1
|
Bizier A, Smit T, Thai JM, Businelle MS, Obasi EM, Gallagher MW, Zvolensky MJ, Garey L. The Indirect Effects of Negative Affect Reduction Motives on the Relationship Between Sex and Severity of Problems When Trying to Quit Among Black Adults Who Smoke. Subst Use Misuse 2024:1-8. [PMID: 39327694 DOI: 10.1080/10826084.2024.2409714] [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] [Indexed: 09/28/2024]
Abstract
BACKGROUND African American/Black (hereafter referred to as Black) persons who smoke constitute a tobacco disparities group in the United States. Within the Black population, female smokers experience a disproportionate percentage of these disparities and are less likely to quit cigarettes than their male counterparts. Two factors implicated in female smokers' relatively worse quit success are (1) motives to smoke to reduce negative affect and (2) expectancies that smoking will reduce negative affect. OBJECTIVES The present study sought to test sex differences in these two clinically relevant cognitive constructs and evaluate the indirect effects of sex and severity of problems when trying to quit via smoking motives and expectancies for negative affect reduction among Black adults who smoke. Participants included 103 Black adults who smoke daily (72% male; Mage = 44.5 years, SD = 11.5 years). RESULTS Results revealed sex differences in both negative affect reduction motives and expectancies, as well as a partial indirect effect for sex on the severity of problems when trying to quit through negative affect reduction motives (a1b1 = 0.18, 95% CI [0.04, 0.38]) but not negative affect reduction expectancies (a2b2 = -0.01, 95% CI [-0.11, 0.09]) in a simultaneous model of indirect effects. CONCLUSIONS These findings shed light on the complex relationship between race, sex, and severity of problems when trying to quit, particularly when complicated by smoking motives and expectancies. Current data should be considered when developing sex-specific, tailored smoking cessation interventions for Black women.
Collapse
Affiliation(s)
- Andre Bizier
- Department of Psychology, University of Houston, Houston, TX, USA
| | - Tanya Smit
- Department of Psychology, University of Houston, Houston, TX, USA
| | - Jessica M Thai
- Department of Psychology, University of Houston, Houston, TX, USA
| | - Michael S Businelle
- TSET Health Promotion Research Center, Stephenson Cancer Center, Oklahoma City, OK, USA
- Department of Family and Preventive Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Ezemenari M Obasi
- HEALTH Institute, University of Houston, Houston, TX, USA
- Department of Psychological, Health, & Learning Sciences, University of Houston, Houston, TX, USA
| | | | - Michael J Zvolensky
- Department of Psychology, University of Houston, Houston, TX, USA
- HEALTH Institute, University of Houston, Houston, TX, USA
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Lorra Garey
- Department of Psychology, University of Houston, Houston, TX, USA
- HEALTH Institute, University of Houston, Houston, TX, USA
| |
Collapse
|
2
|
Golden SD, Kuo TM, Combs T, Kong AY, Ribisl KM, Baggett CD. Supply and demand effects between tobacco retailer density and smoking prevalence. Tob Control 2024:tc-2024-058739. [PMID: 39134401 DOI: 10.1136/tc-2024-058739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2024] [Accepted: 07/30/2024] [Indexed: 09/20/2024]
Abstract
OBJECTIVE Places with more tobacco retailers have higher smoking prevalence levels, but whether this is because retailers locate where people who smoke live or whether tobacco availability prompts tobacco use is unknown. In this study, we compare the role of consumer demand with that of tobacco supply in longitudinal, area-based associations of tobacco retailer density with smoking prevalence. METHODS We merged annual adult smoking prevalence estimates derived from the USA Behavioural Risk Factor Surveillance System data with annual county estimates of tobacco retailer density calculated from the National Establishment Time Series data for 3080 counties between 2000 and 2010. We analysed relationships between retailer density and smoking in 3080 counties, using random intercept cross-lagged panel models and employing two measures of tobacco retailer density capturing the number of likely tobacco retailers in a county divided by either the population or land area. RESULTS Both density models provided evidence of significant demand and supply effects; in the population-based model, the association of smoking prevalence in 1 year with tobacco retailer density in the next year (standardised coefficient=0.038, p<0.01) was about double the association between tobacco retailer density with subsequent smoking prevalence (0.017, p<0.01). The reverse was true in the land area-based model, where the supply effect (0.042, p<0.01) was more than 10 times stronger than the demand effect (0.003, p<0.01). CONCLUSIONS Policies that restrict access to retail tobacco have the potential to reduce smoking prevalence, but pairing such policies with interventions to reduce consumer demand remains important.
Collapse
Affiliation(s)
- Shelley D Golden
- Health Behavior, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Lineberger Comprehensive Cancer Center, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Tzy-Mey Kuo
- Lineberger Comprehensive Cancer Center, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Todd Combs
- Center for Public Health Systems Science, Brown School, Washington University in St Louis, St Louis, Missouri, USA
| | - Amanda Y Kong
- Department of Social Sciences and Health Policy, Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - Kurt M Ribisl
- Health Behavior, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Lineberger Comprehensive Cancer Center, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Chris D Baggett
- Lineberger Comprehensive Cancer Center, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Epidemiology, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| |
Collapse
|
3
|
Kong AY, Lee JGL, Halvorson-Fried SM, Sewell KB, Golden SD, Henriksen L, Herbert L, Ribisl KM. Neighbourhood inequities in the availability of retailers selling tobacco products: a systematic review. Tob Control 2024:tc-2024-058718. [PMID: 38937098 DOI: 10.1136/tc-2024-058718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2024] [Accepted: 06/03/2024] [Indexed: 06/29/2024]
Abstract
OBJECTIVE To examine inequities in tobacco retailer availability by neighbourhood-level socioeconomic, racial/ethnic and same-sex couple composition. DATA SOURCES We conducted a 10 November 2022 search of PubMed, PsycINFO, Global Health, LILACS, Embase, ABI/Inform, CINAHL, Business Source Complete, Web of Science and Scopus. STUDY SELECTION We included records from Organisation for Economic Co-operation and Development member countries that tested associations of area-level measures of tobacco retailer availability and neighbourhood-level sociodemographic characteristics. Two coders reviewed the full text of eligible records (n=58), including 41 records and 205 effect sizes for synthesis. DATA EXTRACTION We used dual independent screening of titles, abstracts and full texts. One author abstracted and a second author confirmed the study design, location, unit of analysis, sample size, retailer data source, availability measure, statistical approach, sociodemographic characteristic and unadjusted effect sizes. DATA SYNTHESIS Of the 124 effect sizes related to socioeconomic inequities (60.5% of all effect sizes), 101 (81.5%) indicated evidence of inequities. Of 205 effect sizes, 69 (33.7%) tested associations between retailer availability and neighbourhood composition of racially and ethnically minoritised people, and 57/69 (82.6%) documented inequities. Tobacco availability was greater in neighbourhoods with more Black, Hispanic/Latine and Asian residents (82.8%, 90.3% and 40.0% of effect sizes, respectively). Two effect sizes found greater availability with more same-sex households. CONCLUSIONS There are stark inequities in tobacco retailer availability. Moving beyond documenting inequities to partnering with communities to design, implement, and evaluate interventions that reduce and eliminate inequities in retail availability is needed to promote an equitable retail environment. PROSPERO REGISTRATION NUMBER CRD42019124984.
Collapse
Affiliation(s)
- Amanda Y Kong
- Department of Family and Preventive Medicine, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
- Stephenson Cancer Center, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Joseph G L Lee
- Department of Health Education and Promotion, College of Health and Human Performance, East Carolina University, Greenville, North Carolina, USA
- University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, North Carolina, USA
| | - Sarah M Halvorson-Fried
- University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, North Carolina, USA
- Department of Health Behavior, University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, North Carolina, USA
| | - Kerry B Sewell
- Laupus Health Sciences Library, East Carolina University, Greenville, North Carolina, USA
| | - Shelley Diane Golden
- University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, North Carolina, USA
- Department of Health Behavior, University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, North Carolina, USA
| | - Lisa Henriksen
- Stanford Prevention Research Center, Stanford University School of Medicine, Palo Alto, Stanford, California, USA
| | - Lily Herbert
- Stephenson Cancer Center, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Kurt M Ribisl
- University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, North Carolina, USA
- Department of Health Behavior, University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, North Carolina, USA
| |
Collapse
|
4
|
Zheng C, Pearce J, Feng Z. Potential impacts of spatial restrictions on tobacco retail availability in China: a simulation study in Shanghai. Tob Control 2024; 33:503-510. [PMID: 36889913 DOI: 10.1136/tc-2022-057704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 02/27/2023] [Indexed: 03/10/2023]
Abstract
OBJECTIVES Regulating tobacco retail availability provides promising new opportunities for effective tobacco control. This study simulates the potential impacts of introducing spatial restrictions on the availability of tobacco in Shanghai, the largest city in China. METHODS Twelve stakeholder-informed simulation scenarios under four types of spatial restrictions were considered: (1) capping, (2) ban of sales, (3) minimum spacing and (4) school-buffer exclusion zone. Tobacco retailer data for Shanghai (n=19 413) were used. The main outcome was per cent reduction in retail availability measured by population-weighted kernel density estimation across neighbourhoods, and impacts on social inequality in availability were estimated using the Kruskal-Wallis test and effect size estimation. All analyses were further stratified by three levels of urbanity to examine geographical disparities in overall effectiveness and equity of the simulation scenarios. RESULTS All simulation scenarios have the potential to reduce availability, with overall reductions ranging from 8.60% to 85.45%. Compared with the baseline, the effect size regarding the association between availability and neighbourhood deprivation quintiles suggests that the most effective scenario, '500 m minimum spacing' between retailers, increased the social inequality in availability (p<0.001). Conversely, school-buffer scenarios were both effective and equitable. Additionally, the effectiveness and the equity impact of scenarios varied by urbanity level. CONCLUSION Spatial restrictions offer potential new policy opportunities to reduce retail availability, but some may increase social inequality in accessing tobacco. For effective tobacco control, policymakers should consider the overall and equity impacts of spatial restrictions when developing comprehensive tobacco retail regulations.
Collapse
Affiliation(s)
- Chunyu Zheng
- Centre for Research on Environment, Society and Health (CRESH), School of GeoSciences, The University of Edinburgh, Edinburgh, UK
| | - Jamie Pearce
- Centre for Research on Environment, Society and Health (CRESH), School of GeoSciences, The University of Edinburgh, Edinburgh, UK
| | - Zhiqiang Feng
- Centre for Research on Environment, Society and Health (CRESH), School of GeoSciences, The University of Edinburgh, Edinburgh, UK
- Scottish Centre for Administrative Data Research, The University of Edinburgh, Edinburgh, UK
| |
Collapse
|
5
|
Dove MS, Gee KA, Tong EK. Flavored Tobacco Sales Restrictions and Youth E-cigarette Behavior: Impact by Tobacco Retailer Density in Diverse Communities in California. Nicotine Tob Res 2024; 26:S65-S72. [PMID: 38817027 PMCID: PMC11140225 DOI: 10.1093/ntr/ntad129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 07/17/2023] [Accepted: 07/20/2023] [Indexed: 06/01/2024]
Abstract
INTRODUCTION Factors that impact flavored tobacco sales restriction (flavor restrictions) effectiveness on youth e-cigarette behavior are unclear. Tobacco retailer density (retailer density) is a health equity issue with greater retailer density in high-minority, low-income areas. We examined the association between flavor restrictions and youth e-cigarette behavior by retailer density across diverse communities in the California Bay Area. AIMS AND METHODS We analyzed data from the California Healthy Kids Survey using a difference-in-differences (DID) strategy. We compared pre- and post-policy changes in e-cigarette access and use one-year post-implementation among high school students in the Bay Area with a flavor restriction (n = 20 832) versus without (n = 66 126). Separate analyses were conducted for students in cities with low and high retailer density, with a median cutoff of 3.3 tobacco retailers/square mile. RESULTS Students with high retailer density were more likely to identify as a minority and have parents with lower education. Among students with low retailer density, flavor restrictions were associated with 24% lower odds in the pre- to post-policy increase in ease of access relative to unexposed students (DID = 0.76, 95% CI: 0.58, 0.99). Among students with high retailer density, flavor restrictions were associated with 26% higher odds in ease of access (DID: 1.26, 95% CI: 1.02, 1.56) and 57% higher odds of current use (DID = 1.57, 95% CI: 1.31, 1.87). CONCLUSIONS Flavor restrictions had positive impacts on youth e-cigarette access in low, but not high retailer density cities. From a health equity perspective, our results underscore how flavor restrictions may have uneven effects among vulnerable groups. IMPLICATIONS In diverse communities in the California Bay Area, our results suggest a protective association between flavored tobacco sales restrictions and youth access to e-cigarettes in low, but not high tobacco retailer density cities one-year post-implementation. These results underscore how flavor restrictions may have uneven effects, and when implemented in high retailer density areas, may disproportionately place already vulnerable groups at heightened exposure to e-cigarette use and access. In high retailer density areas, additional tobacco control efforts may need to be included with flavor restriction implementation, such as increased education, youth prevention and cessation programs, policies to reduce tobacco retailer density, or stronger tobacco retailer enforcement or compliance monitoring.
