the review. The quality assessment identified five primary sources of potential bias: overadjustment for mediators (problems identified in 14 studies), underadjustment for confounders (six studies), poor statistical model fit (four studies), selection bias (three studies), and misclassification of exposure measurements (eight studies). Four studies were of high methodological quality. In studies with relatively high quality, 10 associations were reported, of which seven were nonsignificant, two positive, and one negative. Similarly, the complete body of evidence demonstrated mostly nonsignificant associations, but a larger proportion of positive associations than negative. Conclusion Although there is some support for a positive direction, current literature does not provide consistent evidence for a positive association between outlet density and smoking among youth. This is not necessarily due to bias in specific studies, but more to fundamental challenges in study design and exposure measurements. These issues need to be addressed in future studies using more rigorous methods. Implications Our findings suggest that, although there is some evidence for a positive association, current scientific literature does not provide consistent support to claim an effect of tobacco outlet density or proximity on youth smoking. This underlines the need for more research with improved methodology. There is a need for quasiexperimental studies, in which the outlet density changes substantially, studies measuring the actual exposure of youth to tobacco outlets, and qualitative research on the mechanisms underlying any association.
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Affiliation(s)
- Paulien A W Nuyts
- Department of Public Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Lisa E M Davies
- Department of Public Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Anton E Kunst
- Department of Public Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Mirte A G Kuipers
- Department of Public Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
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20
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Pouranik NS, Saraf S, Wright K, Pandey A, Goel S, Singh RJ, Kennedy RD. Tobacco retailer density and tobacco retailers near schools in two cities of East India, Ranchi and Siliguri. Indian J Tuberc 2021; 68S:S14-S22. [PMID: 34538386 DOI: 10.1016/j.ijtb.2021.07.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 06/23/2021] [Accepted: 07/02/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Passive and active exposure to tobacco smoke is associated with tuberculosis infection and tuberculosis disease. Addressing tobacco use is a critical strategy to address tuberculosis (TB). Studies conducted globally demonstrate that the physical presence and density of tobacco vendors can increase tobacco use in both youth and adults. Little is known about the number and density of tobacco vendors in India, where there are approximately 267 million tobacco users. In India, a national tobacco control law (COTPA, 2003) prohibits the sale of tobacco within 100-yards of an educational institution. Little is known about the number of tobacco vendors operating within 100-yards of schools. This study assesses the number and density of tobacco vendors in the cities of Ranchi (Jharkhand) and Siliguri (West Bengal), and the number of retailers selling tobacco near schools. Both of these jurisdictions have passed local tobacco vendor licensing laws. METHODS Data collectors conducted a census of tobacco vendors within select wards in each city. Each tobacco vendor was classified as either an independent store, permanent kiosk, temporary kiosk, or street vendor. The location of each tobacco vendor was recorded. Data collectors also noted the location of any school/educational institution. Spatial analysis was conducted using GIS software (QGIS 10.5). 100-yard buffers were mapped around school premises. Tobacco vendor density was calculated by area, by road distance, and by population. Tobacco vendors within 100-yards of school properties were counted. RESULTS The study identified 559 tobacco vendors in Ranchi, across three wards, and 367 tobacco vendors in Siliguri, across five wards. When considering the three wards in Ranchi, tobacco vendor density was 68 vendors/km2, 06 vendors/km road, and 08 vendors/1000 population. In Siliguri, the tobacco vendor density was 99 vendors/km2, 05 vendors/km road, and 07 vendors/1000 population. The study found that 19% (n = 105) of vendors observed in Ranchi and 23% (n = 84) of vendors in Siliguri were located within 100-yards of one or more schools. The most common vendor-type in Ranchi was an independent store (58%) and in Siliguri was a permanent kiosk (52%). CONCLUSION Tobacco vendor density was remarkably high in each of the surveyed wards. The study identified tobacco vendors operating within 100-yards of schools. Fully implementing COTPA, 2003 could reduce vendor density in Ranchi and Siliguri. Each city's tobacco vendor licensing laws could further reduce tobacco vendor density. Other strategies should be considered to further reduce density, including setting limits on tobacco vendor type, area or population. The data from this study can be used to inform future tobacco control strategies for these cities and others in the region.
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Affiliation(s)
- Nidhi Sejpal Pouranik
- Tobacco Control Division, International Union Against Tuberculosis and Lung Disease (The Union), New Delhi, Delhi, 110016, India.
| | - Sejal Saraf
- Department of Health, Behaviour & Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA
| | - Kathy Wright
- Tobacco Control Division, International Union Against Tuberculosis and Lung Disease (The Union), New York City, NY, 10005, USA
| | - Ashish Pandey
- Tobacco Control Division, International Union Against Tuberculosis and Lung Disease (The Union), New York City, NY, 10005, USA
| | - Sonu Goel
- Department of Community Medicine and School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh, India; Public Health Masters Program, School of Medicine, University of Limerick, Ireland; Faculty of Human and Health Sciences, Swansea University, United Kingdom
| | - Rana Jugdeep Singh
- Tobacco Control Division, International Union Against Tuberculosis and Lung Disease (The Union), New Delhi, Delhi, 110016, India
| | - Ryan David Kennedy
- Department of Health, Behaviour & Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA
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21
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Marsh L, Vaneckova P, Robertson L, Johnson TO, Doscher C, Raskind IG, Schleicher NC, Henriksen L. Association between density and proximity of tobacco retail outlets with smoking: A systematic review of youth studies. Health Place 2021; 67:102275. [PMID: 33526204 PMCID: PMC8171582 DOI: 10.1016/j.healthplace.2019.102275] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 12/07/2019] [Accepted: 12/16/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND Reducing the retail availability of tobacco has been proposed as a component of tobacco endgame, yet it is not known whether retail availability has a direct impact on smoking behaviours. A narrative review and a meta-analysis have been undertaken to examine the density and proximity of tobacco retail outlets, but were limited in scope, exposure and outcome variables. The aim of this current study was to undertake a systematic review of the international literature on the density and proximity of tobacco retail outlets to homes, schools and communities and their association with smoking behaviours among youth. METHODS We reviewed and critically appraised the evidence documenting the association between density or proximity of tobacco retail outlets and smoking behaviours among school-age youth (18 and under), between 1 January 1990 and 21 October 2019. We reviewed original quantitative research that examined the associations of tobacco retail outlet density and proximity with individual smoking status or population-level smoking prevalence; initiation of smoking; frequency of tobacco use; sales to minors; purchasing by minors; susceptibility to smoking among non-smokers; perceived prevalence of smoking, and quitting behaviours. FINDINGS Thirty-five peer-reviewed papers met the inclusion criteria. This review provided evidence of a relationship between density of tobacco retail outlets and smoking behaviours, particularly for the density near youths' home. A study using activity spaces also found a significant positive association between exposure to tobacco retail outlets and daily tobacco use. The review did not provide evidence of an association between the proximity of tobacco retail outlets to homes or schools and smoking behaviours among youth. CONCLUSIONS The existing evidence supports a positive association between tobacco retail outlet density and smoking behaviours among youth, particularly for the density near youths' home. This review provides evidence for the development and implementation of policies to reduce the density of tobacco retail outlets to reduce smoking prevalence among youth.
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Affiliation(s)
- Louise Marsh
- Cancer Society Social & Behavioural Research Unit, Department of Preventive and Social Medicine, University of Otago, PO Box 56, Dunedin, 9054, New Zealand.
| | - Pavla Vaneckova
- Cancer Council New South Wales, 153 Dowling Street, Woolloomooloo, NSW, 2011, Australia
| | - Lindsay Robertson
- Cancer Society Social & Behavioural Research Unit, Department of Preventive and Social Medicine, University of Otago, PO Box 56, Dunedin, 9054, New Zealand; Tobacco Control Research Group, Department for Health, University of Bath, Claverton Down, Bath, BA2 7AY, UK
| | - Trent O Johnson
- Stanford Prevention Research Center, Stanford University School of Medicine, 3300 Hillview Ave, Mail Code 5537, Palo Alto, CA, 94304-1334, USA
| | - Crile Doscher
- Faculty of Environment, Society and Design, Lincoln University, PO Box 84, Lincoln, 7647, Canterbury, New Zealand
| | - Ilana G Raskind
- Stanford Prevention Research Center, Stanford University School of Medicine, 3300 Hillview Ave, Mail Code 5537, Palo Alto, CA, 94304-1334, USA
| | - Nina C Schleicher
- Stanford Prevention Research Center, Stanford University School of Medicine, 3300 Hillview Ave, Mail Code 5537, Palo Alto, CA, 94304-1334, USA
| | - Lisa Henriksen
- Stanford Prevention Research Center, Stanford University School of Medicine, 3300 Hillview Ave, Mail Code 5537, Palo Alto, CA, 94304-1334, USA
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22
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Lipperman-Kreda S, Finan LJ, Kowitt SD, Grube JW, Abadi M, Balassone A, Kaner E. Youth daily exposure to tobacco outlets and cigarette smoking behaviors: does exposure within activity space matter? Addiction 2020; 115:1728-1735. [PMID: 32032445 PMCID: PMC7415501 DOI: 10.1111/add.15001] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 12/09/2019] [Accepted: 01/31/2020] [Indexed: 11/28/2022]
Abstract
AIMS To examine whether daily exposure to tobacco outlets within activity spaces is associated with cigarette smoking and with the number of cigarettes smoked by youth that day. DESIGN The study used geographic ecological momentary assessment (GEMA) data that combined daily surveys with ecological momentary assessment of global positioning systems (GPS) using geographic information systems (GIS) to allow for real-time data collection of participants' environments and behaviors. SETTING Eight mid-sized California (USA) city areas. PARTICIPANTS The analytical sample included 1065 days, which were clustered within 100 smoker and non-smoker participants (aged 16-20 years, 60% female). MEASUREMENTS Any cigarette smoking and number of cigarettes smoked on a given day, the number of tobacco outlets within 100 m of activity space polylines each day, the number of minutes participants spent within 100 m of tobacco outlets each day and demographic characteristics (age, sex, race/ethnicity and perceived socio-economic status). FINDINGS Controlling for demographic characteristics, the findings of multi-level mixed effects logistic models were inconclusive, whether or not the number of tobacco outlets within 100 m of youths' activity space polylines or the number of minutes spent within 100 m of tobacco outlets were associated with whether the participant smoked cigarettes on a given day [odds ratio (OR) = 1.05, P = 0.24; OR = 0.99, P = 0.81, respectively]. However, in multi-level zero-inflated negative binomial models, the risk of smoking an additional cigarette on a given day increased with each additional tobacco outlet [incidence rate ratio (IRR) = 1.04, P < 0.05] and each additional minute spent within 100 m of tobacco outlets (IRR = 1.01, P < 0.001) each day. CONCLUSIONS Among young people in urban California, differences in day-to-day exposure to tobacco outlets within activity spaces does not seem to be significantly associated with whether a person smokes a cigarette on a given day, but higher exposure to tobacco outlets appears to be positively associated with the number of cigarettes smoked on that day.