Collapse
Affiliation(s)
- Melanie S Dove
- Department of Public Health Sciences, Division of Health Policy and Management, University of California, Davis, USA
| | - Kevin A Gee
- School of Education, University of California, Davis, USA
| | - Elisa K Tong
- Department of Internal Medicine, University of California, Davis, USA
| |
Collapse
|
6
|
Zvolensky MJ, Clausen BK, Shepherd JM, Redmond BY, Robison JH, Santiago-Torres M, Bricker JB. Emotional dysregulation among English-speaking Hispanic persons who smoke living in the United states. Addict Behav 2024; 152:107959. [PMID: 38309241 PMCID: PMC11195297 DOI: 10.1016/j.addbeh.2024.107959] [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: 11/30/2023] [Revised: 01/08/2024] [Accepted: 01/17/2024] [Indexed: 02/05/2024]
Abstract
Hispanic/Latinx (hereafter Hispanic) individuals in the United States (US) experience serious tobacco-related disparities and factors contributing to such disparities need to be adequately identified and clinically addressed. Emotion dysregulation is a key transdiagnostic relevant to smoking. The present cross-sectional investigation sought to test if emotion dysregulation was related to more severe problems during smoking quit attempts (e.g., irritability, weight gain), perceptions of difficulty about quitting, as well as negative and positive beliefs about smoking abstinence in a sample of English-speaking Hispanic adults residing in the US who smoke. Participants included 332 Hispanic adults who engaged in daily cigarette smoking (35.46 years old, 37 % identified as female). Emotion dysregulation was significantly related to more severe problems when quitting and perceived barriers for quitting, as well as negative beliefs about smoking abstinence. Additionally, emotion dysregulation was significantly and negatively related to positive outcomes about smoking abstinence. The amount of change in the various smoking criterion variables accounted for by emotion dysregulation was small (sr2 range: 0.028-0.085), but evident in adjusted models that accounted for a wide range of factors (e.g., depression, drug use severity). Overall, this investigation found consistent empirical evidence that individual differences in emotion dysregulation in Hispanic individuals were associated with several clinically significant smoking processes, suggesting this construct may represent an important factor involved in the maintenance and relapse of smoking among this ethnic population.
Collapse
Affiliation(s)
- Michael J Zvolensky
- Department of Psychology, University of Houston; Department of Behavioral Science, The University of Texas MD Anderson Cancer Center; HEALTH Institute, University of Houston.
| | | | | | | | | | | | - Jonathan B Bricker
- Fred Hutchinson Cancer Center, Division of Public Health Sciences; Department of Psychology, University of Washington
| |
Collapse
|
7
|
Zhang BY, Bannon OS, Tzu-Hsuan Chen D, Filippidis FT. Dual and poly-nicotine and tobacco use among adolescents in the United States from 2011 to 2022. Addict Behav 2024; 152:107970. [PMID: 38277994 DOI: 10.1016/j.addbeh.2024.107970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 01/19/2024] [Accepted: 01/22/2024] [Indexed: 01/28/2024]
Abstract
BACKGROUND Adolescent nicotine and tobacco product use remains common despite declining smoking rates in the United States, likely due to the emergence of novel products. Concurrent use of multiple products may increase the risk of nicotine dependency and subsequent substance use. AIM To identify patterns and trends of dual and poly nicotine and tobacco use among adolescents in the US and explore associations of dual and poly nicotine and tobacco use with sociodemographic factors. METHODS 12 years of annual National Youth Tobacco Survey data (2011-2022) from 242,637 respondents were used to examine prevalence trends of different combinations of nicotine or tobacco product use among adolescents in the US using weighted point estimates for each year. Poisson regression models examined sociodemographic factors associated with different patterns of dual and poly-product use from 2011 to 2022. RESULTS Overall, the prevalence of dual (i.e. at least two products) and poly (i.e. at least three products) use decreased between 2011 and 2021 (from 9.5 % to 2.8 % and from 5.1 % to 1.1 %, respectively), but showed signs of increase between 2021 and 2022 (3.7 % for dual and 1.7 % for poly use). The most common combinations included a combustible product with either a novel or noncombustible product. The risk for dual and poly-product use was higher among non-Hispanic Whites, males, and high school students. CONCLUSIONS Previously declining trends in the prevalence of tobacco/nicotine dual and poly use may have been reversed. Close monitoring and targeted tobacco control policies are essential to tackle multiple product use among adolescents.
Collapse
Affiliation(s)
- Baihui Y Zhang
- Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, England, United Kingdom
| | - Olivia S Bannon
- Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, England, United Kingdom.
| | - Daniel Tzu-Hsuan Chen
- Nuffield Department of Primary Care Health Science, University of Oxford, Radcliffe Observatory Quarter, Woodstock Road, Oxford, United Kingdom
| | - Filippos T Filippidis
- Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, England, United Kingdom
| |
Collapse
|
8
|
Mohottige D. Paving a Path to Equity in Cardiorenal Care. Semin Nephrol 2024; 44:151519. [PMID: 38960842 DOI: 10.1016/j.semnephrol.2024.151519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/05/2024]
Abstract
Cardiorenal syndrome encompasses a dynamic interplay between cardiovascular and kidney disease, and its prevention requires careful examination of multiple predisposing underlying conditions. The unequal distribution of diabetes, heart failure, hypertension, and kidney disease requires special attention because of the influence of these conditions on cardiorenal disease. Despite growing evidence regarding the benefits of disease-modifying agents (e.g., sodium-glucose cotransporter 2 inhibitors) for cardiovascular, kidney, and metabolic (CKM) disease, significant disparities remain in access to and utilization of these essential therapeutics. Multilevel barriers impeding their use require multisector interventions that address patient, provider, and health system-tailored strategies. Burgeoning literature also describes the critical role of unequal social determinants of health, or the sociopolitical contexts in which people live and work, in cardiorenal risk factors, including heart failure, diabetes, and chronic kidney disease. This review outlines (i) inequality in the burden and treatment of hypertension, type 2 diabetes, and heart failure; (ii) disparities in the use of key disease-modifying therapies for CKM diseases; and (iii) multilevel barriers and solutions to achieve greater pharmacoequity in the use of disease-modifying therapies. In addition, this review provides summative evidence regarding the role of unequal social determinants of health in cardiorenal health disparities, further outlining potential considerations for future research and intervention. As proposed in the 2023 American Heart Association presidential advisory on CKM health, a paradigm shift will be needed to achieve cardiorenal health equity. Through a deeper understanding of CKM health and a commitment to equity in the prevention, detection, and treatment of CKM disease, we can achieve this critical goal.
Collapse
Affiliation(s)
- Dinushika Mohottige
- Institute for Health Equity Research, Department of Population Health, Icahn School of Medicine at Mount Sinai, New York, NY; Barbara T. Murphy Division of Nephrology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY.
| |
Collapse
|
9
|
Marsh L, Doscher C, Iosua E, Quigg R, Tomintz M. What impact would tobacco retailer proximity limit have on tobacco availability in New Zealand? Tob Control 2024; 33:215-220. [PMID: 35953283 DOI: 10.1136/tc-2022-057462] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 07/28/2022] [Indexed: 11/03/2022]
Abstract
INTRODUCTION One policy option to reduce the density of tobacco retailers is to restrict the distance retailers can be located to each other. This study examined the impacts of proximity limits of 150 m, 300 m and 450 m between tobacco retailers in New Zealand and if critical threshold reduction in tobacco retailers of 90%-95% would be achieved. METHODS Using a spatial modelling approach, tobacco retailers were randomly removed based on a minimum distance between retailers until there were zero retailers within each scenario's minimum distance. This was repeated for all three proximity limit scenarios and descriptive statistics are provided for each. RESULTS Implementation of 150 m, 300 m or 450 m distance restrictions between tobacco retailers would result in an average reduction in availability of 35%, 49% and 58%, respectively. On average, the current median distance to the closest retailer increases from 110 m to 377 m, to 568 m or to 718 m, respectively. The average median distance from a retailer to the closest school also increases across the three proximity limits, from 1017 m to 1087 m, to 1149 m or to 1231 m, respectively. Reduced clustering in deprived areas would be most apparent if a 450 m restriction policy was implemented. CONCLUSIONS A proximity limit of 450 m would reduce retailers by 58%, but would not reach proposed critical behaviour-change threshold of 90%-95% required to reduce smoking prevalence independently. There is a need for a combination of policies, which focus on promoting equity, to achieve this bold endgame goal.
Collapse
Affiliation(s)
- Louise Marsh
- Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | - Crile Doscher
- Faculty of Environment, Society and Design, Lincoln University, Christchurch, New Zealand
| | - Ella Iosua
- Biostatistics Centre, Division of Health Sciences, University of Otago, Dunedin, New Zealand
| | - Robin Quigg
- Ngāi Tahu Māori Health Research Unit, Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | - Melanie Tomintz
- Geospatial Research Institute, University of Canterbury, Christchurch, New Zealand
| |
Collapse
|
10
|
Giovenco DP, Morrison CN, Mehranbod CA, Spillane TE, Easter AG, Hernández D, Humphreys DK, Mauro CM, Kong AY, Branas CC. Impact and Equity of New York City's Tobacco Retail Reduction Initiative. Am J Prev Med 2024; 66:235-242. [PMID: 37816459 PMCID: PMC10872861 DOI: 10.1016/j.amepre.2023.10.004] [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: 07/10/2023] [Revised: 10/05/2023] [Accepted: 10/05/2023] [Indexed: 10/12/2023]
Abstract
INTRODUCTION High levels of tobacco retailer density in communities is associated with a range of tobacco use behaviors and is a key structural driver of tobacco-related disparities. This study evaluates the impacts of New York City's (NYC) novel policy intervention to cap tobacco retail licenses on tobacco retailer density levels and neighborhood inequities in tobacco access. METHODS Using geocoded tobacco retail licensing data from 2010 to 2022, Bayesian conditional autoregressive Poisson panel models estimated the association between policy implementation in 2018 and retailer density per 1,000 population, controlling for neighborhood-level sociodemographic factors. Data were analyzed in 2023. RESULTS The number of tobacco retail licenses decreased from 9,304 in 2010 to 5,107 in 2022, with the rate of decline significantly accelerating post-policy (-14·2% versus -34·2%). Policy effects were stronger in districts with lower income and greater proportions of non-Hispanic Black residents. CONCLUSIONS NYC's policy substantially reduced tobacco retailer density and appeared to close longstanding patterns of inequity in tobacco access, serving as a rare example of a tobacco control policy that may effectively reduce tobacco-related disparities. This emergent approach to restructure tobacco retail in communities may reach populations that have not benefitted from traditional tobacco control policies and should be considered by other localities.
Collapse
Affiliation(s)
- Daniel P Giovenco
- Columbia University Mailman School of Public Health, Department of Sociomedical Sciences, New York, NY, USA.
| | - Christopher N Morrison
- Columbia University Mailman School of Public Health, Department of Epidemiology, New York, NY, USA; Monash University, School of Public Health and Preventive Medicine, Department of Epidemiology and Preventive Medicine, Melbourne, Australia
| | - Christina A Mehranbod
- Columbia University Mailman School of Public Health, Department of Epidemiology, New York, NY, USA
| | - Torra E Spillane
- Columbia University Mailman School of Public Health, Department of Sociomedical Sciences, New York, NY, USA
| | - Alexa G Easter
- Columbia University Mailman School of Public Health, Department of Sociomedical Sciences, New York, NY, USA
| | - Diana Hernández
- Columbia University Mailman School of Public Health, Department of Sociomedical Sciences, New York, NY, USA
| | - David K Humphreys
- University of Oxford, Department of Social Policy and Intervention, Oxford, UK
| | - Christine M Mauro
- Columbia University Mailman School of Public Health, Department of Biostatistics, New York, NY, USA
| | - Amanda Y Kong
- The University of Oklahoma Health Sciences Center, Department of Family and Preventive Medicine, Oklahoma City, OK, USA; TSET Health Promotion Research Center, Stephenson Cancer Center, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Charles C Branas
- Columbia University Mailman School of Public Health, Department of Epidemiology, New York, NY, USA
| |
Collapse
|
11
|
Halvorson-Fried SM, Kong AY, D’Angelo H, Delamater PL, Ribisl KM. Spatial Clustering of Tobacco Retailers Near US Public Schools. Nicotine Tob Res 2024; 26:185-193. [PMID: 37632567 PMCID: PMC10803112 DOI: 10.1093/ntr/ntad161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 07/11/2023] [Accepted: 08/24/2023] [Indexed: 08/28/2023]
Abstract
INTRODUCTION Previous studies have found that tobacco retailers cluster near schools. However, all retail outlets may be located near each other and near schools due to existing infrastructure and zoning policies. We assessed whether tobacco retailers cluster near schools in the United States more than expected when accounting for existing retail locations. AIMS AND METHODS We identified 322 056 probable tobacco retailers, 95 110 public schools, and more than 3.8 million businesses comparable to tobacco retailers in land use and business type. We created 500 simulated tobacco retailer datasets by randomly selecting from the larger list of businesses. For each simulated dataset, we calculated the distance from schools to the nearest tobacco retailer (proximity) and the count of tobacco retailers within 800 m of schools (density). Observed proximity and density values were compared to 95% coverage intervals from the 500 simulations. We stratified analyses by urbanicity, percentage of students in the free and reduced-priced lunch program (FRLP), and percentage of Hispanic/Latino, non-Hispanic Black, and non-Hispanic white students. RESULTS Tobacco retailers were closer to schools in rural areas, cities, and towns and more dense around schools in rural areas, cities, and suburbs compared to random locations in potential retail space. Schools with more students receiving FRLP had higher density than expected while schools with fewer students receiving FRLP had lower density than expected. Within rural areas, clustering did not vary across sociodemographic groups. Within non-rural areas, there were inequities in clustering by racial, ethnic, and socioeconomic school composition. CONCLUSIONS Tobacco retailers cluster near schools after accounting for existing business patterns. There are inequities in clustering by sociodemographic school composition. IMPLICATIONS This study provides compelling evidence that tobacco retailers cluster near US public schools and that there are racial, ethnic, and socioeconomic inequities in clustering, even when accounting for overall retail location patterns. Given that public schools tend to reflect neighborhood demographics, policies to limit tobacco retailers near schools may reduce both school-based and neighborhood-based inequities.
Collapse
Affiliation(s)
- Sarah M Halvorson-Fried
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA
| | - Amanda Y Kong
- Department of Family and Preventive Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- TSET Health Promotion Research Center, Stephenson Cancer Center, Oklahoma City, OK, USA
| | - Heather D’Angelo
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Paul L Delamater
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA
- Department of Geography, University of North Carolina, Chapel Hill, NC, USA
| | - Kurt M Ribisl
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA
| |
Collapse
|
12
|
Benson KRK, Diamantidis CJ, Davenport CA, Sandler RS, Boulware LE, Mohottige D. Racial Differences in Over-the-Counter Non-steroidal Anti-inflammatory Drug Use Among Individuals at Risk of Adverse Cardiovascular Events. J Racial Ethn Health Disparities 2023:10.1007/s40615-023-01743-x. [PMID: 37594625 DOI: 10.1007/s40615-023-01743-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 07/29/2023] [Accepted: 08/02/2023] [Indexed: 08/19/2023]
Abstract
PURPOSE Black Americans are disproportionately affected by adverse cardiovascular events (ACEs). Over-the-counter (OTC) non-steroidal anti-inflammatory drugs (NSAIDs) confer increased risk for ACEs, yet racial differences in the use of these products remain understudied. This study sought to determine racial differences in OTC NSAID and high-potency powdered NSAID (HPP-NSAID) use. METHODS AND MATERIALS This retrospective analysis examined participants at risk of ACEs (defined as those with self-reported hypertension, diabetes, heart disease, or smoking history ≥ 20 years) from the North Carolina Colon Cancer Study, a population-based case-control study. We used multivariable logistic regression models to assess the independent associations of race with any OTC NSAID use, HPP-NSAID use, and regular use of these products. RESULTS Of the 1286 participants, 585 (45%) reported Black race and 701 (55%) reported non-Black race. Overall, 665 (52%) reported any OTC NSAID use and 204 (16%) reported HPP-NSAID use. Compared to non-Black individuals, Black individuals were more likely to report both any OTC NSAID use (57% versus 48%) and HPP-NSAID use (22% versus 11%). In multivariable analyses, Black (versus non-Black) race was independently associated with higher odds of both NSAID use (OR 1.4, 95% CI (1.1, 1.8)) and HPP-NSAID use (OR 1.8 (1.3, 2.5)). CONCLUSIONS Black individuals at risk of ACEs had higher odds of any OTC NSAID and HPP-NSAID use than non-Black individuals, after controlling for pain and socio-economic status. Further research is necessary to identify potential mechanisms driving this increased use.
Collapse
Affiliation(s)
- Kathryn R K Benson
- Department of Medicine, Division of General Internal Medicine, Duke University, Durham, NC, USA
- Center for Community and Population Health Improvement, Duke Clinical and Translational Science Institute, Duke University, Durham, NC, USA
| | - Clarissa J Diamantidis
- Department of Medicine, Division of General Internal Medicine, Duke University, Durham, NC, USA
- Center for Community and Population Health Improvement, Duke Clinical and Translational Science Institute, Duke University, Durham, NC, USA
- Department of Population Health Sciences, Duke University, Durham, NC, USA
- Department of Medicine, Division of Nephrology, Duke University, Durham, NC, USA
| | - Clemontina A Davenport
- Center for Community and Population Health Improvement, Duke Clinical and Translational Science Institute, Duke University, Durham, NC, USA
- Department of Biostatistics and Bioinformatics, Duke University, Durham, NC, USA
| | - Robert S Sandler
- Center for Community and Population Health Improvement, Duke Clinical and Translational Science Institute, Duke University, Durham, NC, USA
- Department of Medicine, Division of Gastroenterology and Hepatology, University of North Carolina, Chapel Hill, NC, USA
| | - L Ebony Boulware
- Department of Medicine, Division of General Internal Medicine, Duke University, Durham, NC, USA
- Center for Community and Population Health Improvement, Duke Clinical and Translational Science Institute, Duke University, Durham, NC, USA
- Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Dinushika Mohottige
- Center for Community and Population Health Improvement, Duke Clinical and Translational Science Institute, Duke University, Durham, NC, USA.
- Department of Population Health, Icahn School of Medicine at Mount Sinai, Institute for Health Equity Research, 1425 Madison Avenue Floor 2, New York, NY, 10029, USA.
- Department of Medicine, Icahn School of Medicine at Mount Sinai, Barbara T. Murphy Division of Nephrology, 1425 Madison Avenue Floor 2, New York, NY, 10029, USA.
- Division of Data-Driven and Digital Medicine (D3M), Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| |
Collapse
|
13
|
McDaniel PA, Smith EA, Malone RE. Retailer experiences with tobacco sales bans: lessons from two early adopter jurisdictions. Tob Control 2023:tc-2023-057944. [PMID: 37277180 DOI: 10.1136/tc-2023-057944] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 05/21/2023] [Indexed: 06/07/2023]
Abstract
BACKGROUND Beverly Hills and Manhattan Beach, California, are the first two US cities to prohibit the sale of tobacco products, passing ordinances that went into effect on 1 January 2021. We sought to learn about retailers' experiences with these laws 22 months after implementation. METHODS Brief in-person interviews with owners or managers of businesses that formerly sold tobacco (n=22). RESULTS Participant experiences varied by type of retailer. Managers at large chain stores reported no problems adapting to the law and little effect on overall sales. Many were largely indifferent to the sales bans. By contrast, most managers or owners of small, independent retailers reported losses of both revenue and customers, and expressed dissatisfaction with the laws. Small retailers in Beverly Hills objected particularly to exemptions that city made allowing hotels and cigar lounges to continue their sales, which they saw as undermining the health rationale for the law. The small geographical area covered by the policies was also a source of frustration, and retailers reported that they had lost business to retailers in nearby cities. The most common advice small retailers had for other retailers was to organise to oppose any similar attempts in their cities. A few retailers were pleased with the law or its perceived effects, including a reduction in litter. CONCLUSION Planning for tobacco sales ban or retailer reduction policies should include considering impacts on small retailers. Adopting such policies in as wide a geographical area as possible, as well as allowing no exemptions, may help reduce opposition.
Collapse
Affiliation(s)
- Patricia A McDaniel
- Social and Behavioral Sciences, University of California San Francisco School of Nursing, San Francisco, California, USA
| | - Elizabeth A Smith
- Social and Behavioral Sciences, University of California San Francisco School of Nursing, San Francisco, California, USA
| | - Ruth E Malone
- Social and Behavioral Sciences, University of California San Francisco School of Nursing, San Francisco, California, USA
| |
Collapse
|
14
|
Reimold AE, Kong AY, Delamater PL, Baggett CD, Golden SD. Urban-rural differences in tobacco product availability in food retailers, United States, 2017. J Rural Health 2023; 39:338-346. [PMID: 35708094 PMCID: PMC9755460 DOI: 10.1111/jrh.12687] [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] [Indexed: 11/29/2022]
Abstract
PURPOSE Tobacco use prevalence is higher in rural compared to urban settings, possibly due to differences in tobacco availability, including the option to purchase food and other essential items in stores that do not sell tobacco (tobacco-free food retailers). The goal of this research is to determine whether tobacco-free food retailer availability varies by urbanicity/rurality. METHODS Using the 2017 National Establishment Time-Series database, we identified food retailers across all census tracts containing food retailers in the United States (n = 66,053). We used multivariable logistic and linear regression models to test whether tobacco-free food retailer availability varied across 4-levels of census tract urbanicity/rurality (urban, suburban, large town, and small town/rural) for 2 outcomes: (1) the presence of at least 1 tobacco-free food retailer and (2) the percent of all food retailers that were tobacco-free. FINDINGS Compared to urban core census tracts, suburban census tracts had a lower odds (aOR = 0.77, 95% CI = 0.73, 0.81) of having at least 1 tobacco-free food retailer, while small town/rural census tracts had greater odds (aOR = 1.23, 95% CI = 1.15, 1.32). Suburban census tracts (B = -2.29, P < .001) and large town census tracts (B = -1.90, P < .001) also had a lower percentage of tobacco-free food retailers compared to urban census tracts. CONCLUSIONS Compared to urban cores, tobacco-free food retailers were less prevalent in suburban and large town areas, though similarly or slightly more available in rural areas. Future research should assess whether these differences depend on varying store types.