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Affiliation(s)
- Sharon Lipperman-Kreda
- Prevention Research Center, Pacific Institute for Research and Evaluation, 2150 Shattuck Avenue, Suite 601, Berkeley, CA 94704
| | - Laura J. Finan
- Department of Psychology, Illinois State University, Campus Box 4620, Normal, IL 61790-4620
| | - Sarah D. Kowitt
- Department of Family Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Joel W. Grube
- Prevention Research Center, Pacific Institute for Research and Evaluation, 2150 Shattuck Avenue, Suite 601, Berkeley, CA 94704
| | - Melissa Abadi
- Pacific Institute for Research and Evaluation, One Riverfront Plaza, Suite 2100, 401 West Main Street, Louisville, KY 40202
| | - Anna Balassone
- Prevention Research Center, Pacific Institute for Research and Evaluation, 2150 Shattuck Avenue, Suite 601, Berkeley, CA 94704
| | - Emily Kaner
- Prevention Research Center, Pacific Institute for Research and Evaluation, 2150 Shattuck Avenue, Suite 601, Berkeley, CA 94704
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23
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Brown R, Van Godwin J, Copeland L, Hallingberg B, Angel L, MacDonald S, Segrott J, Moore G. Ecological Exploration of Knowledge and Attitudes Towards Tobacco and E-Cigarettes Among Primary School Children, Teachers, and Parents in Wales: A Qualitative Study. Tob Use Insights 2020; 13:1179173X20938770. [PMID: 32848489 PMCID: PMC7425248 DOI: 10.1177/1179173x20938770] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Accepted: 05/28/2020] [Indexed: 12/27/2022] Open
Abstract
Experimentation with e-cigarettes has grown rapidly among UK adolescents. To date, this topic has been primarily researched in secondary schools, with less understanding of development of attitudes and behaviours at an earlier age. This research reports qualitative data from interviews with pupils, parents, and teachers at 4 case study schools in Wales (N = 42). It draws on Bronfenbrenner's Ecological Systems Theory to consider how the intersection of systems surrounding primary school-age children and their interaction with these systems, shape knowledge, and attitudes towards e-cigarettes and tobacco. Findings indicate that consistent messaging on smoking from school and family was reflected in strong disapproval among pupils and clear understanding of harms. This was less evident for e-cigarettes, where messages were mixed and inconsistent between home and school, with concerns over what to tell children about e-cigarettes in light of mixed messages and absence of official guidance. Implications of findings for policy and teaching are discussed.
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Affiliation(s)
- Rachel Brown
- Centre for Development, Evaluation, Complexity and Implementation in Public Health Improvement (DECIPHer), School of Social Sciences, Cardiff University, Cardiff, UK
| | - Jordan Van Godwin
- Centre for Development, Evaluation, Complexity and Implementation in Public Health Improvement (DECIPHer), School of Social Sciences, Cardiff University, Cardiff, UK
| | - Lauren Copeland
- Centre for Development, Evaluation, Complexity and Implementation in Public Health Improvement (DECIPHer), School of Social Sciences, Cardiff University, Cardiff, UK
| | - Britt Hallingberg
- Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, UK
| | - Lianna Angel
- Centre for Development, Evaluation, Complexity and Implementation in Public Health Improvement (DECIPHer), School of Social Sciences, Cardiff University, Cardiff, UK
| | - Sarah MacDonald
- Centre for Development, Evaluation, Complexity and Implementation in Public Health Improvement (DECIPHer), School of Social Sciences, Cardiff University, Cardiff, UK
| | - Jeremy Segrott
- Centre for Development, Evaluation, Complexity and Implementation in Public Health Improvement (DECIPHer), School of Social Sciences, Cardiff University, Cardiff, UK
- Centre for Trials Research, School of Medicine, Cardiff University, Cardiff, UK
| | - Graham Moore
- Centre for Development, Evaluation, Complexity and Implementation in Public Health Improvement (DECIPHer), School of Social Sciences, Cardiff University, Cardiff, UK
- Spectrum Consortium, London, UK
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24
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Hust SJT, Willoughby JF, Li J, Couto L. Youth's Proximity to Marijuana Retailers and Advertisements: Factors Associated with Washington State Adolescents' Intentions to Use Marijuana. JOURNAL OF HEALTH COMMUNICATION 2020; 25:594-603. [PMID: 33030100 DOI: 10.1080/10810730.2020.1825568] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The current study explored the influences of advertising exposure, numbers of marijuana retailers, distance to retailers, and constructs from the integrative model of behavioral prediction, including outcome beliefs, perceived norms, and efficacy, on youth's intentions to use marijuana in a state in which the use of recreational marijuana is legal. A state-wide online cross-sectional survey of 350 adolescents ages 13-17, residing in Washington state, was conducted in June 2018. The results of the regression analysis suggest that exposure to marijuana advertising, positive and negative outcome beliefs, and perceived peer norms were associated with intention to use marijuana. Distances to retailers moderated the relationships between exposure to advertising and intentions, as well as between positive outcome beliefs and intentions. States that have legalized recreational marijuana should continue considering the location of retailers in relation to neighborhoods and advertising regulations to reduce the appeal to youth. Additionally, prevention efforts could aim to influence outcome beliefs and norms in an attempt to reduce adolescents' intentions to use recreational marijuana.
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Affiliation(s)
- Stacey J T Hust
- Edward R. Murrow College of Communication, Washington State University , Pullman, Washington, USA
| | - Jessica Fitts Willoughby
- Edward R. Murrow College of Communication, Washington State University , Pullman, Washington, USA
| | - Jiayu Li
- Edward R. Murrow College of Communication, Washington State University , Pullman, Washington, USA
| | - Leticia Couto
- Edward R. Murrow College of Communication, Washington State University , Pullman, Washington, USA
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25
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Vyas P, Tsoh JY, Gildengorin G, Stewart SL, Yu E, Guan A, Pham A, Burke NJ, McPhee SJ. Disentangling individual and neighborhood differences in the intention to quit smoking in Asian American male smokers. Prev Med Rep 2020; 18:101064. [PMID: 32226728 PMCID: PMC7093831 DOI: 10.1016/j.pmedr.2020.101064] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Revised: 01/29/2020] [Accepted: 02/08/2020] [Indexed: 11/22/2022] Open
Abstract
Numerous studies have assessed individual-level factors associated with intention to quit smoking. However, fewer studies have assessed how neighborhood and built environment also contribute towards individual-level behavior. We used baseline data of 340 Chinese and Vietnamese male daily smokers from August 2015 to November 2017 living in the San Francisco Bay Area, who enrolled in a lifestyle intervention trial. The outcome variable was intention to quit in 30 days. To understand the role of contextual factors participants' residential addresses were geocoded, and neighborhood median income, ethnic composition, and tobacco retail density were computed. Individual level analysis suggested that Vietnamese American men had greater intention to quit smoking (OR = 2.90 CI = 1.59, 5.26) in comparison to Chinese Americans. However, after adding neighborhood level factors to the model, no ethnic group difference was observed. Neighborhood household median income (OR = 0.74, CI = 0.64, 0.86) and tobacco retail counts (OR = 0.79, CI = 0.67, 0.94) were negatively associated with intention to quit. Years lived in the U.S. was the only individual level factor associated with intention to quit. By comparing two Asian American groups that live in heterogeneous neighborhoods, we identify key environmental and policy drivers that are associated with quit intention. Future studies aimed at influencing individual-level behavior should take into consideration the neighborhood context and built environment characteristics.