Collapse
Affiliation(s)
- Alexandria E. Reimold
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Amanda Y. Kong
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
- Department of Family and Preventive Medicine, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
- TSET Health Promotion Research Center, Stephenson Cancer Center, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Paul L. Delamater
- Department of Geography, University of North Carolina, Chapel Hill, North Carolina, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Christopher D. Baggett
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina, USA
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Shelley D. Golden
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina, USA
| |
Collapse
|
15
|
Cohn AM, Sedani A, Niznik T, Alexander A, Lowery B, McQuoid J, Campbell J. Population and Neighborhood Correlates of Cannabis Dispensary Locations in Oklahoma. CANNABIS (ALBUQUERQUE, N.M.) 2023; 6:99-113. [PMID: 37287730 PMCID: PMC10212267 DOI: 10.26828/cannabis/2023.01.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Background Cannabis dispensaries have proliferated exponentially in Oklahoma since the state legalized medical cannabis in 2018. Oklahoma is unique from many other legalized states given its high number of lower income, rural, and uninsured residents, who may seek medical cannabis as an alternative to traditional medical treatment. Methods This study examined demographic and neighborhood characteristics associated with dispensary density (n = 1,046 census tracts) in Oklahoma. Results Compared to census tracts with no dispensaries, those with at least one dispensary had a higher proportion of uninsured individuals living below the poverty level and a greater number of hospitals and pharmacies. Almost half (42.35%) of census tracts with at least one dispensary were classified as a rural locale. In fully adjusted models, percent uninsured, percent of household rentals, and the number of schools and pharmacies were positively associated with greater number of cannabis dispensaries, while the number of hospitals was negatively associated. In the best fitting interaction models, dispensaries were predominant in areas with a higher percentage of uninsured residents and no pharmacies, suggesting that cannabis retailers may capitalize on the health needs of communities with limited healthcare outlets or access to medical treatment. Conclusions Policies and regulatory actions that seek to decrease disparities in dispensary locations should be considered. Future studies should examine whether people living in communities with a scarcity of health resources are more likely to associate cannabis with medical uses than those living in communities with more resources.
Collapse
Affiliation(s)
- Amy M Cohn
- Department of Pediatrics, College of Medicine, University of Oklahoma Health Sciences Center
- TSET Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center
| | - Ami Sedani
- Department of Biostatistics and Epidemiology, Hudson College of Public Health, University of Oklahoma Health Sciences Center
| | - Taylor Niznik
- Department of Pediatrics, College of Medicine, University of Oklahoma Health Sciences Center
| | - Adam Alexander
- Department of Pediatrics, College of Medicine, University of Oklahoma Health Sciences Center
- Department of Family and Preventive Medicine, University of Oklahoma Health Sciences Center
| | - Bryce Lowery
- Regional + City Planning, Christopher C. Gibbs College of Architecture, University of Oklahoma
| | - Julia McQuoid
- Department of Pediatrics, College of Medicine, University of Oklahoma Health Sciences Center
- Department of Family and Preventive Medicine, University of Oklahoma Health Sciences Center
| | - Janis Campbell
- Department of Biostatistics and Epidemiology, Hudson College of Public Health, University of Oklahoma Health Sciences Center
| |
Collapse
|
16
|
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.
Collapse
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
| |
Collapse
|
17
|
Lee JGL, Kong AY, Sewell KB, Golden SD, Combs TB, Ribisl KM, Henriksen L. Associations of tobacco retailer density and proximity with adult tobacco use behaviours and health outcomes: a meta-analysis. Tob Control 2022; 31:e189-e200. [PMID: 34479990 PMCID: PMC9421913 DOI: 10.1136/tobaccocontrol-2021-056717] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 07/21/2021] [Indexed: 11/03/2022]
Abstract
OBJECTIVE We sought to conduct a systematic review and meta-analysis of evidence to inform policies that reduce density and proximity of tobacco retailers. DATA SOURCES Ten databases were searched on 16 October 2020: MEDLINE via PubMed, PsycINFO, Global Health, LILACS, Embase, ABI/Inform, CINAHL, Business Source Complete, Web of Science and Scopus, plus grey literature searches using Google and the RAND Publication Database. STUDY SELECTION Included studies used inferential statistics about adult participants to examine associations between tobacco retailer density/proximity and tobacco use behaviours and health outcomes. Of 7373 studies reviewed by independent coders, 37 (0.5%) met inclusion criteria. DATA EXTRACTION Effect sizes were converted to a relative risk reduction (RRR) metric, indicating the presumed reduction in tobacco use outcomes based on reducing tobacco retailer density and decreasing proximity. DATA SYNTHESIS We conducted a random effects meta-analysis and examined heterogeneity across 27 studies through subgroup analyses and meta-regression. Tobacco retailer density (RRR=2.55, 95% CI 1.91 to 3.19, k=155) and proximity (RRR=2.38, 95% CI 1.39 to 3.37, k=100) were associated with tobacco use behaviours. Pooled results including both density and proximity found an estimated 2.48% reduction in risk of tobacco use from reductions in tobacco retailer density and proximity (RRR=2.48, 95% CI 1.95 to 3.02, k=255). Results for health outcomes came from just two studies and were not significant. Considerable heterogeneity existed. CONCLUSIONS Across studies, lower levels of tobacco retailer density and decreased proximity are associated with lower tobacco use. Reducing tobacco supply by limiting retailer density and proximity may lead to reductions in tobacco use. Policy evaluations are needed.
Collapse
Affiliation(s)
- Joseph G L Lee
- Department of Health Education & Promotion, College of Health and Human Performance, East Carolina University, Greenville, North Carolina, USA
- Cancer Prevention and Control, University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, North Carolina, USA
| | - Amanda Y Kong
- Department of Health Behavior, University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, North Carolina, USA
| | - Kerry B Sewell
- Laupus Health Sciences Library, East Carolina University, Greenville, North Carolina, USA
| | - Shelley D Golden
- Cancer Prevention and Control, University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, North Carolina, USA
- Department of Health Behavior, University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, North Carolina, USA
| | - Todd B Combs
- Center for Public Health Systems Science, Washington University in St Louis, St Louis, Missouri, USA
| | - Kurt M Ribisl
- Cancer Prevention and Control, University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, North Carolina, USA
- Department of Health Behavior, University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, North Carolina, USA
| | - Lisa Henriksen
- Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, California, USA
| |
Collapse
|
18
|
Obinwa U, Pasch KE, Jetelina KK, Ranjit N, Perez A, Perry CL, Harrell M. Restricting Tobacco Retail Outlets Around Middle and High Schools as a Way to Reduce Tobacco Marketing Disparities: A Simulation Study. Nicotine Tob Res 2022; 24:1994-2002. [PMID: 35738013 PMCID: PMC9653075 DOI: 10.1093/ntr/ntac150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 04/05/2022] [Accepted: 06/21/2022] [Indexed: 01/03/2023]
Abstract
INTRODUCTION Communities with more people of color and economically disadvantaged residents are disproportionately exposed to tobacco marketing from tobacco companies. This study examined if banning tobacco retail outlets (TROs) within 1000 ft of schools would reduce these marketing disparities through a greater reduction in the amount of tobacco advertising around schools in these communities. METHODS Data from objectively audited advertisement data from 106 convenience stores and gas stations around 42 middle and high schools located in the four major metropolitan areas of Texas were linked with schools' enrollment data. ArcGIS (Aeronautical Reconnaissance Coverage Geographic Information System) was used to simulate a 1000-ft ban of tobacco sales around the schools. Independent sample T-tests and Mann-Whitney U tests were used to test mean differences where appropriate. RESULTS Schools with a higher enrollment of Hispanic/Latino (mean = 171.6, SD = 96.9) and economically disadvantaged students (mean = 168.9, SD = 102.3) were surrounded with significantly greater advertising at TROs than schools with lower enrollment of these groups (mean = 82.8, SD = 49.1 and mean = 89.2, SD = 50.6, respectively). A simulated 1000 ft ban of TROs around schools led to greater advertising reduction around schools with a higher enrollment of Hispanic/Latino students (13.3%-29.4% reductions) in comparison to schools with lower Hispanic/Latino student enrollment. However, the more economically disadvantaged schools had a smaller reduction in the number of advertisements (5.9%-21.9% reductions) in comparison to schools with less economically disadvantaged students. CONCLUSION The implementation of a ban of tobacco sales at TROs within 1000 ft of schools is one policy approach to reduce youth exposure to tobacco marketing, particularly among students of color. STUDY IMPLICATION Tobacco retail outlets (TROs) around schools with a higher enrollment of Hispanic/Latino and economically disadvantaged students had significantly more tobacco advertisements in comparison to schools with lower enrollment of these student groups. A simulated ban of TROs within 1000 ft of schools led to greater advertising reduction around schools with a higher enrollment of Hispanic/Latino students. For schools with more economically disadvantaged students, the ban led to a smaller reduction in advertisements in comparison to schools with less economically disadvantaged students. This proposed place-based strategy could be a successful means to reduce tobacco advertising and marketing disparity among communities of color.
Collapse
Affiliation(s)
- Udoka Obinwa
- School of Public Health, University of Texas Health Science Center at Houston, Austin Regional Campus, Austin, TX, USA
| | - Keryn E Pasch
- Department of Kinesiology and Health Education, University of Texas at Austin, Austin, TX, USA
| | - Katelyn K Jetelina
- School of Public Health, University of Texas Health Science Center at Houston, Austin Regional Campus, Austin, TX, USA
| | - Nalini Ranjit
- School of Public Health, University of Texas Health Science Center at Houston, Austin Regional Campus, Austin, TX, USA
| | - Adriana Perez
- School of Public Health, University of Texas Health Science Center at Houston, Austin Regional Campus, Austin, TX, USA
| | - Cheryl L Perry
- School of Public Health, University of Texas Health Science Center at Houston, Austin Regional Campus, Austin, TX, USA
| | - Melissa Harrell
- School of Public Health, University of Texas Health Science Center at Houston, Austin Regional Campus, Austin, TX, USA
| |
Collapse
|
19
|
Zheng C, Feng Z, Pearce J. A Cross-sectional Analysis of Socio-spatial Patterning of Tobacco Retail in Shanghai, China. Nicotine Tob Res 2022; 24:2018-2025. [PMID: 35777980 PMCID: PMC9653074 DOI: 10.1093/ntr/ntac155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 04/19/2022] [Accepted: 06/28/2022] [Indexed: 01/03/2023]
Abstract
INTRODUCTION International evidence from high-income countries demonstrates that the availability of tobacco tends to be greater in more urban and more deprived neighborhoods. However, little is known about the socio-spatial disparities in other settings, including megacities in China. This study investigated the patterning of tobacco retailers across Shanghai by types of tobacco retailers, including the relationship with levels of urbanity and neighborhood deprivation. AIMS AND METHODS Tobacco retailer data (n = 19 413) was extracted from a web-scraped Points-of-Interest database. For all communities (n = 5432) across Shanghai, neighborhood tobacco retail availability was calculated using population-weighted kernel density estimation and grouped by quintiles of neighborhood deprivation and a 3-level urban classification. Associations were analyzed using the Kruskal-Wallis tests and epsilon squared. RESULTS Across Shanghai, tobacco retail availability decreased from more urbanized areas to less urbanized areas. There was a statistical difference (p < .001) in the availability of tobacco retail across quintiles of deprivation, with the highest availability in the less deprived neighborhoods, and the lowest availability in the most deprived neighborhoods. However, this trend was reversed in the urban center, where retail availability was greatest in the most deprived areas. Convenience stores were the most common type of tobacco retailer across the city, while tobacco-only outlets were most strongly associated with levels of neighborhood deprivation. CONCLUSIONS The results show an association between tobacco retail availability and neighborhood deprivation, which varied with levels of urbanity and types of tobacco retailers. These findings provide supportive evidence for further interventions that target reducing inequalities in exposure to tobacco retail. IMPLICATIONS This is the first study to examine the relationship between tobacco retail availability and neighborhood deprivation in the context of Chinese megacities. Using data from Shanghai, China, we found a significant non-linear association between tobacco retail availability and neighborhood deprivation across the city. It is plausible that the socio-spatial disparities in tobacco retail availability at the neighborhood level may be a key factor explaining differences in smoking behaviors between sociodemographic groups. The findings emphasize the need for greater efforts in regulating neighborhood-level tobacco retailing in China.
Collapse
Affiliation(s)
- Chunyu Zheng
- Centre for Research on Environment, Society and Health, School of GeoSciences, University of Edinburgh, Edinburgh, UK
| | - Zhiqiang Feng
- Centre for Research on Environment, Society and Health, School of GeoSciences, University of Edinburgh, Edinburgh, UK
- Scottish Centre for Administrative Data Research, University of Edinburgh, Edinburgh, UK
| | - Jamie Pearce
- Centre for Research on Environment, Society and Health, School of GeoSciences, University of Edinburgh, Edinburgh, UK
| |
Collapse
|
20
|
Jenkins C, Schwartz E, Onnen N, Craigmile PF, Roberts ME. Variations in Tobacco Retailer Type Across Community Characteristics: Place Matters. Prev Chronic Dis 2022; 19:E49. [PMID: 35951439 PMCID: PMC9390794 DOI: 10.5888/pcd19.210454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Introduction The density of tobacco retailers varies by community characteristics such as poverty levels or racial and ethnic composition. However, few studies have investigated how specific types of tobacco retailers vary by community characteristics. Our objective was to assess how the types of tobacco retailers in Ohio varied by the characteristics of the communities in which they were located. Results For all US Census tracts, convenience stores were the most common type of retailer selling tobacco. Yet, the prevalence of convenience stores was higher in high-poverty urban tracts than in low-poverty urban tracts. Discount stores were the second-most common type of tobacco retailer and were most prevalent in rural tracts and high-racial and ethnic minority urban tracts. Grocery stores, pharmacies, and vape or hookah shops typically had the highest prevalence in more advantaged tracts. Conclusion Our findings demonstrate that the distribution of specific retailer types varies by community characteristics. The distribution of these retailer types has implications for product availability and price, which may subsequently affect tobacco use and cessation. To create equitable outcomes, policies should focus on retailers such as convenience and discount stores, which are heavily located in communities experiencing tobacco-related health disparities.
Collapse
Affiliation(s)
- Claire Jenkins
- College of Public Health, The Ohio State University, Columbus, Ohio
| | - Elli Schwartz
- College of Public Health, The Ohio State University, Columbus, Ohio
| | - Nathaniel Onnen
- Department of Statistics, The Ohio State University, Columbus, Ohio
| | | | - Megan E Roberts
- College of Public Health, The Ohio State University, Columbus, Ohio.,The Ohio State University, 1841 Neil Avenue, Columbus, OH 43210.
| |
Collapse
|
21
|
Bostean G, Sánchez LA, Douglas JA. Spatial Disparities: The Role of Nativity in Neighborhood Exposure to Alcohol and Tobacco Retailers. J Immigr Minor Health 2022; 24:945-955. [PMID: 34591231 DOI: 10.1007/s10903-021-01277-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/16/2021] [Indexed: 01/25/2023]
Abstract
Studies of retail environment, one of the social determinants of health, document racial/ethnic disparities in exposure to alcohol and tobacco (A and T) retailers, but have largely overlooked nativity. We examined associations between A and T retailer density and rates of foreign-born Latinx and foreign-born Asian residents in California census tracts (N = 7888), using spatial regressions and controlling for population and ecological confounders (e.g., population density, zoning, residential instability, urbanicity). Socio-demographic data came from the American Community Survey (2012-2016); census tract density of A and T retailers came from geocoded addresses from state license data for off-sale alcohol distributors and purchased data on tobacco retailers from a commercial provider. Models predicting A and T tract retailer density showed that the rate of foreign-born Latinx residents was associated with higher tobacco retailer density but lower alcohol retailer density, and demonstrate no significant associations between rate of foreign-born Asian residents tobacco and alcohol retail density. Retail environment could contribute to observed declines in immigrant health over time in the US and across generations.
Collapse
Affiliation(s)
- Georgiana Bostean
- Department of Sociology and Environmental Science and Policy Program, Chapman University, One University Drive, Orange, CA, 92866, USA.
| | - Luis A Sánchez
- Department of Sociology, California State University, Channel Islands, One University Drive, Camarillo, CA, 93012, USA
| | - Jason A Douglas
- Department of Health Sciences, Crean College of Health and Behavioral Sciences, Chapman University, One University Drive, Orange, CA, 92866, USA
| |
Collapse
|
22
|
Bourke J, Brooks MM, Siegel SD. Policy Recommendations for Reducing Tobacco Exposure for Youth and Adults in Wilmington, Delaware. Dela J Public Health 2022; 8:20-23. [PMID: 36177169 PMCID: PMC9495483 DOI: 10.32481/djph.2022.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Objective To highlight and recommend policies that can be projected to reduce disproportionate tobacco exposure for youth and adults in Wilmington, Delaware's densest and most disadvantaged neighborhoods. Four policy options were drawn from the literature: pharmacy tobacco bans, zoning-based tobacco retailer reductions, residential density caps, and buffers around K-12 schools. Method Changes in tobacco retailer density and resident-to-retailer distance in Wilmington's medium- and high- density residentially zoned neighborhoods were projected using GIS analysis of current conditions and projections for each of the four policies. Results Banning tobacco sales in pharmacies was found to be least effective, while 500-meter buffers around K-12 schools was projected to have the greatest impact on both retailer density and resident-to-retailer distance. Policy Implications As a result of these findings, the authors recommend a ban of tobacco sales with a 500-meter radius of all K-12 schools in the City of Wilmington.
Collapse
Affiliation(s)
- Jason Bourke
- Director, Master of Public Administration Program, Delaware State University
| | - Madeline M Brooks
- Research Investigator, Institute for Research on Equity & Community Health (iREACH), ChristianaCare
| | - Scott D Siegel
- Director, Master of Public Administration Program, Delaware State University
- Research Investigator, Institute for Research on Equity & Community Health (iREACH), ChristianaCare
- Director, Population Health; Institute for Research on Equity & Community Health (iREACH), ChristianaCare
| |
Collapse
|
23
|
Mills SD, Kong AY, Reimold AE, Baggett CD, Wiesen CA, Golden SD. Sociodemographic Disparities in Tobacco Retailer Density in the United States, 2000-2017. Nicotine Tob Res 2022; 24:1291-1299. [PMID: 35079790 PMCID: PMC9278831 DOI: 10.1093/ntr/ntac020] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Revised: 01/06/2022] [Accepted: 01/24/2022] [Indexed: 01/27/2023]
Abstract
INTRODUCTION Studies find differences in tobacco retailer density according to neighborhood sociodemographic characteristics, raising issues of social justice, but not all research is consistent. AIMS AND METHODS This study examined associations between tobacco retailer density and neighborhood sociodemographic characteristics in the United States at four timepoints (2000, 2007, 2012, and 2017) and investigated if associations remained stable over time. Data on tobacco retailers came from the National Establishment Time-Series Database. Adjusted log-linear models examined the relationship between retailer density and census tract sociodemographic characteristics (% non-Hispanic Black [Black], % Hispanic, % vacant housing units, median household income), controlling for percentage of youth, urbanicity, and US region. To examine whether the relationship between density and sociodemographic characteristics changed over time, additional models were estimated with interaction terms between each sociodemographic characteristic and year. RESULTS Tobacco retailer density ranged from 1.22 to 1.44 retailers/1000 persons from 2000 to 2017. There were significant, positive relationships between tobacco retailer density and the percentage of Black (standardized exp(b) = 1.05 [95% CI: 1.04% to 1.07%]) and Hispanic (standardized exp(b) = 1.06 [95% CI: 1.05% to 1.08%]) residents and the percentage of vacant housing units (standardized exp(b) =1.08 [95% CI: 1.07% to 1.10%]) in a census tract. Retailer density was negatively associated with income (standardized exp(b) = 0.84 [95% CI: 0.82% to 0.86%]). From 2000 to 2017, the relationship between retailer density and income and vacant housing units became weaker. CONCLUSIONS Despite the weakening of some associations, there are sociodemographic disparities in tobacco retailer density from 2000 to 2017, which research has shown may contribute to inequities in smoking. IMPLICATIONS This study examines associations between tobacco retailer density and neighborhood sociodemographic characteristics in the United States at four timepoints from 2000 to 2017. Although some associations weakened, there are sociodemographic disparities in tobacco retailer density over the study period. Research suggests that sociodemographic disparities in retailer density may contribute to inequities in smoking. Findings from this study may help identify which communities should be prioritized for policy intervention and regulation.
Collapse
Affiliation(s)
- Sarah D Mills
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, Chapel Hill, NC, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, Chapel Hill, NC, USA
| | - Amanda Y Kong
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, Chapel Hill, NC, USA
- Department of Family and Preventive Medicine, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- TSET Health Promotion Research Center, Stephenson Cancer Center, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Alexandria E Reimold
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, Chapel Hill, NC, USA
| | - Chris D Baggett
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, Chapel Hill, NC, USA
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, Chapel Hill, NC, USA
| | | | - Shelley D Golden
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, Chapel Hill, NC, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, Chapel Hill, NC, USA
| |
Collapse
|
24
|
Trapl E, Pike Moore S, Osborn C, Gupta N, Love TE, Kinzy TG, Kinsella A, Frank S. Evaluation of Restrictions on Tobacco Sales to Youth Younger Than 21 Years in Cleveland, Ohio, Area. JAMA Netw Open 2022; 5:e2222987. [PMID: 35819781 PMCID: PMC9277498 DOI: 10.1001/jamanetworkopen.2022.22987] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 06/04/2022] [Indexed: 11/14/2022] Open
Abstract
Importance Tobacco 21 (T21) policies raise the minimum legal age to purchase tobacco from 18 to 21 years to curb youth access to tobacco products. While some studies have found that T21 is associated with reducing prevalence of youth tobacco use, little is known about the impact it may have on youth of different racial and ethnic identities. Objective To evaluate the association of T21 policy with the prevalence of high school youth tobacco use across sex, race, and ethnicity. Design, Setting, and Participants This survey study used representative survey data collected from the local biennial Youth Risk Behavior Survey from 2013 to 2017 comparing Cleveland, Ohio (which has a T21 policy), to proximal jurisdictions in the first-ring suburbs in Cuyahoga County (which do not have T21 policies). Within-Cleveland demographic information was also collected for 2013 to 2019. Overall high school youth tobacco use rates were compared between Cleveland and the first-ring suburbs and then examined within Cleveland among Hispanic, non-Hispanic Black, and non-Hispanic White high school students. Percentage data were adjusted to more closely align with local population demographics. Data were analyzed from January to June 2022. Exposures T21 was implemented in Cleveland in 2016 and not adopted in proximal jurisdictions or at the state and federal level until at least 1 year later. Main Outcomes and Measures The main outcomes were prevalence of past 30-day cigarette, cigar product, or e-cigarette use, measured using geographically representative high school youth survey data from 2013 to 2015 (prelegislation) and 2017 to 2019 (postlegislation) and compared using a difference-in-differences analysis. Results The unweighted sample included 12 616 high school students (27.0% [95% CI, 26.9%-28.0%] in 10th grade; 50.9% [95% CI, 50.3%-51.6%] females) participating in 1 or more Youth Risk Behavior Surveys from 2013 to 2019, including 7064 students in Cleveland and 5552 students in the first-ring suburbs. Compared with the first-ring suburbs, Cleveland had a greater proportion of younger students (1623 [28.5%] ninth grade students vs 2179 [34.0%] ninth grade students) and Hispanic students (436 students [1.1%] vs 1433 students [12.6%]) and non-Hispanic Black students (2000 students [53.1%] vs 3971 students [75.1%]). Cigars were the most commonly used tobacco product in Cleveland, with use reported by 6201 students (19.8%) in 2013, 5877 students (21.3%) in 2015, and 5784 students (16.8%) in 2019. Compared with the first-ring suburbs, there was a greater decline in prevalence of use of cigars in Cleveland (β = 0.18 [SE, 0.05]; P < .001). The disparity across race, ethnicity, and sex decreased for all current tobacco product use. For example, the maximum difference between demographic subpopulations in current cigarette use was 11.6 (95% CI, 9.5-13.7) percentage points in 2013 between White females (16.1% [95% CI, 11.3%-20.8%]) and Black males (4.5% [95% CI, 3.5%-5.4%]). This maximum difference in current cigarette use decreased significantly to 5.1 (95% CI, 3.5-6.7) percentage points in 2019 between White females (6.9% [95% CI, 3.4%-10.3%]) and Black females (1.8% [95% CI, 0.7%-2.8%]). Conclusions and Relevance This survey study found that there was a decline in youth-reported tobacco use across every tobacco product category from 2013 to 2019. This decline changed the trajectory of use among several demographic groups and brought the youth populations with the highest tobacco product use to similar rates of others.