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Affiliation(s)
- Priyanka Vyas
- Center for Tobacco Control Research and Education, University of California, San Francisco, United States
| | - Janice Y. Tsoh
- Center for Tobacco Control Research and Education, University of California, San Francisco, United States
- Department of Psychiatry, University of California, San Francisco, CA, United States
| | - Ginny Gildengorin
- Division of General Internal Medicine, University of California, San Francisco, United States
| | - Susan L. Stewart
- Department of Public Health Sciences, University of California, Davis, United States
| | - Edgar Yu
- Department of Psychiatry, University of California, San Francisco, CA, United States
| | - Alice Guan
- Department of Psychiatry, University of California, San Francisco, CA, United States
| | - Amber Pham
- DePaul University, Chicago, United States
| | | | - Steven J. McPhee
- Division of General Internal Medicine, University of California, San Francisco, United States
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26
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Kowitt SD, Lipperman-Kreda S. How Is Exposure to Tobacco Outlets Within Activity Spaces Associated With Daily Tobacco Use Among Youth? A Mediation Analysis. Nicotine Tob Res 2020; 22:958-966. [PMID: 31123755 DOI: 10.1093/ntr/ntz088] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Accepted: 05/22/2019] [Indexed: 11/12/2022]
Abstract
INTRODUCTION We investigated associations between exposure to tobacco outlets within activity spaces and daily tobacco use, and whether exposure to adults or peers using tobacco mediate these relationships. METHODS We used Geographic Ecological Momentary Assessment data over 14 days from 85 youth aged 16-20 years in eight mid-sized California city areas. Tobacco outlet addresses and global positioning systems locations were geocoded and activity spaces were constructed by joining sequential points. We assessed daily number of tobacco outlets within 50 or 100 m of activity space polylines and number of minutes participants were within 50 or 100 m of tobacco outlets each day; daily use of tobacco; and whether participants saw (1) adults and (2) people their age (peers) using tobacco each day. RESULTS Controlling for demographics, results of multilevel structural equation models showed no association between number of tobacco outlets within 50 m of polylines and tobacco use (probit regression coefficient: 0.01, p = .82). However, we found evidence of an indirect effect (p = .001) through daily exposure to peers using tobacco. Specifically, greater number of tobacco outlets within 50 m of polylines was positively associated with seeing peers use tobacco (probit regression coefficient: 0.10, p < .001). In turn, seeing peers use tobacco was positively associated with tobacco use on that day (probit regression coefficient: 2.23, p < .001). Similar results were found for number of tobacco outlets within 100 m of polylines. CONCLUSIONS Exposure to tobacco outlets within activity spaces affects youth tobacco use through daily exposure to peers who use tobacco. IMPLICATIONS Using real-time-ordered data, this article examines whether exposure to adults and peers using tobacco mediate associations between exposure to tobacco outlets within activity spaces and daily tobacco use among youth. Results suggest that exposure to tobacco outlets within activity spaces affects daily tobacco use through exposure to peers who use tobacco. These findings provide additional significant support for policy makers who are considering regulating the number and density of tobacco retailers and point to the importance of interventions focused on peer tobacco use and youths' daily environments to reduce tobacco use.
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Affiliation(s)
- Sarah D Kowitt
- Department of Family Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC
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27
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Abdel Magid HS, Halpern-Felsher B, Ling PM, Bradshaw PT, Mujahid MS, Henriksen L. Tobacco Retail Density and Initiation of Alternative Tobacco Product Use Among Teens. J Adolesc Health 2020; 66:423-430. [PMID: 31784411 PMCID: PMC7089810 DOI: 10.1016/j.jadohealth.2019.09.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Revised: 09/05/2019] [Accepted: 09/06/2019] [Indexed: 02/02/2023]
Abstract
PURPOSE The rise of noncigarette, alternative tobacco product (ATP) use among adolescents may be due in part to an increase in retail availability of ATPs. We examined whether proximity and density of tobacco retailers near students' homes are associated with a higher likelihood of initiating ATP use over time. METHODS Using data from 728 adolescents (aged 13-19 years at baseline) residing in 191 different neighborhoods and attending 10 different California high schools, longitudinal multilevel and cross-classified random effect models evaluated individual-level, neighborhood-level, and school-level risk factors for ATP initiation after 1 year. Covariates were obtained from the American Community Survey and the California Department of Education. RESULTS The sample was predominantly female (63.5%) and was racially and ethnically diverse. Approximately one third of participants (32.5%) reported ever ATP use at baseline, with 106 (14.5%) initiating ATP use within 1 year. The mean number of tobacco retailers per square mile within a tract was 5.66 (standard deviation = 6.3), and the average distance from each participant's residence to the nearest tobacco retailer was .61 miles (standard deviation = .4). Living in neighborhoods with greater tobacco retailer density at baseline was associated with higher odds of ATP initiation (odds ratio = 1.22, 95% confidence interval = 1.07-2.12), controlling for individual and school factors. CONCLUSIONS Tobacco retailers clustered in students' home neighborhood may be an environmental influence on adolescents' ATP use. Policy efforts to reduce adolescent ATP use should aim to reduce the density of tobacco retailers and limit the proximity of tobacco retailers near adolescents' homes and schools.
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Affiliation(s)
- Hoda S Abdel Magid
- Department of Epidemiology and Population Health, Stanford University, Palo Alto, California
| | - Bonnie Halpern-Felsher
- Division of Adolescent Medicine, Department of Pediatrics, Stanford University, Palo Alto, California.
| | - Pamela M Ling
- Center for Tobacco Control Research and Education, University of California, San Francisco, San Francisco, California
| | - Patrick T Bradshaw
- Division of Epidemiology, School of Public Health, University of California, Berkeley, Berkeley, California
| | - Mahasin S Mujahid
- Division of Epidemiology, School of Public Health, University of California, Berkeley, Berkeley, California
| | - Lisa Henriksen
- Stanford Prevention Research Center, Stanford University School of Medicine, Stanford University, Palo Alto, California
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28
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Weitzman M, Lee L. Similarities Between Alcohol and Tobacco Advertising Exposure and Adolescent Use of Each of These Substances. J Stud Alcohol Drugs Suppl 2020:97-105. [PMID: 32079565 PMCID: PMC7063999 DOI: 10.15288/jsads.2020.s19.97] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2018] [Accepted: 12/30/2018] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Underage alcohol use is a major public health problem and substantial corporate money supports alcohol advertising across multiple venues. A diverse research literature demonstrates that adolescent exposure to such advertising is associated with drinking attitudes and behavior, but no scientific body has determined these associations to be causal. The objective of this study was to assess the association between alcohol advertising and teen drinking in the context of the "Analogy" criterion of the Bradford Hill criteria and consider a determination that the association between exposure to alcohol advertising and alcohol use is causal. METHOD This study was a narrative review on the association between adolescent exposure to alcohol advertising and subsequent alcohol use in the context of domains utilized in the Surgeon General's 2012 Report, Preventing Tobacco Use Among Youth and Young Adults, which concluded, "Advertising and promotional activities by tobacco companies have been shown to cause the onset and continuation of smoking among adolescents and young adults." RESULTS In every aspect compared (i.e., adolescent knowledge; attitudes toward; initiation of use; continuation of use; mediums of advertisement; the use of mascots, celebrities, and themes; and frequency and density of advertisements and retailers), the findings for both tobacco and alcohol and their association with exposure to advertising are analogous. CONCLUSIONS Application of the Analogy criterion of the Bradford Hill criteria comparing alcohol and tobacco supports a judgment that the association between exposure to alcohol advertising and increased adolescent knowledge, attitudes toward, initiation, and continuation of alcohol use are causal in nature.
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Affiliation(s)
- Michael Weitzman
- Department of Pediatrics, New York University School of Medicine, New York, New York
- Department of Environmental Medicine, New York University School of Medicine, New York, New York
- College of Global Public Health, New York University, New York, New York
| | - Lily Lee
- Downstate Medical Center, New York, New York
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29
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Kong AY, Myers AE, Isgett LF, Ribisl KM. Neighborhood racial, ethnic, and income disparities in accessibility to multiple tobacco retailers: Mecklenburg County, North Carolina, 2015. Prev Med Rep 2020; 17:101031. [PMID: 32021758 PMCID: PMC6993011 DOI: 10.1016/j.pmedr.2019.101031] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 10/09/2019] [Accepted: 12/15/2019] [Indexed: 01/25/2023] Open
Abstract
•Existing studies assess an individual's proximity to a single tobacco retailer.•Measuring proximity to more than one retailer may better capture accessibility.•Disparities in multi-retailer proximity exist by neighborhood race and income.•Policies to address disparities in tobacco retailer exposure are needed.
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Affiliation(s)
- Amanda Y. Kong
- Gillings School of Global Public Health, Department of Health Behavior, University of North Carolina, 135 Dauer Drive, 302 Rosenau Hall, CB #7440, Chapel Hill, NC, 27599-7440, USA
- Counter Tools, 205 Lloyd Street #210 & 211, Carrboro, NC, 27510, USA
| | - Allison E. Myers
- Counter Tools, 205 Lloyd Street #210 & 211, Carrboro, NC, 27510, USA
- College of Public Health and Human Sciences, Oregon State University, 160 SW 26th Street, Corvallis, OR, 97331, USA
| | - Lisa F. Isgett
- Counter Tools, 205 Lloyd Street #210 & 211, Carrboro, NC, 27510, USA
| | - Kurt M. Ribisl
- Gillings School of Global Public Health, Department of Health Behavior, University of North Carolina, 135 Dauer Drive, 302 Rosenau Hall, CB #7440, Chapel Hill, NC, 27599-7440, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina, 101 Manning Dr, Chapel Hill, NC, 27514, USA
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30
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Lawman HG, Henry KA, Scheeres A, Hillengas A, Coffman R, Strasser AA. Tobacco Retail Licensing and Density 3 Years After License Regulations in Philadelphia, Pennsylvania (2012-2019). Am J Public Health 2020; 110:547-553. [PMID: 32078358 DOI: 10.2105/ajph.2019.305512] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Objectives. To evaluate changes in licensed tobacco retailers and retailer density 5 years before and 3 years after novel tobacco retailer licensing regulations were implemented in a large, urban area.Methods. We used administrative tobacco license data (n = 23 806 licenses, 2012-2019) to calculate (1) annual retailer density by district (n = 18), (2) density by district and school income status, and (3) retailers within 500 feet of schools (n = 673) before and after regulations.Results. Observed tobacco retailer density declined by 20.3% (from 1.97 to 1.57 per 1000 daytime residents) 3 years after regulation implementation. Regression results showed a decline in the trend of retailers per 1000 daytime population (b = -0.19; 95% confidence interval[CI] = -0.23, -0.14) that was modestly but significantly greater in low-income districts (interaction b = -0.18; 95% CI = -0.25, -0.11) and a 12% decline in the rates of retailers near schools (rate ratio = 0.88; 95% CI = 0.85, 0.92) following implementation of the regulations. We did not observe similar density changes in comparable cities.Conclusions. Tobacco retailer licensing strategies can be an effective policy approach to reduce the availability of tobacco and tobacco marketing, lessen socioeconomic disparities in tobacco retailer density, and decrease the number of tobacco outlets near schools.