Collapse
Affiliation(s)
- Erika Trapl
- Prevention Research Center for Healthy Neighborhoods, Case Western Reserve University, Cleveland, Ohio
| | - Stephanie Pike Moore
- Prevention Research Center for Healthy Neighborhoods, Case Western Reserve University, Cleveland, Ohio
| | - Catherine Osborn
- Prevention Research Center for Healthy Neighborhoods, Case Western Reserve University, Cleveland, Ohio
| | - Neha Gupta
- Case Western Reserve University, Cleveland, Ohio
| | - Thomas E. Love
- Case Western Reserve University, Cleveland, Ohio
- Population Health Research Institute, The MetroHealth System, Cleveland, Ohio
| | | | - Audrey Kinsella
- Prevention Research Center for Healthy Neighborhoods, Case Western Reserve University, Cleveland, Ohio
| | - Scott Frank
- Case Western Reserve University, Cleveland, Ohio
| |
Collapse
|
25
|
Kong AY, Delamater PL, Gottfredson NC, Ribisl KM, Baggett CD, Golden SD. Neighborhood Inequities in Tobacco Retailer Density and the Presence of Tobacco-Selling Pharmacies and Tobacco Shops. HEALTH EDUCATION & BEHAVIOR 2022; 49:478-487. [PMID: 33870767 PMCID: PMC8523582 DOI: 10.1177/10901981211008390] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Studies document inequitable tobacco retailer density by neighborhood sociodemographics, but these findings may not be robust to different density measures. Policies to reduce density may be less equitable depending on how the presence of store types differs by neighborhood characteristics. We built a 2018 list of probable tobacco retailers in the United States and calculated four measures of density for all census tracts (N = 71,495), including total count, and number of retailers per 1,000 people, square mile, and kilometers of roadway. We fit multivariable regression models testing associations between each density measure and tract-level sociodemographics. We fit logistic regression models testing associations between sociodemographics and the presence of a tobacco-selling pharmacy or tobacco shop. Across all measures, tracts with a greater percentage of residents living below 150% of the federal poverty level (FPL) had higher density. A higher percentage of Black residents, Hispanic or Latino residents, and vacant housing was inconsistently associated with density across measures. Neighborhoods with a greater percentage of Black residents had a lower odds of having a pharmacy (adjusted odds ratio [aOR] = 0.96, 95% confidence interval [CI; 0.95, 0.97]) and tobacco shop (aOR = 0.87, CI [0.86, 0.89]), while those with a greater percentage of residents living below 150% FPL had greater odds of having a tobacco shop (aOR = 1.18, CI [1.16, 1.20]). Researchers and policymakers should consider how various measures of retailer density may capture different aspects of the environment. Furthermore, there may be an inequitable impact of retailer-specific policies on tobacco availability.
Collapse
|
26
|
Kong AY, Henriksen L. Retail endgame strategies: reduce tobacco availability and visibility and promote health equity. Tob Control 2022; 31:243-249. [PMID: 35241596 PMCID: PMC8908901 DOI: 10.1136/tobaccocontrol-2021-056555] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 01/06/2022] [Indexed: 12/26/2022]
Abstract
An increasing number of countries have set tobacco endgame goals that target dramatic reductions in smoking prevalence. To achieve those targets and promote health equity, policies are needed to reduce the retail supply and visibility of tobacco products. Focusing on retailer reduction strategies and tobacco display bans, this special communication reviews solution-oriented research about the retail environment. It highlights examples of policy implementation and identifies data needs and research gaps for designing and evaluating retail policies to promote population health equitably.
Collapse
Affiliation(s)
- Amanda Y Kong
- Family and Preventive Medicine, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
- TSET Health Promotion Center, Stephenson Cancer Center, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Lisa Henriksen
- Stanford Prevention Research Center, Stanford University School of Medicine, Palo Alto, California, USA
| |
Collapse
|
27
|
Kaviany P, Senter JP, Collaco JM, Corrigan AE, Brigham E, Wood M, Woo H, Liu C, Koehl R, Galiatsatos P, Koehler K, Hansel N, McCormack M. Spatial analysis of tobacco outlet density on secondhand smoke exposure and asthma health among children in Baltimore City. Tob Control 2022; 32:tobaccocontrol-2021-056878. [PMID: 35046128 PMCID: PMC9294062 DOI: 10.1136/tobaccocontrol-2021-056878] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 12/27/2021] [Indexed: 11/03/2022]
Abstract
RATIONALE Tobacco outlets are concentrated in low-income neighbourhoods; higher tobacco outlet density is associated with increased smoking prevalence. Secondhand smoke (SHS) exposure has significant detrimental effects on childhood asthma. We hypothesised there was an association between higher tobacco outlet density, indoor air pollution and worse childhood asthma. METHODS Baseline data from a home intervention study of 139 children (8-17 years) with asthma in Baltimore City included residential air nicotine monitoring, paired with serum cotinine and asthma control assessment. Participant addresses and tobacco outlets were geocoded and mapped. Multivariable regression modelling was used to describe the relationships between tobacco outlet density, SHS exposure and asthma control. RESULTS Within a 500 m radius of each participant home, there were on average six tobacco outlets. Each additional tobacco outlet in a 500 m radius was associated with a 12% increase in air nicotine (p<0.01) and an 8% increase in serum cotinine (p=0.01). For every 10-fold increase in air nicotine levels, there was a 0.25-point increase in Asthma Therapy Assessment Questionnaire (ATAQ) score (p=0.01), and for every 10-fold increase in serum cotinine levels, there was a 0.54-point increase in ATAQ score (p<0.05). CONCLUSIONS Increased tobacco outlet density is associated with higher levels of bedroom air nicotine and serum cotinine. Increasing levels of SHS exposure (air nicotine and serum cotinine) are associated with less controlled childhood asthma. In Baltimore City, the health of children with asthma is adversely impacted in neighbourhoods where tobacco outlets are concentrated. The implications of our findings can inform community-level interventions to address these health disparities.
Collapse
Affiliation(s)
- Parisa Kaviany
- Eudowood Division of Pediatric Respiratory Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - James Paul Senter
- Pediatrics Residency Program, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Joseph Michael Collaco
- Eudowood Division of Pediatric Respiratory Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Anne E Corrigan
- Spatial Science for Public Health Center, Johns Hopkins University, Baltimore, Maryland, USA
| | - Emily Brigham
- Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Megan Wood
- Department of Environmental Health and Engineering, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Han Woo
- Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Chen Liu
- Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Rachelle Koehl
- Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Panagis Galiatsatos
- Pulmonary and Critical Care Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Kirsten Koehler
- Department of Environmental Health and Engineering, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Nadia Hansel
- Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Meredith McCormack
- Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| |
Collapse
|
28
|
Alharthy A, Hosler AS, Leckman-Westin E, Kammer JR. Association Between Tobacco Retailer Density and Smoking Among Adults With Diabetes and Serious Mental Illness in New York State. Prev Chronic Dis 2022; 19:E01. [PMID: 34990338 PMCID: PMC8794262 DOI: 10.5888/pcd19.210270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Smoking prevalence is high among adults with comorbid diabetes and serious mental illness. This population is at elevated risk of smoking-related health consequences and premature death. We focused on the community environment and investigated the association between tobacco retailer density and smoking in this population. METHODS We obtained individual-level data from the 2017 Patient Characteristics Survey, a medical record-based survey of patients served by the public mental health system in New York State. We computed the density of state-authorized tobacco retailers at the 3-digit zip code level. RESULTS The data included 19,492 adults (aged ≥18) with comorbid diabetes and serious mental illness. Of these, 55.6% resided in New York City, 53.1% were female, 38.1% were non-Hispanic White, 30.7% were non-Hispanic Black, 25.2% were Hispanic, and 38.1% were smokers, including electronic cigarette users. The density of tobacco retailers (range, 6.1-16.4 per 10,000 population) was positively associated with smoking (odds ratio = 1.05; 95% CI, 1.03-1.07) after adjusting for sex, race or ethnicity, education, employment, health insurance coverage, obesity, and region (New York City vs outside New York City). We observed no interaction between region and tobacco retailer density. CONCLUSION Findings of this study suggest that allocating more smoking cessation resources to zip code areas with a high density of tobacco retailers, especially in rural areas, along with supporting policy change to reduce tobacco retailor density, may mitigate the negative health consequences of smoking among people with comorbid diabetes and serious mental illness.
Collapse
Affiliation(s)
- Amani Alharthy
- Department of Epidemiology and Biostatistics, University at Albany School of Public Health, Rensselaer, New York
- Department of Epidemiology, Princess Nourah bint Abdulrahman University College of Health and Rehabilitation Sciences, Riyadh, Saudi Arabia
- Department of Epidemiology and Health Sciences, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia.
| | - Akiko S Hosler
- Department of Epidemiology and Biostatistics, University at Albany School of Public Health, Rensselaer, New York
| | - Emily Leckman-Westin
- Department of Epidemiology and Biostatistics, University at Albany School of Public Health, Rensselaer, New York
- New York State Office of Mental Health, Albany, New York
| | - Jamie R Kammer
- New York State Office of Mental Health, Albany, New York
| |
Collapse
|
29
|
Kong AY, Golden SD, Ribisl KM, Krukowski RA, Vandegrift SM, Little MA. Cheaper tobacco product prices at US Air Force Bases compared with surrounding community areas, 2019. Tob Control 2021; 31:e169-e174. [PMID: 34907089 DOI: 10.1136/tobaccocontrol-2021-056984] [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: 08/16/2021] [Accepted: 11/17/2021] [Indexed: 11/04/2022]
Abstract
INTRODUCTION In March 2017, the US Department of Defense (DoD) implemented a policy requiring all military stores to set tobacco prices equal to 'prevailing prices' in the 'local community' adjusted for state and local taxes. We compared tobacco product prices in a sample of retailers located on five Air Force Bases (AFBs) in Texas and Mississippi with those sold in nearby off-base stores. METHODS We constructed a list of on-base and off-base tobacco retailers. Off-base retailers included stores that were located within a 1.5-mile road network service area from main AFB gates. Between July and September 2019, a trained auditor visited 23 on-base and 50 off-base retailers to confirm tobacco product sales, and documented the price of cigarettes and Copenhagen smokeless tobacco. For each area, the median price for each product, as well as the difference in median prices by on-base versus off-base status, was calculated. RESULTS The median price of cigarettes and smokeless products was cheaper at on-base retailers. All products were cheaper at on-base stores in Fort Sam Houston and Lackland AFB. Similarly, all products were cheaper in on-base stores at Keesler AFB, with the exception of Marlboro Red packs ($0.22 more), and at Sheppard AFB with the exception of cheapest cigarette cartons ($6.26 more). CONCLUSION Despite the implementation of the new DoD policy, tobacco products are cheaper in on-base retailers compared with off-base retailers. Refining of the definitions used and improved compliance with the new DoD policy are needed.
Collapse
Affiliation(s)
- Amanda Y Kong
- TSET Health Promotion Research Center, Stephenson Cancer Center, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.,Family & Preventive Medicine, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.,Health Behavior, University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, NC, USA
| | - Shelley D Golden
- Health Behavior, University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, NC, USA.,Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Kurt M Ribisl
- Health Behavior, University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, NC, USA.,Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Rebecca A Krukowski
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Sara M Vandegrift
- Health Behavior, University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, NC, USA
| | - Melissa A Little
- Public Health Sciences, University of Virginia, Charlottesville, VA, USA
| |
Collapse
|
30
|
Kong AY, King BA. Boosting the Tobacco Control Vaccine: recognizing the role of the retail environment in addressing tobacco use and disparities. Tob Control 2021; 30:e162-e168. [PMID: 32967986 PMCID: PMC9377406 DOI: 10.1136/tobaccocontrol-2020-055722] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 07/22/2020] [Accepted: 07/28/2020] [Indexed: 01/18/2023]
Abstract
Much of the progress in reducing cigarette smoking and tobacco-related morbidity and mortality among youth and adults is attributable to population-level strategies previously described in the context of the Tobacco Control Vaccine. The retail environment is used heavily by the tobacco industry to promote and advertise its products, and variations in exposure to and characteristics of the retail environment exist across demographic groups. It is therefore also an essential environment for further reducing smoking, as well as ameliorating racial, ethnic and socioeconomic tobacco-related disparities. This commentary provides an overview of the importance of incorporating strategies focused on the tobacco retailer environment (availability; pricing and promotion; advertising and display; age of sale; and retail licensure) as part of a comprehensive approach to tobacco prevention and control. To reach tobacco endgame targets, such innovative strategies are a complement to, but not a replacement for, long-standing evidence-based components of the Tobacco Control Vaccine.
Collapse
Affiliation(s)
- Amanda Y Kong
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Brian A King
- Office on Smoking and Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| |
Collapse
|
31
|
Fakunle DO, Curriero FC, Leaf PJ, Furr-Holden DM, Thorpe RJ. Black, white, or green? The effects of racial composition and socioeconomic status on neighborhood-level tobacco outlet density. ETHNICITY & HEALTH 2021; 26:1012-1027. [PMID: 31124377 PMCID: PMC6875694 DOI: 10.1080/13557858.2019.1620178] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2018] [Accepted: 05/14/2019] [Indexed: 05/23/2023]
Abstract
Objective: To compare predominantly-Black and predominantly-White Maryland areas with similar socioeconomic status to examine the role of both race and socioeconomic status on tobacco outlet availability and tobacco outlet access.Design: Maryland tobacco outlet addresses were geocoded with 2011-2015 American Community Survey sociodemographic data. Two-sample t-tests were conducted comparing the mean values of sociodemographic variables and tobacco outlet density per Census Tract, and spatial lag based regression models were conducted to analyze the direct association between covariables and tobacco outlet density while accounting for spatial dependence between and within jurisdictions.Results: Predominantly-White jurisdictions had lower tobacco outlet availability and access than predominantly-Black jurisdictions, despite similar socioeconomic status. Spatial lag model results showed that median household income and vacant houses had consistent associations with tobacco outlet density across most of the jurisdictions analyzed, and place-based spatial lag models showed direct associations between predominantly-Black jurisdictions and tobacco outlet availability and access.Conclusion: Predominantly-White areas have lower levels of tobacco outlet density than predominantly-Black areas, despite both areas having similar socioeconomic statuses.
Collapse
Affiliation(s)
- David O. Fakunle
- Kaiser Research Fellow, School of Community Health & Policy – Morgan State University, Baltimore, Maryland
- Department of Mental Health – Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Frank C. Curriero
- Department of Epidemiology – Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Philip J. Leaf
- Department of Mental Health – Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Debra M. Furr-Holden
- Division of Public Health – Michigan State University College of Human Medicine, Flint, Michigan
| | - Roland J. Thorpe
- Department of Health, Behavior & Society – Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| |
Collapse
|
32
|
Tseng TS, Celestin MD, Yu Q, Li M, Luo T, Moody-Thomas S. Use of Geographic Information System Technology to Evaluate Health Disparities in Smoking Cessation Class Accessibility for Patients in Louisiana Public Hospitals. Front Public Health 2021; 9:712635. [PMID: 34476230 PMCID: PMC8406529 DOI: 10.3389/fpubh.2021.712635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 07/14/2021] [Indexed: 11/13/2022] Open
Abstract
Research has shown cigarette smoking is a major risk factors for many type of cancer or cancer prognosis. Tobacco related health disparities were addressed continually in cancer screening, diagnosis, treatment, prevention and control. The present study evaluated the health disparities in attendance of smoking cessation counseling classes for 4,826 patients scheduled to attend between 2005 and 2007. Of 3,781 (78.4%) patients with records to calculate the distance from their home domicile to counseling sites using Geographic Information System technology, 1,435 (38%) of smokers who attended counseling had shorter travel distances to counseling sites (11.6 miles, SD = 11.29) compared to non-attendees (13.4 miles, SD = 16.72). When the travel distance was >20 miles, the estimated odds of attending decreased with greater travel distance. Smokers who actually attended were more likely to be older, female, White, living in urban areas, and receiving free healthcare. After controlling for other socio-demographic factors, shorter distances were associated with greater class attendance, and individuals more likely to attend included those that lived closer to the counseling site and in urban settings, were female, White, commercially insured, and older than their counterparts. These findings have the potential to provide important insights for reducing health disparities for cancer prevention and control, and to improve shared decision making between providers and smokers.
Collapse
Affiliation(s)
- Tung Sung Tseng
- Behavioral and Community Health Sciences, School of Public Health, Louisiana State University Health Sciences Center, New Orleans, LA, United States
| | - Michael D Celestin
- Behavioral and Community Health Sciences, School of Public Health, Louisiana State University Health Sciences Center, New Orleans, LA, United States
| | - Qingzhao Yu
- Behavioral and Community Health Sciences, School of Public Health, Louisiana State University Health Sciences Center, New Orleans, LA, United States
| | - Mirandy Li
- Behavioral and Community Health Sciences, School of Public Health, Louisiana State University Health Sciences Center, New Orleans, LA, United States.,Louisiana State University Health New Orleans, School of Medicine, New Orleans, LA, United States
| | - Ting Luo
- Moores Cancer Center, School of Medicine, University of California San Diego, San Diego, CA, United States
| | - Sarah Moody-Thomas
- Behavioral and Community Health Sciences, School of Public Health, Louisiana State University Health Sciences Center, New Orleans, LA, United States
| |
Collapse
|
33
|
Oliver JA, Sweitzer MM, Engelhard MM, Hallyburton MB, Ribisl KM, McClernon FJ. Identifying neural signatures of tobacco retail outlet exposure: Preliminary validation of a "community neuroscience" paradigm. Addict Biol 2021; 26:e13029. [PMID: 33663023 DOI: 10.1111/adb.13029] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 12/23/2020] [Accepted: 02/22/2021] [Indexed: 11/27/2022]
Abstract
An extensive epidemiological literature indicates that increased exposure to tobacco retail outlets (TROs) places never smokers at greater risk for smoking uptake and current smokers at greater risk for increased consumption and smoking relapse. Yet research into the mechanisms underlying this effect has been limited. This preliminary study represents the first effort to examine the neurobiological consequences of exposure to personally relevant TROs among both smokers (n = 17) and nonsmokers (n = 17). Individuals carried a global positioning system (GPS) tracker for 2 weeks. Traces were used to identify TROs and control outlets that fell inside and outside their ideographically defined activity space. Participants underwent functional MRI (fMRI) scanning during which they were presented with images of these storefronts, along with similar store images from a different county and rated their familiarity with these stores. The main effect of activity space was additive with a Smoking status × Store type interaction, resulting in smokers exhibiting greater neural activation to TROs falling inside activity space within the parahippocampus, precuneus, medial prefrontal cortex, and dorsal anterior insula. A similar pattern was observed for familiarity ratings. Together, these preliminary findings suggest that the otherwise distinct neural systems involved in self-orientation/self-relevance and smoking motivation may act in concert and underlie TRO influence on smoking behavior. This study also offers a novel methodological framework for evaluating the influence of community features on neural activity that can be readily adapted to study other health behaviors.
Collapse
Affiliation(s)
- Jason A. Oliver
- Department of Psychiatry and Behavioral Sciences Duke University School of Medicine Durham North Carolina USA
- Cancer Control and Population Sciences Program Duke Cancer Institute Durham North Carolina USA
| | - Maggie M. Sweitzer
- Department of Psychiatry and Behavioral Sciences Duke University School of Medicine Durham North Carolina USA
| | - Matthew M. Engelhard
- Department of Psychiatry and Behavioral Sciences Duke University School of Medicine Durham North Carolina USA
| | - Matthew B. Hallyburton
- Department of Psychiatry and Behavioral Sciences Duke University School of Medicine Durham North Carolina USA
| | - Kurt M. Ribisl
- Department of Health Behavior UNC Gillings School of Global Public Health Chapel Hill North Carolina USA
- Cancer Prevention and Control UNC Lineberger Comprehensive Cancer Center Chapel Hill North Carolina USA
| | - Francis Joseph McClernon
- Department of Psychiatry and Behavioral Sciences Duke University School of Medicine Durham North Carolina USA
- Cancer Control and Population Sciences Program Duke Cancer Institute Durham North Carolina USA
| |
Collapse
|
34
|
Kong AY, Gottfredson NC, Ribisl KM, Baggett CD, Delamater PL, Golden SD. Associations of County Tobacco Retailer Availability With U.S. Adult Smoking Behaviors, 2014-2015. Am J Prev Med 2021; 61:e139-e147. [PMID: 34134883 PMCID: PMC8384706 DOI: 10.1016/j.amepre.2021.03.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 02/26/2021] [Accepted: 03/21/2021] [Indexed: 12/13/2022]
Abstract
INTRODUCTION Greater availability of tobacco product retailers in an area may be associated with smoking behaviors, and the majority of people who smoke purchase their cigarettes at gas stations and convenience stores. This cross-sectional study investigates the associations of overall tobacco retailer density and gas/convenience density with adult smoking behaviors. METHODS This study built a list of tobacco retailers in 2014 and calculated the county-level number of retailers per 1,000 people. Individual-level smoking behavior data were drawn from the 2014-2015 Tobacco Use Supplement for a sample of adults (n=88,850) residing in metropolitan counties across the U.S. General estimating equation models were fit to investigate the associations between retailer density and cigarette smoking behaviors (smoking status, quit attempt, quit length). Analyses were conducted in 2020. RESULTS A greater number of tobacco retailers (AOR=1.63, 95% CI=1.35, 1.96) and gas stations and convenience stores (AOR=3.29, 95% CI=2.39, 4.52) per 1,000 people were each associated with a higher odds of a respondent smoking every day than the odds of a respondent not smoking. In addition, both measures were associated with a higher odds of a respondent being an every-day than being a some-day smoker. Associations for gas/convenience density were similar in models that additionally controlled for other tobacco retailers (excluding gas/convenience). Study results did not support associations between retailer density and cessation. CONCLUSIONS Tobacco retailer density, especially gas/convenience density, is correlated with daily smoking, the most harmful tobacco use behavior. Calculating tobacco retailer density using gas/convenience stores may be a feasible proxy for overall tobacco retailer density.
Collapse
Affiliation(s)
- Amanda Y Kong
- Department of Health Behavior, UNC Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
| | - Nisha C Gottfredson
- Department of Health Behavior, UNC Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Kurt M Ribisl
- Department of Health Behavior, UNC Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; UNC Lineberger Comprehensive Cancer Center, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Chris D Baggett
- UNC Lineberger Comprehensive Cancer Center, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Department of Epidemiology, UNC Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Paul L Delamater
- UNC Lineberger Comprehensive Cancer Center, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Department of Geography, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Shelley D Golden
- Department of Health Behavior, UNC Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; UNC Lineberger Comprehensive Cancer Center, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| |
Collapse
|
35
|
Kong AY, Delamater PL, Gottfredson NC, Ribisl KM, Baggett CD, Golden SD. Sociodemographic inequities in tobacco retailer density: Do neighboring places matter? Health Place 2021; 71:102653. [PMID: 34461529 PMCID: PMC8490323 DOI: 10.1016/j.healthplace.2021.102653] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 08/07/2021] [Accepted: 08/10/2021] [Indexed: 11/28/2022]
Abstract
We apply a spatial perspective to measure the extent to which the 2018 U.S. racial, ethnic, and socioeconomic composition of census tracts were each associated with tobacco retailer density within a tract and in its neighboring tracts (n = 71,409). A 10-percentage point increase in the Black population was associated with 0.07 (p < 0.05) more retailers per square mile within a focal tract and 0.35 (p < 0.001) more retailers per square mile in its neighbors on average. A greater percent of Hispanic/Latino residents was associated with more retailers per square mile, both within a focal tract (b = 0.95, p < 0.001) and in its neighbors 0.39 (p < 0.001). Inverse associations were observed for percent white. We also observed inequities by socioeconomic status. The overall magnitude of inequities may be underestimated if the spatial dependence between focal tracts and their neighbors are not taken into consideration. Policymakers should prioritize interconnected geographic areas experiencing high racialized and socioeconomic segregation when designing and implementing policies to reduce retail tobacco product availability.