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Affiliation(s)
- Hannah G Lawman
- Hannah G. Lawman, Annaka Scheeres, Amory Hillengas, and Ryan Coffman are with the Division of Chronic Disease and Injury Prevention, Philadelphia Department of Public Health, Philadelphia, PA. Kevin A. Henry is with the Department of Geography and Urban Studies, Temple University, Philadelphia. Andrew A. Strasser is with the Tobacco Center of Regulatory Science and Department of Psychiatry, University of Pennsylvania, Philadelphia
| | - Kevin A Henry
- Hannah G. Lawman, Annaka Scheeres, Amory Hillengas, and Ryan Coffman are with the Division of Chronic Disease and Injury Prevention, Philadelphia Department of Public Health, Philadelphia, PA. Kevin A. Henry is with the Department of Geography and Urban Studies, Temple University, Philadelphia. Andrew A. Strasser is with the Tobacco Center of Regulatory Science and Department of Psychiatry, University of Pennsylvania, Philadelphia
| | - Annaka Scheeres
- Hannah G. Lawman, Annaka Scheeres, Amory Hillengas, and Ryan Coffman are with the Division of Chronic Disease and Injury Prevention, Philadelphia Department of Public Health, Philadelphia, PA. Kevin A. Henry is with the Department of Geography and Urban Studies, Temple University, Philadelphia. Andrew A. Strasser is with the Tobacco Center of Regulatory Science and Department of Psychiatry, University of Pennsylvania, Philadelphia
| | - Amory Hillengas
- Hannah G. Lawman, Annaka Scheeres, Amory Hillengas, and Ryan Coffman are with the Division of Chronic Disease and Injury Prevention, Philadelphia Department of Public Health, Philadelphia, PA. Kevin A. Henry is with the Department of Geography and Urban Studies, Temple University, Philadelphia. Andrew A. Strasser is with the Tobacco Center of Regulatory Science and Department of Psychiatry, University of Pennsylvania, Philadelphia
| | - Ryan Coffman
- Hannah G. Lawman, Annaka Scheeres, Amory Hillengas, and Ryan Coffman are with the Division of Chronic Disease and Injury Prevention, Philadelphia Department of Public Health, Philadelphia, PA. Kevin A. Henry is with the Department of Geography and Urban Studies, Temple University, Philadelphia. Andrew A. Strasser is with the Tobacco Center of Regulatory Science and Department of Psychiatry, University of Pennsylvania, Philadelphia
| | - Andrew A Strasser
- Hannah G. Lawman, Annaka Scheeres, Amory Hillengas, and Ryan Coffman are with the Division of Chronic Disease and Injury Prevention, Philadelphia Department of Public Health, Philadelphia, PA. Kevin A. Henry is with the Department of Geography and Urban Studies, Temple University, Philadelphia. Andrew A. Strasser is with the Tobacco Center of Regulatory Science and Department of Psychiatry, University of Pennsylvania, Philadelphia
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Haw S, Currie D, Eadie D, Pearce J, MacGregor A, Stead M, Amos A, Best C, Wilson M, Cherrie M, Purves R, Ozakinci G, MacKintosh AM. The impact of the point-of-sale tobacco display ban on young people in Scotland: before-and-after study. PUBLIC HEALTH RESEARCH 2020. [DOI: 10.3310/phr08010] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Background
Tobacco displays at point of sale have been shown to increase young people’s pro-smoking attitudes, susceptibility to smoking and smoking initiation. In Scotland, legislation that prohibited tobacco point-of-sale displays was implemented in large stores (i.e. those > 280 m2) in April 2013 and in small retailers in April 2015.
Objective
To assess the impact of the point-of-sale tobacco display ban on young people’s exposure to tobacco advertising, their attitudes to smoking and smoking susceptibility, and their risk of smoking initiation.
Design
Multimodal before-and-after study design using mixed methods to collect data at baseline (2013) and then longitudinally for 4 years.
Setting
Four main study communities in the central belt of mainland Scotland, UK, purposively selected to reflect two levels of urbanity (urban vs. small town) and two levels of deprivation (high vs. medium/low). Four matched communities.
Participants
In the main study communities, 94 tobacco retail outlets. All Secondary 2 (aged 13 years) and Secondary 4 (aged 15 years) pupils in 2013 and 2014 together with all Secondary 1 to Secondary 6 (aged 12–17 years) pupils in 2015–17. This included 6612 pupils who completed 14,344 questionnaires over 5 years. Three hundred and eighty-two participants in 80 focus groups who were recruited from Secondary 2 and Secondary 4 in 2013–17. In matched communities, 24 retail panel members in 2013–17.
Main outcome measures
Tobacco product and tobacco storage visibility, density of retail outlets (the number of retailers in a pre-defined area such as a residential neighbourhood), tobacco product exposure, brand awareness, perceived accessibility of tobacco, pro-smoking attitudes, pro-smoking norms, smoking susceptibility and smoking initiation.
Data platform and methods
The study had four components – a mapping and spatial analysis of retail outlets; a tobacco marketing audit, including retail panel interviews in matched communities; school surveys; and focus group discussions with secondary school pupils.
Limitations
The study was based on a small number of communities and did not include communities in remote areas.
Results
Compliance with the point-of-sale legislation in Scotland was high. This led to a large reduction in the visibility of tobacco products in retail outlets. However, when the results were stratified by socioeconomic status, declines in retailer density, weighted by total product visibility, were restricted to the least disadvantaged tertile of participants. Nevertheless, the implementation of the legislation was associated with a reduction in risk of both smoking susceptibility and smoking initiation in young people, as well as a reduction in the perceived accessibility of tobacco and in pro-smoking attitudes after both the partial and the comprehensive bans were introduced.
Conclusions
The Scottish point-of-sale legislation has been successful in reducing the overall visibility of tobacco products and is associated with improvements in attitudinal and behavioural outcomes in young people. However, cues that tobacco is for sale are still highly visible, particularly in retail outlets in areas of deprivation. In addition, the increase in retailer density that was observed after 2015 increased inequalities in product visibility. There was also evidence that the emergence of e-cigarettes may have disrupted the full impact of the legislation.
Future work
Our research indicates that further research is needed to examine the longitudinal relationships between tobacco outlet availability and product visibility inequalities; and the impact of e-cigarettes and standardised packaging on smoking initiation and prevalence.
Funding
This project was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full in Public Health Research; Vol. 8, No. 1. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Sally Haw
- Faculty of Health Sciences and Sport, University of Stirling, Stirling, UK
| | - Dorothy Currie
- Centre for Adolescent and Child Health Research, School of Medicine, University of St Andrews, St Andrews, UK
| | - Douglas Eadie
- Institute for Social Marketing, Faculty of Health Sciences and Sport, University of Stirling, Stirling, UK
| | - Jamie Pearce
- Institute of Geography, School of GeoSciences, University of Edinburgh, Edinburgh, UK
| | | | - Martine Stead
- Institute for Social Marketing, Faculty of Health Sciences and Sport, University of Stirling, Stirling, UK
| | - Amanda Amos
- Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
| | - Catherine Best
- Faculty of Health Sciences and Sport, University of Stirling, Stirling, UK
| | - Michael Wilson
- Faculty of Health Sciences and Sport, University of Stirling, Stirling, UK
| | - Mark Cherrie
- Institute of Geography, School of GeoSciences, University of Edinburgh, Edinburgh, UK
| | - Richard Purves
- Institute for Social Marketing, Faculty of Health Sciences and Sport, University of Stirling, Stirling, UK
| | - Gozde Ozakinci
- School of Medicine, Medical & Biological Sciences, University of St Andrews, St Andrews, UK
| | - Anne Marie MacKintosh
- Institute for Social Marketing, Faculty of Health Sciences and Sport, University of Stirling, Stirling, UK
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RAUTELA Y, REDDY B, SINGH A, GUPTA A. Smoking and alcoholism among adult population and its association with outlet density in a hilly area of North India. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2019; 60:E361-E367. [PMID: 31967094 PMCID: PMC6953459 DOI: 10.15167/2421-4248/jpmh2019.60.4.1341] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Accepted: 11/20/2019] [Indexed: 11/16/2022]
Abstract
Background The rising burden of non-communicable diseases is a threat to India. The behavioural risk factors having largest contribution to NCDs. Neighbourhood retailing of tobacco products, and alcohol are important risk factors. The objectives of the present study were to determine the prevalence of smoking and alcoholism among adults of Srikot, Uttarakhand, and to determine its relationship with tobacco, and alcohol retail outlet density. Materials and methods The study design was a community based cross sectional study, which was done in Srikot, Uttarakhand among adults aged above 20 years, selected by systematic sampling. A semi-structured questionnaire was used. The outlet density was measured mapped using android application. Results A total of 155 were enrolled in the study of which 61.3% were females. A total of 11.6% of the study participants were smokers. On multivariate analysismale gender, and alcohol use was significantly associated with increased risk of smoking (p < 0.05). A total of 16.8% of the study participants were alcohol user. On multivariate analysis it was found male gender, and smoking was significantly associated with increased risk of alcohol use (p < 0.05). On mapping the study area, it was found that total tobacco selling outlets were 40. There was no alcohol-selling outlet in the study area. Conclusion The community is in an early stage of urbanization as evident from the burden of smoking, and alcohol use. This burden of smoking might be worsened by outlet density of tobacco seller.
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Affiliation(s)
- Y.S. RAUTELA
- Veer Chandra Singh Garhwali Government Medical Sciences and Research Institute, Uttarakhand, India
| | - B.V. REDDY
- Department of Community Medicine, NRI Academy of Medical Sciences Andhra Pradesh, India
| | - A.K. SINGH
- Department of Community Medicine, Veer Chandra Singh Garhwali Government Medical Sciences and Research Institute, Uttarakhand, India
| | - A. GUPTA
- Department of Community and Family Medicine, All India Institute of Medical Sciences Mangalagiri, Andhra Pradesh, India
- Correspondence: Arti Gupta, Department of Community and Family Medicine, All India Institute of Medical Sciences Mangalagiri, Andhra Pradesh, India - Tel. +91 9013902976 - E-mail:
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Capewell S, Capewell A. An effectiveness hierarchy of preventive interventions: neglected paradigm or self-evident truth? J Public Health (Oxf) 2019; 40:350-358. [PMID: 28525612 DOI: 10.1093/pubmed/fdx055] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Indexed: 01/28/2023] Open
Abstract
Non-communicable disease prevention strategies usually target the four major risk factors of poor diet, tobacco, alcohol and physical inactivity. Yet, the most effective approaches remain disputed. However, increasing evidence supports the concept of an effectiveness hierarchy. Thus, 'downstream' preventive activities targeting individuals (such as 1:1 personal advice, health education, 'nudge' or primary prevention medications) consistently achieve a smaller population health impact than interventions aimed further 'upstream' (for instance, smoke-free legislation, alcohol minimum pricing or regulations eliminating dietary transfats). These comprehensive, policy-based interventions reach all parts of the population and do not depend on a sustained 'agentic' individual response. They thus tend to be more effective, more rapid, more equitable and also cost-saving. This effectiveness hierarchy is self-evident to many professionals working in public health. Previously neglected in the wider world, this effectiveness hierarchy now needs to be acknowledged by policy makers.
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Affiliation(s)
- Simon Capewell
- Department of Public Health & Policy, Institute of Psychology, Health & Society, Whelan Building, Quadrangle, University of Liverpool, Liverpool, UK
| | - Ann Capewell
- Department of Public Health & Policy, Institute of Psychology, Health & Society, Whelan Building, Quadrangle, University of Liverpool, Liverpool, UK
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Golden SD, Kuo TM, Kong AY, Baggett CD, Henriksen L, Ribisl KM. County-level associations between tobacco retailer density and smoking prevalence in the USA, 2012. Prev Med Rep 2019; 17:101005. [PMID: 31934535 PMCID: PMC6951276 DOI: 10.1016/j.pmedr.2019.101005] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Revised: 09/15/2019] [Accepted: 09/27/2019] [Indexed: 11/23/2022] Open
Abstract
We examine whether county-level tobacco retailer density and adult smoking prevalence are positively associated in the United States and determine whether associations differ in metropolitan vs. nonmetropolitan counties. We merged a list of likely tobacco retailers from the 2012 National Establishment Time-Series with smoking prevalence data from the Behavioral Risk Factor Surveillance System for 2828 US counties, as well as state tobacco policy information and county-level demographic data for the same year. We modeled adult smoking prevalence as a function of tobacco retailer density, accounting for clustering of counties within states. Average density in US counties was 1.25 retailers per 1000 people (range = 0.3–4.5). Smoking prevalence was 0.86 percentage points higher in the most retailer-dense counties, compared to the least. This association, however, was only significant for metropolitan counties. Metropolitan counties in the highest tobacco retailer density quartile had smoking prevalence levels that were 1.9 percentage points higher than metropolitan counties in the lowest density quartile. Research should examine whether policies limiting the quantity, type and location of tobacco retailers could reduce smoking prevalence.
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Affiliation(s)
- Shelley D. Golden
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, 135 Dauer Drive, Chapel Hill, NC 27599-7440, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina, 101 Manning Drive, Chapel Hill, NC 27599-7295, USA
- Corresponding author at: Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, 135 Dauer Drive, Chapel Hill, NC 27599-7440, USA.
| | - Tzy-Mey Kuo
- Lineberger Comprehensive Cancer Center, University of North Carolina, 101 Manning Drive, Chapel Hill, NC 27599-7295, USA
| | - Amanda Y. Kong
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, 135 Dauer Drive, Chapel Hill, NC 27599-7440, USA
| | - Christopher D. Baggett
- Lineberger Comprehensive Cancer Center, University of North Carolina, 101 Manning Drive, Chapel Hill, NC 27599-7295, USA
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, 135 Dauer Drive, Chapel Hill, NC 27599-7435, USA
| | - Lisa Henriksen
- Stanford Prevention Research Center, 3300 Hillview Ave Suite 120, Palo Alto, CA 94304, USA
| | - Kurt M. Ribisl
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, 135 Dauer Drive, Chapel Hill, NC 27599-7440, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina, 101 Manning Drive, Chapel Hill, NC 27599-7295, USA
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Smith EA, Malone RE. An argument for phasing out sales of cigarettes. Tob Control 2019; 29:703-708. [PMID: 31542777 PMCID: PMC7591796 DOI: 10.1136/tobaccocontrol-2019-055079] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Revised: 08/21/2019] [Accepted: 08/26/2019] [Indexed: 11/04/2022]
Abstract
The successes of tobacco control in some countries and locales have led to discussions of ending the tobacco epidemic, often called the 'endgame'. In this paper, we recommend articulating the endgame goal as phasing out sales of cigarettes, a goal once called 'unthinkable'. We develop a logic and argumentation for ending cigarette sales intended to move the discussion beyond the shadow of 'prohibition', proposing an approach that appeals to consumer protection standards and suggesting that the effort be led by low-prevalence communities. While phasing out cigarettes will not happen everywhere all at once, and may unfold differently along several lines, we argue that the gradual phase-out approach we propose will reduce the likelihood of the negative consequences often predicted to come with such a policy. To continue permitting widespread sales of the single most deadly consumer product in history is a public health failure that must be addressed.
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Affiliation(s)
- Elizabeth A Smith
- Social and Behavioral Sciences, University of California San Francisco, San Francisco, California, USA
| | - Ruth E Malone
- Social and Behavioral Sciences, University of California San Francisco, San Francisco, California, USA
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Online tobacco marketing among US adolescent sexual, gender, racial, and ethnic minorities. Addict Behav 2019; 95:189-196. [PMID: 30954888 DOI: 10.1016/j.addbeh.2019.03.015] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Revised: 03/20/2019] [Accepted: 03/21/2019] [Indexed: 11/21/2022]
Abstract
INTRODUCTION The tobacco industry has previously targeted sexual/gender and racial/ethnic minorities with focused campaigns in traditional, offline marketing. We assess whether these populations report more engagement with online tobacco marketing compared with heterosexual and non-Hispanic white youth. METHODS Data were from 8015 adolescents sampled between 2014 and 2015 in the nationally-representative Population Assessment for Tobacco and Health (PATH) Study. Engagement with online tobacco marketing within the past year was assessed through eight forms of engagement. A weighted logistic regression model was fit with engagement as outcome and socio-demographic and psychosocial characteristics, internet-related and substance use behavior, tobacco-related risk factors, tobacco use status, and prior engagement with online tobacco marketing as covariates. RESULTS Accounting for other covariates including tobacco use status and prior engagement with online tobacco marketing, the odds of past-year engagement were higher for sexual minority males (aOR = 1.57; 95% CI: 1.05-2.35) compared to straight males and higher for sexual minority females (aOR = 1.45; 95% CI: 1.13-1.87) compared to straight females. The odds of past-year engagement were also higher for Hispanics (aOR = 1.31; 95% CI: 1.11-1.56) and non-Hispanic Blacks (aOR = 1.42; 95% CI: 1.14-1.77) compared to non-Hispanic Whites. CONCLUSIONS Sexual/gender and and racial/ethnic minority youth reported higher engagement with online tobacco marketing than their heterosexual and non-Hispanic white peers, respectively.
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Astuti PAS, Mulyawan KH, Sebayang SK, Kurniasari NMD, Freeman B. Cigarette retailer density around schools and neighbourhoods in Bali, Indonesia: A GIS mapping. Tob Induc Dis 2019; 17:55. [PMID: 31582944 PMCID: PMC6770614 DOI: 10.18332/tid/110004] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 06/05/2019] [Accepted: 06/12/2019] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION The presence and density of tobacco retailers is associated with the perception of high availability of cigarettes and ease of purchase. Indonesia is the second largest cigarette market in the world with an increasing smoking rate among young people aged 10-18 years. Our study aims to assess density of cigarette outlets in neighbourhoods and around schools, and to evaluate correlation between retailer proximity to schools and retailer selling practices. METHODS We conducted a geographical mapping and then an audit survey of 1000 randomly selected cigarette retailers in Denpasar, Bali, Indonesia. We measured neighbourhood retailer density, and retailer proximity to schools. We linked the coordinate data to the audit data to assess the association between retailer distance from schools with likelihood of selling tobacco to young people and selling single cigarette sticks. RESULTS We mapped 4114 cigarette retailers in Denpasar, the most common type was a kiosk, 3199 (77.8%), followed by mini market/convenience stores, 606 (14.7%). Retailer density was 32.2/km2 and 4.6/1000 population. We found that 37 (9.7 %) of the 379 schools in Denpasar have at least one cigarette retailer within a 25 m radius and 367 (96.8%) within a 250 m radius. Of the 485 audited retailers within a 250 m radius of a school, 281 (57.9%) admitted selling cigarettes to young people and 325 (67.0%) sold cigarettes as single sticks. Cigarette retailers were less likely to sell cigarettes to young people based on distance from schools, but this was only significant at the furthest distance of more than 500 m from schools. CONCLUSIONS In an unregulated retailer setting such as Indonesia, cigarette retailers are ubiquitous and selling to young people is commonplace. The Indonesian government should enforce the prohibition on selling to young people and should regulate cigarette retailers to reduce youth access to cigarettes.
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Affiliation(s)
- Putu A S Astuti
- Department of Public Health and Preventive Medicine, Universitas Udayana, Denpasar, Indonesia.,The University of Sydney School of Public Health, Sydney, Australia.,Udayana Center for NCDs, Tobacco Control and Lung Health (Central), Universitas Udayana, Denpasar, Indonesia
| | - Ketut H Mulyawan
- Department of Public Health and Preventive Medicine, Universitas Udayana, Denpasar, Indonesia.,Udayana Center for NCDs, Tobacco Control and Lung Health (Central), Universitas Udayana, Denpasar, Indonesia
| | - Susy K Sebayang
- Department of Biostatistics and Population Studies, Universitas Airlangga, Banyuwangi, Indonesia
| | - Ni Made D Kurniasari
- Department of Public Health and Preventive Medicine, Universitas Udayana, Denpasar, Indonesia.,Udayana Center for NCDs, Tobacco Control and Lung Health (Central), Universitas Udayana, Denpasar, Indonesia
| | - Becky Freeman
- The University of Sydney School of Public Health, Sydney, Australia.,Prevention Research Collaboration (PRC), Charles Perkins Centre, The University of Sydney, Sydney, Australia
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Caryl F, Shortt NK, Pearce J, Reid G, Mitchell R. Socioeconomic inequalities in children's exposure to tobacco retailing based on individual-level GPS data in Scotland. Tob Control 2019; 29:tobaccocontrol-2018-054891. [PMID: 31278083 PMCID: PMC7116585 DOI: 10.1136/tobaccocontrol-2018-054891] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 05/02/2019] [Accepted: 05/16/2019] [Indexed: 11/04/2022]
Abstract
BACKGROUND Identifying factors shaping knowledge of and attitudes towards tobacco products in preadolescence is a key component supporting tobacco control policies aimed at preventing smoking initiation. This study quantified exposure to tobacco retailing environments within the individual-level activity spaces of children across a socioeconomic gradient. METHODS One week of global positioning system (GPS) tracking data were collected at 10 s intervals from a nationally representative sample of 10-11-year olds (n=692). Proximity of GPS locations (n=~16 M) to the nearest tobacco retailer (n=9030) was measured and exposure defined when a child came within 10 m of a retailer. Duration, frequency, timing and source of exposure were compared across income deprivation quintiles, along with retail density within children's home neighbourhoods. RESULTS On average, children were exposed to tobacco retailing for 22.7 min (95% CI 16.8 to 28.6) per week in 42.7 (35.2-50.1) independent encounters. However, children from the most deprived areas accumulated six times the duration and seven times the frequency of exposure as children from the least deprived areas. Home neighbourhood retail densities were 2.6 times higher in deprived areas, yet the average number of businesses encountered did not differ. Most exposure came from convenience stores (35%) and newsagents (15%), with temporal peaks before and after school hours. CONCLUSIONS By accounting for individual mobility, we showed that children in socially disadvantaged areas accumulate higher levels of exposure to tobacco retailing than expected from disparities in home neighbourhood densities. Reducing tobacco outlet availability, particularly in areas frequently used by children, might be crucial to policies aimed at creating 'tobacco-free' generations.
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Affiliation(s)
- Fiona Caryl
- MRC/CSO Social & Public Health Sciences, Insistute of Health & Wellbeing, University of Glasgow, Glasgow, UK
| | - Niamh K Shortt
- School of Geosciences, Univerity of Edinburgh, Edinburgh, UK
| | - Jamie Pearce
- School of Geosciences, Univerity of Edinburgh, Edinburgh, UK
| | - Garth Reid
- Public Health Science Directorate, NHS Health Scotland, Edinburgh, UK
| | - Richard Mitchell
- MRC/CSO Social & Public Health Sciences, Insistute of Health & Wellbeing, University of Glasgow, Glasgow, UK
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Gonzalez M, Sanders-Jackson A, Henriksen L. Social Capital and Tobacco Retail Outlet Density: An Empirical Test of the Relationship. Am J Health Promot 2019; 33:1020-1027. [PMID: 31195802 DOI: 10.1177/0890117119853716] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE To examine the relationship between tobacco outlet density and social capital. PARTICIPANTS Parents of at least one teen (N = 2734) in a representative sample of US households with teens (ages 13-16). DESIGN Population-based, cross-sectional survey of a web panel of adolescent-parent pairs matched with spatial data for address to characterize household neighborhoods. SETTING US households identified by latitude and longitude with a 50-ft random shift. MEASURES Perceived social capital (trust and informal social control as reported by parents), tobacco outlet density (retailers per land area in 1/2-mile buffer around each household), neighborhood demographics (derived from American Community Survey), and parent demographics. ANALYSIS Multivariable regression examined the relationship between tobacco outlet density and social capital controlling for household buffer and individual-level covariates, including correlates of social capital. RESULTS Tobacco outlet density was inversely correlated with perceived trust in neighbors (B = -1.12, P = .0004), but not social control (B = 0.11, P = .731). CONCLUSION This study is the first we are aware of to find that social capital is related to tobacco outlet density. The results imply that individuals with low social capital may benefit from policies regulating tobacco outlet density and may benefit from policies that address neighborhood inequality by increasing social capital and reducing poverty.
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Affiliation(s)
- Mariaelena Gonzalez
- 1 Department of Public Health, University of California, Merced, CA, USA.,2 Nicotine and Cannabis Policy Center, University of California, Merced, CA, USA
| | | | - Lisa Henriksen
- 4 Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, CA, USA
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Lankenau SE, Tabb LP, Kioumarsi A, Ataiants J, Iverson E, Wong CF. Density of Medical Marijuana Dispensaries and Current Marijuana Use among Young Adult Marijuana Users in Los Angeles. Subst Use Misuse 2019; 54:1862-1874. [PMID: 31154889 PMCID: PMC6681649 DOI: 10.1080/10826084.2019.1618332] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Background: While tobacco and alcohol studies have focused on density of outlets as a determinant of consumption, research has begun examining the effects of medical marijuana (MM) dispensaries on marijuana use. Objectives: Examine the relationship between density of MM dispensaries and frequency of marijuana use among young adult medical marijuana patients (MMP) and nonpatient users (NPU). Methods: Young adult marijuana users (n = 329) aged 18- to 26-year old were sampled in Los Angeles in 2014-2015 and separated into MMP (n = 198) and NPU (n = 131). In 2014, 425 operational MM dispensaries were identified within the City of Los Angeles. Sequential multilevel Poisson random effect models examined density of MM dispensaries per square mile and 90 d marijuana use among MMP and NUP at the ZIP code level while controlling for demographic, behavioral, and community characteristics. Results: Density of MM dispensaries was not related to 90 d use of marijuana (days of use or hits per day) among either MMP or NPU. MMP reported significantly greater days of marijuana use in the past 90 d compared to NPU but no differences were found for hits per day. African-Americans reported significantly greater hits per day compared to whites. Hispanics reported significantly fewer hits per day compared to non-Hispanics. Conclusion: Concentration of MM dispensaries surrounding young adult marijuana users in Los Angeles was unrelated to days of marijuana use irrespective of having a MM recommendation or not. Rather, individual factors related to consumer choices and behaviors were more important in determining recent marijuana use among MMP and NPU.
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Affiliation(s)
- Stephen E. Lankenau
- Drexel University, Dornsife School of Public Health, Department of Community Health and Prevention, 3215 Market Street, Philadelphia, PA 19104
| | - Loni Philip Tabb
- Drexel University, Dornsife School of Public Health, Department of Epidemiology and Biostatistics, 3215 Market Street, Philadelphia, PA 19104
| | - Avat Kioumarsi
- Drexel University, Dornsife School of Public Health, Department of Community Health and Prevention, 3215 Market Street, Philadelphia, PA 19104
| | - Janna Ataiants
- Drexel University, Dornsife School of Public Health, Department of Community Health and Prevention, 3215 Market Street, Philadelphia, PA 19104
- Rory Meyers College of Nursing, New York University, 433 1st Avenue, New York, NY 10010
| | - Ellen Iverson
- University of Southern California, Keck School of Medicine, Department of Pediatrics, Los Angeles, CA 90027
- Children’s Hospital Los Angeles, Division of Adolescent Medicine, 4650 Sunset Blvd., MS #2, Los Angeles, CA 90027
| | - Carolyn F. Wong
- University of Southern California, Keck School of Medicine, Department of Pediatrics, Los Angeles, CA 90027
- Children’s Hospital Los Angeles, Division of Adolescent Medicine, 4650 Sunset Blvd., MS #2, Los Angeles, CA 90027
- Children’s Hospital Los Angeles, Division of Research on Children, Youth, & Families, 4650 Sunset Blvd., MS #2, Los Angeles, CA 90027
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Smoking and Tobacco Retail Density Among Neighborhoods in Delaware. Dela J Public Health 2019; 5:40-48. [PMID: 34467014 PMCID: PMC8352428 DOI: 10.32481/djph.2019.02.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Burgoon ML, Albani T, Keller-Hamilton B, Lu B, Roberts ME, Craigmile PF, Browning C, Xi W, Ferketich AK. Exposures to the tobacco retail environment among adolescent boys in urban and rural environments. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2019; 45:217-226. [PMID: 30601033 PMCID: PMC6430681 DOI: 10.1080/00952990.2018.1549562] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2018] [Revised: 11/14/2018] [Accepted: 11/14/2018] [Indexed: 10/27/2022]
Abstract
BACKGROUND The tobacco industry spends billions on retail marketing and such marketing is associated with tobacco use. Previous research has not examined actual and potential exposures that adolescents have on a daily basis. OBJECTIVE The objective of this study was to determine whether both self-reported and geographically estimated tobacco retailer exposures differ by participant or neighborhood characteristics among urban and rural adolescents. METHODS The data for this study were part of a cohort study of 1220 adolescent males residing in urban and rural (Appalachian) regions in Ohio. The baseline survey asked participants how often they visited stores that typically sell tobacco in the past week (self-reported exposures). The number of tobacco retailers between home and school was determined using ArcGIS software (potential exposures). Adjusted regression models were fit to determine the characteristics that were associated with self-reported or potential exposures to retailers. RESULTS Adolescents who were non-Hispanic black or other racial/ethnic minority, had used tobacco in the past, and lived in rural areas had higher self-reported exposures. Urban adolescents, non-Hispanic black or other racial/ethnic minority, and those living in neighborhoods with a higher percentage of poverty had more potential exposures to tobacco retailers in their path between home and school. CONCLUSIONS Rural adolescents had more self-reported marketing exposures than urban adolescents. However, urban adolescents had more potential tobacco exposures between home and school. Thus, point of sale marketing limitations might be a more effective policy intervention in rural areas whereas limits on tobacco retailers might be more effective for urban areas.
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Affiliation(s)
| | - Thomas Albani
- College of Public Health, The Ohio State University, Columbus, OH, USA
| | | | - Bo Lu
- College of Public Health, The Ohio State University, Columbus, OH, USA
| | - Megan E. Roberts
- College of Public Health, The Ohio State University, Columbus, OH, USA
| | | | | | - Wenna Xi
- College of Public Health, The Ohio State University, Columbus, OH, USA
| | - Amy K. Ferketich
- College of Public Health, The Ohio State University, Columbus, OH, USA
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Finan LJ, Lipperman-Kreda S, Abadi M, Grube JW, Kaner E, Balassone A, Gaidus A. Tobacco outlet density and adolescents' cigarette smoking: a meta-analysis. Tob Control 2019; 28:27-33. [PMID: 29519934 PMCID: PMC6129215 DOI: 10.1136/tobaccocontrol-2017-054065] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Revised: 01/24/2018] [Accepted: 02/10/2018] [Indexed: 11/04/2022]
Abstract
OBJECTIVE We conducted meta-analyses of studies that investigated the associations between tobacco outlet density around homes and schools and adolescents' past-month cigarette smoking. DATA SOURCES Systematic literature searches of eight databases were carried out in February 2017. Searches were not limited by date, language, country or peer-reviewed status. STUDY SELECTION After screening for quality, studies that examined the relationship between tobacco outlet density and adolescents' past-month smoking were selected for inclusion. DATA EXTRACTION Two investigators screened study abstracts and full texts and independently extracted data. Consensus was reached at each stage. DATA SYNTHESIS Random-effects meta-analyses were conducted on 11 studies that provided 13 effect sizes. Results showed that there was a significant association between tobacco outlet density around homes and adolescents' past-month smoking behaviour, with an overall effect size of OR=1.08 (95% CI 1.04 to 1.13; P<0.001; I2=0%). For density around schools, the association was not statistically significant (OR=1.01, 95% CI 0.98 to 1.03; P=0.53; I2=39%). CONCLUSIONS These findings suggest that exposure to tobacco outlets near home environments may be important for understanding adolescents' past-month smoking. Restricting access to tobacco outlets and controlling the number of outlets in residential areas may be an effective preventive strategy to help reduce adolescents' smoking.
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Affiliation(s)
- Laura J. Finan
- Prevention Research Center, Pacific Institute for Research and Evaluation, 180 Grand Avenue, Suite 1200, Oakland, CA 94612
| | - Sharon Lipperman-Kreda
- Prevention Research Center, Pacific Institute for Research and Evaluation, 180 Grand Avenue, Suite 1200, Oakland, CA 94612
| | - Melissa Abadi
- Louisville Center, Pacific Institute for Research and Evaluation, 1300 South 4th Street, Suite 300, Louisville, KY 40208
| | - Joel W. Grube
- Prevention Research Center, Pacific Institute for Research and Evaluation, 180 Grand Avenue, Suite 1200, Oakland, CA 94612
| | - Emily Kaner
- Prevention Research Center, Pacific Institute for Research and Evaluation, 180 Grand Avenue, Suite 1200, Oakland, CA 94612
| | - Anna Balassone
- Prevention Research Center, Pacific Institute for Research and Evaluation, 180 Grand Avenue, Suite 1200, Oakland, CA 94612
| | - Andrew Gaidus
- Prevention Research Center, Pacific Institute for Research and Evaluation, 180 Grand Avenue, Suite 1200, Oakland, CA 94612
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Clemens T, Dibben C, Pearce J, Shortt NK. Neighbourhood tobacco supply and individual maternal smoking during pregnancy: a fixed-effects longitudinal analysis using routine data. Tob Control 2018; 29:tobaccocontrol-2018-054422. [PMID: 30389809 PMCID: PMC6952837 DOI: 10.1136/tobaccocontrol-2018-054422] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Revised: 09/21/2018] [Accepted: 10/15/2018] [Indexed: 11/06/2022]
Abstract
BACKGROUND Tobacco policy is increasingly focusing on the 'tobacco endgame' which commits to eradicating tobacco use (prevalence below 5%) within the next two decades. Strategies for achieving the endgame are likely to include addressing the supply of tobacco products, yet current evidence to support this approach is primarily cross-sectional. METHODS We use longitudinal smoking information from routine maternity records of all women who gave birth in Scotland between 2000 and 2015. We linked this data to the residential density of retailers selling tobacco products and the neighbourhood prevalence of smoking during pregnancy. In the analysis, individual mothers act as their own controls because we compare changes in their smoking behaviour between pregnancies to changes in exposure to tobacco retailing that arises from residential movement between pregnancies. RESULTS Adjusted ORs showed an increased risk of being a smoker associated with increases in exposure to retailer density (OR 1.67, 95% CI 1.27 to 2.20). CONCLUSIONS The results provide the strongest evidence to date of an association between the neighbourhood availability of tobacco and smoking, and the first to do so among pregnant women. These findings provide supportive evidence for interventions targeting the supply of tobacco products in achieving the endgame.
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Affiliation(s)
- Tom Clemens
- School of Geosciences, University of Edinburgh, Edinburgh, UK
| | - Chris Dibben
- School of Geosciences, University of Edinburgh, Edinburgh, UK
| | - Jamie Pearce
- School of Geosciences, University of Edinburgh, Edinburgh, UK
| | - Niamh K Shortt
- School of Geosciences, University of Edinburgh, Edinburgh, UK
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Mills SD, Henriksen L, Golden SD, Kurtzman R, Kong AY, Queen TL, Ribisl KM. Disparities in retail marketing for menthol cigarettes in the United States, 2015. Health Place 2018; 53:62-70. [PMID: 30055469 PMCID: PMC6161357 DOI: 10.1016/j.healthplace.2018.06.011] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2018] [Revised: 06/19/2018] [Accepted: 06/26/2018] [Indexed: 11/22/2022]
Abstract
This study describes retail marketing for menthol cigarettes and its relationship with neighborhood demographics in a national sample of tobacco retailers in the United States. Mixed-effects models were used to examine three outcomes: menthol cigarette exterior advertising, menthol cigarette price promotions, and the pack price of menthol and non-menthol cigarettes. Thirty-eight percent of retailers displayed at least one menthol advertisement on the store exterior and 69% advertised price promotions. Retail advertising was more common in neighborhoods in the second (OR = 1.5 [1.1, 2.0]) and fourth (OR = 1.9 [1.3, 2.7]) quartiles of Black residents as compared to the lowest quartile. Menthol advertising was more prevalent in the third (OR = 1.4 [1.0, 1.9]) and lowest (OR = 1.6 [1.2, 2.2]) income quartiles as compared to the highest quartile. Price promotions for Newport were more common in neighborhoods with the highest quartile of Black residents (OR = 1.8 [1.2, 2.7]). Prices of Newport were cheaper in neighborhoods with the highest quartiles of youth, Black residents, and lower-income households. Policies that restrict the sales and marketing of menthol cigarettes are needed to address disparities.
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Affiliation(s)
- Sarah D Mills
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, 450 West Drive, Chapel Hill, NC 27599, USA
| | - Lisa Henriksen
- Stanford Prevention Research Center, Stanford University School of Medicine, 3300 Hillview Road Suite 120, Palo Alto, CA 94304, USA
| | - Shelley D Golden
- Department of Health Behavior, University of North Carolina, Chapel Hill, 303 Rosenau Hall, Chapel Hill, NC 27599, USA
| | - Rachel Kurtzman
- Department of Health Behavior, University of North Carolina, Chapel Hill, 303 Rosenau Hall, Chapel Hill, NC 27599, USA
| | - Amanda Y Kong
- Department of Health Behavior, University of North Carolina, Chapel Hill, 303 Rosenau Hall, Chapel Hill, NC 27599, USA
| | - Tara L Queen
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, 450 West Drive, Chapel Hill, NC 27599, USA
| | - Kurt M Ribisl
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, 450 West Drive, Chapel Hill, NC 27599, USA; Department of Health Behavior, University of North Carolina, Chapel Hill, 303 Rosenau Hall, Chapel Hill, NC 27599, USA.
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Valiente R, Sureda X, Bilal U, Navas-Acien A, Pearce J, Franco M, Escobar F. Regulating the local availability of tobacco retailing in Madrid, Spain: a GIS study to evaluate compliance. Tob Control 2018; 28:325-333. [DOI: 10.1136/tobaccocontrol-2018-054269] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Revised: 05/21/2018] [Accepted: 06/13/2018] [Indexed: 11/04/2022]
Abstract
BackgroundIn Spain, tobacco sales are limited to tobacco-exclusive stores and associated vending machines. A minimum of 150 m between stores is required, unless they exceed a legal sales threshold. Minimum distances to schools are recommended but not defined. We evaluated compliance with these regulations in Madrid, Spain.MethodsInformation about tobacco-exclusive stores and their sales volume was obtained in 2014. We used geographic information system to identify stores closer than 150 m between them and examine whether they exceeded the sales threshold. We estimated distances between stores and schools, considering different distance intervals (<150 m, 150–300 m and >300 m) and calculations (crow flies and street network). We assessed the association of area-level demographic and socioeconomic characteristics with the distribution of tobacco stores.Results5.3% (34/638) of tobacco stores were within 150 m of each other. Among those, 76% (26/34) did not meet the regulation sales threshold. These stores were in areas with lower proportion of young population (<15 years) and higher proportion of people with university-level education. 75% (476/638) of stores were situated closer than 300 m to schools. No differences were identified in sociodemographic and economic characteristics by the store distance to schools.ConclusionMost tobacco stores are compliant with the regulations in Spain. However, these regulations are insufficient to reduce tobacco availability. More restrictive regulations are needed to limit the geographic distribution of tobacco retailers, and health criteria should also be considered in the current legislation. The evaluation of the Spanish regulatory model may provide useful insights for other jurisdictions looking to decrease the tobacco retail availability.
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Levy JI, Quirós-Alcalá L, Fabian MP, Basra K, Hansel NN. Established and Emerging Environmental Contributors to Disparities in Asthma and Chronic Obstructive Pulmonary Disease. CURR EPIDEMIOL REP 2018; 5:114-124. [PMID: 30319934 PMCID: PMC6178976 DOI: 10.1007/s40471-018-0149-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
PURPOSE OF REVIEW Multiple respiratory diseases, including asthma and chronic obstructive pulmonary disease (COPD), display significant socioeconomic and racial/ethnic disparities. The objective of this review is to evaluate the evidence supporting a link between disproportionate environmental exposures and these health disparities. RECENT FINDINGS Studies suggest that various co-occurring factors related to the home environment, neighborhood environment, non-modifiable individual factors, and individual behaviors and attributes can increase or modify the risk of adverse respiratory outcomes among socioeconomically-disadvantaged and racially/ethnically diverse populations. Pollutants in the home environment, including particulate matter, nitrogen dioxide, and pesticides, are elevated among lower socioeconomic status populations and have been implicated in the development or exacerbation of respiratory-related conditions. Neighborhood crime and green space are socioeconomically patterned and linked with asthma outcomes through psychosocial pathways. Non-modifiable individual factors such as genetic predisposition cannot explain environmental health disparities but can increase susceptibility to air pollution and other stressors. Individual behaviors and attributes, including obesity and physical activity, contribute to worse outcomes among those with asthma or COPD. SUMMARY The root causes of these multifactorial exposures are complex, but many likely stem from economic forces and racial/ethnic and economic segregation that influence the home environment, neighborhood environment, and access to healthy foods and consumer products. Critical research needs include investigations that characterize exposure to and health implications of numerous stressors simultaneously, both to guard against potential confounding in epidemiological investigations and to consider the cumulative impact of multiple elevated environmental exposures and sociodemographic stressors on health disparities.
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Affiliation(s)
- Jonathan I. Levy
- Department of Environmental Health, Boston University School of Public Health
| | - Lesliam Quirós-Alcalá
- Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health; Division of Pulmonary & Critical Care Medicine, Johns Hopkins University
| | - M. Patricia Fabian
- Department of Environmental Health, Boston University School of Public Health
| | - Komal Basra
- Department of Environmental Health, Boston University School of Public Health
| | - Nadia N. Hansel
- Division of Pulmonary & Critical Care Medicine, Johns Hopkins University
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Policy coherence, integration, and proportionality in tobacco control: Should tobacco sales be limited to government outlets? J Public Health Policy 2018; 38:345-358. [PMID: 28432335 DOI: 10.1057/s41271-017-0074-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Multiple factors, including marijuana decriminalization/legalization, tobacco endgame discourse, and alcohol industry pressures, suggest that the retail regulatory environment for psychoactive or addictive substances is a dynamic one in which new options may be considered. In most countries, the regulation of tobacco, marijuana, and alcohol is neither coherent, nor integrated, nor proportional to the potential harms caused by these substances. We review the possible consequences of restricting tobacco sales to outlets run by government-operated alcohol retail monopolies, as well as the likely obstacles to such a policy. Such a move would allow governments more options for regulating tobacco sales, and increase coherence, integration, and proportionality of substance regulation. It might also serve as an incremental step toward an endgame goal of eliminating sales of commercial combustible tobacco.
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Wagoner KG, Sutfin EL, Song EY, King JL, Egan KL, Reboussin B, Debinski B, Spangler J, Wolfson M. Trends in point-of-sale tobacco marketing around college campuses: Opportunities for enhanced tobacco control efforts. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2018; 66:145-154. [PMID: 29020532 PMCID: PMC5922252 DOI: 10.1080/07448481.2017.1389734] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
OBJECTIVE Colleges have implemented policies to limit tobacco use on-campus; however, the off-campus environment is often overlooked in tobacco control efforts. We assessed availability, marketing, and promotion of cigarettes, snus, and traditional smokeless tobacco (SLT) in a sample of communities surrounding 11 college campuses in North Carolina and Virginia. PARTICIPANTS Between January-March of 2011, 2012 and 2013, 481 tobacco-selling retailers, including convenience stores, pharmacies and supermarkets, located near campuses were assessed. METHODS Trained observers completed annual point-of-sale assessments. RESULTS The percentage of stores selling (81.4% to 58.6%; p < .0001) and advertising snus (80.1% to 53.11%; p < .0001) significantly decreased over time. Convenience stores increased promotions of cigarettes (65.4% to 72.8%; p = 0.04) and SLT (3.1% to 23.3%; p = 0.02). CONCLUSIONS Off-campus environments have abundant tobacco availability and marketing. Colleges should collaborate with state and local tobacco control advocates to address tobacco promotion near campuses to potentially decrease product appeal and access among young adults.
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Affiliation(s)
- Kimberly G. Wagoner
- Wake Forest School of Medicine, Department of Social Sciences and Health Policy, Medical Center Blvd, Winston-Salem, NC 27157, USA
| | - Erin L. Sutfin
- Wake Forest School of Medicine, Department of Social Sciences and Health Policy, Medical Center Blvd, Winston-Salem, NC 27157, USA
| | - Eunyoung Y. Song
- Wake Forest School of Medicine, Department of Social Sciences and Health Policy, Medical Center Blvd, Winston-Salem, NC 27157, USA
| | - Jessica L. King
- Wake Forest School of Medicine, Department of Social Sciences and Health Policy, Medical Center Blvd, Winston-Salem, NC 27157, USA
| | - Kathleen L. Egan
- University of Florida, Department of Epidemiology, 2004 Mowry Road, Gainesville, Florida 32610, USA
| | - Beth Reboussin
- Wake Forest School of Medicine, Department of Biostatistical Sciences, Medical Center Blvd, Winston-Salem, NC 27157, USA
| | - Beata Debinski
- Johns Hopkins University Bloomberg School of Public Health, Department of Health, Behavior and Society, 615 N. Wolfe St # E4527, Baltimore, MD 21205, USA
| | - John Spangler
- Wake Forest School of Medicine, Department of Family Medicine, Medical Center Blvd, Winston-Salem, NC 27157, USA
| | - Mark Wolfson
- Wake Forest School of Medicine, Department of Social Sciences and Health Policy, Medical Center Blvd, Winston-Salem, NC 27157, USA
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Tobacco outlet density and tobacco knowledge, beliefs, purchasing behaviours and price among adolescents in Scotland. Soc Sci Med 2018; 206:1-13. [PMID: 29677578 DOI: 10.1016/j.socscimed.2017.11.046] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Revised: 10/24/2017] [Accepted: 11/27/2017] [Indexed: 11/22/2022]
Abstract
Despite long-term falls in global adult smoking prevalence and over 50 years of tobacco control policies, adolescent smoking persists. Research suggests greater densities of tobacco retail outlets in residential neighbourhoods are associated with higher adolescent smoking rates. Policies to reduce retail outlets have therefore been identified by public health researchers as a potential 'new frontier' in tobacco control. Better understanding of the pathways linking density of tobacco retailers and smoking behaviour could support these policies. In this study we use path analysis to assess how outlet density in the home environment is related to adolescent tobacco knowledge, beliefs, retail purchases and price in Scotland. We assessed 22,049 13 and 15 year old respondents to the nationally representative cross-sectional 2010 Scottish School Adolescent Lifestyle and Substance Use Survey. Outlet density was based on Scottish Tobacco Retailers Register, 2012, data. A spatially-weighted Kernel Density Estimation measure of outlet density within 400 m of respondents' home postcode was grouped into tertiles. The analysis considered whether outlet density was associated with the number of cigarette brands adolescents could name, positive beliefs about smoking, whether smokers purchased cigarettes from shops themselves or through adult proxies and perceived cost of cigarettes. Models were stratified by adolescent smoking status. The path analyses indicated that outlet density was not associated with most outcomes, but small, significant direct effects on knowledge of cigarette brands among those who had never smoked were observed. With each increase in outlet density tertile the mean number of brands adolescents could name rose by 0.07 (mean = 1.60; SD = 1.18; range = 4). This suggests greater outlet densities may have affected adolescents' knowledge of cigarette brands but did not encourage positive attitudes to smoking, purchases from shops or lower cigarette prices. Exposure to tobacco outlets may influence adolescents' awareness of tobacco products, a potential pathway to smoking behaviour.
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