Collapse
Affiliation(s)
- 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.
| | - Paul L Delamater
- Department of Geography, University of North Carolina, Carolina Hall, Chapel Hill, NC, 27599-7435, USA
| | - Nisha C Gottfredson
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, 135 Dauer Drive, Chapel Hill, NC, 27599-7440, 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
| | - Chris 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
| | - 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
| |
Collapse
|
36
|
Golden SD, Baggett CD, Kuo TM, Kong AY, Delamater PL, Tao VQ, Ribisl KM. Trends in the Number and Type of Tobacco Product Retailers, United States, 2000-2017. Nicotine Tob Res 2021; 24:77-84. [PMID: 34302488 DOI: 10.1093/ntr/ntab150] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 07/23/2021] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Tobacco product retailers provide access to tobacco products and exposure to tobacco marketing. Without a national tobacco retailer licensing system in the United States (U.S.), there are no estimates of national trends in tobacco retailer numbers and store type over time. METHODS We developed a protocol to identify likely tobacco retailers across the U.S. between 2000-2017 using industry codes and retailer names in the annual National Establishment Time Series (NETS) database. We calculated annual counts of tobacco retailers in seven store type categories, and annual numbers of tobacco retailers that opened and closed. RESULTS We estimate that there were 317,492 tobacco product retailers in 2000; the number grew to 412,536 in 2009 before falling to 356,074 in 2017, for a net 12% increase overall. Gas/convenience stores and grocery stores accounted for more than two thirds of all retailers. On average, new openings accounted for 8.0% of the total retailers, while 7.3% of retailers closed or stopped selling tobacco each year, with stronger market volatility following the Great Recession. Since 2011, there was a disproportionate reduction in tobacco-selling pharmacies, and an increase in both tobacco-specialty shops and tobacco-selling discount stores. CONCLUSIONS During two decades when smoking declined, tobacco retailer availability increased in the U.S. The economic climate, corporate and public policies, and new tobacco products may all contribute to trends in tobacco retailer availability. State and local jurisdictions considering tobacco retailer policies may find retailer trend information useful for forecasting or evaluating potential policy impacts. IMPLICATIONS This study provides historic data tracking tobacco retailers in the U.S. between 2000-2017, documenting trends that unfolded as the general economic market contracted and grew, with greater regulation of the tobacco retailer environment. These data provide a context for better understanding future changes in the tobacco retailer market. In addition, the protocol established in this study could be applied in any U.S.-based location without tobacco retailer licensing to allow identification of stores and tracking of trends.
Collapse
Affiliation(s)
- Shelley D Golden
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, USA.,Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, USA
| | - Christopher D Baggett
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, USA.,Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, USA
| | - Tzy-Mey Kuo
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, USA
| | - Amanda Y Kong
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, USA
| | - Paul L Delamater
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, USA.,Department of Geography, University of North Carolina, Chapel Hill, NC, USA.,Carolina Population Center, University of North Carolina, Chapel Hill, NC, USA
| | - Vivian Qingzi Tao
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, USA
| | - Kurt M Ribisl
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, USA.,Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, USA
| |
Collapse
|
37
|
Siegel SD, Brooks M, Bourke J, Curriero FC. Reducing Exposure to Tobacco Retailers with Residential Zoning Policy: Insights from a Geospatial Analysis of Wilmington, Delaware. CITIES & HEALTH 2021; 6:752-764. [PMID: 36570619 PMCID: PMC9783014 DOI: 10.1080/23748834.2021.1935141] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 05/21/2021] [Indexed: 01/03/2023]
Abstract
Cigarette use remains the leading preventable cause of premature mortality in the US, with declines in smoking rates slowing in recent years. One promising target for improved tobacco control is the expanded regulation of tobacco retailers. Evaluations of such policy attempts have largely produced mixed results to date. The objective of this study was to the assess the potential of using a novel, residentially-focused zoning approach to produce a more targeted and equitable reduction in tobacco retailers in high-risk urban settings. We focused on Wilmington, Delaware, a city characterized by high poverty rates, a majority Black population, a disparate number of tobacco retailers, and an elevated smoking prevalence. Through the use of geospatial analyses, we observed disproportionately higher counts of convenience store tobacco retailers in medium- and high-density residential zones in Wilmington relative to the surrounding county. By linking electronic health record (EHR) data from a local health care system and US Census Bureau data, we further found that approximately 80% of Wilmington smokers and 60% of Wilmington youth lived in these residential zones. These findings highlight the potential to more equitably reduce tobacco retailer exposure through a residentially-focused zoning approach. Tobacco control policy and research implications are considered.
Collapse
Affiliation(s)
- Scott D. Siegel
- Institute for Research on Equity and Community Health, Christiana Care Health System
- Helen F. Graham Cancer Center & Research Institute, Christiana Care Health System
| | - Madeline Brooks
- Institute for Research on Equity and Community Health, Christiana Care Health System
| | | | - Frank C. Curriero
- Johns Hopkins Spatial Science for Public Health Center, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health
| |
Collapse
|
38
|
Delanois RE, Tarazi JM, Wilkie WA, Remily E, Salem HS, Mohamed NS, Pollack AN, Mont MA. Social determinants of health in total knee arthroplasty : are social factors associated with increased 30-day post-discharge cost of care and length of stay? Bone Joint J 2021; 103-B:113-118. [PMID: 34053276 DOI: 10.1302/0301-620x.103b6.bjj-2020-2430.r1] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AIMS Social determinants of health (SDOHs) may contribute to the total cost of care (TCOC) for patients undergoing total knee arthroplasty (TKA). The aim of this study was to investigate the association between demographic data, health status, and SDOHs on 30-day length of stay (LOS) and TCOC after this procedure. METHODS Patients who underwent TKA between 1 January 2018 and 31 December 2019 were identified. A total of 234 patients with complete SDOH data were included. Data were drawn from the Chesapeake Regional Information System, the Centers for Disease Control social vulnerability index (SVI), the US Department of Agriculture, and institutional electronic medical records. The SVI identifies areas vulnerable to catastrophic events with four themed scores: socioeconomic status; household composition and disability; minority status and language; and housing and transportation. Food deserts were defined as neighbourhoods located one or ten miles from a grocery store in urban and rural areas, respectively. Multiple regression analyses were performed to determine associations with LOS and costs after controlling for various demographic parameters. RESULTS Divorced status was significantly associated with an increased LOS (p = 0.043). Comorbidities significantly associated with an increased LOS included chronic obstructive pulmonary disease/asthma and congestive heart failure (p = 0.043 and p = 0.001, respectively). Communities with a higher density of tobacco stores were significantly associated with an increased LOS (p = 0.017). Comorbidities significantly associated with an increased TCOC included chronic obstructive pulmonary disease (p = 0.004), dementia (p = 0.048), and heart failure (p = 0.007). Increased TCOCs were significantly associated with patients who lived in food deserts (p = 0.001) and in areas with an increased density of tobacco stores (p = 0.023). CONCLUSION Divorced marital status was significantly associated with an increased LOS following TKA. Living in food deserts and in communities with more tobacco stores were significant risk factors for increased LOS and TCOC. Food access and ease of acquiring tobacco may both prove to be prognostic of outcome after TKA and an opportunity for intervention. Cite this article: Bone Joint J 2021;103-B(6 Supple A):113-118.
Collapse
Affiliation(s)
- Ronald E Delanois
- Center for Joint Preservation and Replacement, Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, Baltimore, Maryland, USA
| | - John M Tarazi
- Northwell Health Orthopaedics, Lenox Hill Hospital, New York, New York, USA
| | - Wayne A Wilkie
- Center for Joint Preservation and Replacement, Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, Baltimore, Maryland, USA
| | - Ethan Remily
- Center for Joint Preservation and Replacement, Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, Baltimore, Maryland, USA
| | - Hytham S Salem
- Northwell Health Orthopaedics, Lenox Hill Hospital, New York, New York, USA
| | - Nequesha S Mohamed
- Center for Joint Preservation and Replacement, Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, Baltimore, Maryland, USA
| | - Andrew N Pollack
- Center for Joint Preservation and Replacement, Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, Baltimore, Maryland, USA.,Orthopaedic Surgery, University of Maryland Medical System, Baltimore, Maryland, USA
| | - Michael A Mont
- Northwell Health Orthopaedics, Lenox Hill Hospital, New York, New York, USA
| |
Collapse
|
39
|
Cambron C, Lam CY, Cinciripini P, Li L, Wetter DW. Socioeconomic Status, Social Context, and Smoking Lapse During a Quit Attempt: An Ecological Momentary Assessment Study. Ann Behav Med 2021; 54:141-150. [PMID: 31612218 DOI: 10.1093/abm/kaz034] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Low socioeconomic status (SES) is linked to failure to quit smoking. Health inequity models suggest that low SES smokers experience barriers to quitting in part due to greater exposure to pro-smoking social contexts. PURPOSE The current study examined longitudinal associations among socioeconomic status, pro-smoking social context factors (i.e., exposure to other smokers, places where smoking was allowed), cigarette availability, and smoking lapse during a quit attempt. METHODS Ecological momentary assessments (EMA) were gathered from a multiethnic sample of 365 smokers engaged in a quit attempt. A multilevel structural equation model estimated a latent variable for SES indicated by income, education, health insurance, and employment, associations among EMAs for pro-smoking social contexts and cigarette availability, and indirect effects of SES through, pro-smoking social contexts and cigarette availability to subsequent smoking lapse. RESULTS Lower SES scores were associated with a higher likelihood of smoking lapse. Decomposition of the path from SES to smoking lapse into indirect effects showed significant paths through exposure to places where smoking is allowed and cigarette availability. Additionally, significant serial indirect paths from SES through both exposure to other smokers and places where smoking was allowed, in turn, through cigarette availability, and, ultimately, to smoking lapse were noted. CONCLUSIONS Consistent with models positing that SES influences health behaviors via contextual factors, the current study demonstrated that low SES smokers attempting to quit experienced greater pro-smoking social contexts that affected subsequent risk for lapse.
Collapse
Affiliation(s)
- Christopher Cambron
- College of Social Work, University of Utah, Salt Lake City, UT.,Huntsman Cancer Institute and the Department of Population Health Sciences, University of Utah, Salt Lake City, UT
| | - Cho Y Lam
- Huntsman Cancer Institute and the Department of Population Health Sciences, University of Utah, Salt Lake City, UT
| | - Paul Cinciripini
- Department of Behavioral Science, M. D. Anderson Cancer Center, The University of Texas, Austin, TX
| | - Liang Li
- Department of Biostatistics, M. D. Anderson Cancer Center, The University of Texas, Austin, TX
| | - David W Wetter
- Huntsman Cancer Institute and the Department of Population Health Sciences, University of Utah, Salt Lake City, UT
| |
Collapse
|
40
|
Brooks MM, Siegel SD, Curriero FC. Characterizing the spatial relationship between smoking status and tobacco retail exposure: Implications for policy development and evaluation. Health Place 2021; 68:102530. [PMID: 33609995 PMCID: PMC7986985 DOI: 10.1016/j.healthplace.2021.102530] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 02/03/2021] [Accepted: 02/04/2021] [Indexed: 11/20/2022]
Abstract
Tobacco retail density and smoking prevalence remain elevated in marginalized communities, underscoring the need for strategies to address these place-based disparities. The spatial variation of smokers and tobacco retailers is often measured by aggregating them to area-level units (e.g., census tracts), but spatial statistical methods that use point-level data, such as spatial intensity and K-functions, can better describe their geographic patterns. We applied these methods to a case study in New Castle County, DE to characterize the cross-sectional spatial relationship between tobacco retailers and smokers, finding that current smokers experience greater tobacco retail exposure and clustering relative to former smokers. We discuss how analysis at different geographic scales can provide complementary insights for tobacco control policy.
Collapse
Affiliation(s)
- Madeline M Brooks
- Value Institute, Christiana Care Health System, Newark, DE, United States.
| | - Scott D Siegel
- Value Institute, Christiana Care Health System, Newark, DE, United States; Helen F. Graham Cancer Center & Research Institute, Christiana Care Health System, Newark, DE, United States
| | - Frank C Curriero
- Johns Hopkins Spatial Science for Public Health Center, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| |
Collapse
|
41
|
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.
Collapse
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
| |
Collapse
|
42
|
Kong AY, Baggett CD, Gottfredson NC, Ribisl KM, Delamater PL, Golden SD. Associations of tobacco retailer availability with chronic obstructive pulmonary disease related hospital outcomes, United States, 2014. Health Place 2021; 67:102464. [PMID: 33276261 PMCID: PMC7854476 DOI: 10.1016/j.healthplace.2020.102464] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 10/04/2020] [Accepted: 10/07/2020] [Indexed: 10/22/2022]
Abstract
There are associations between tobacco retailer density and smoking behaviors, but little is known about whether places with more tobacco retailers have more smoking-related health problems. Using cross-sectional data from 2014, we investigated the relationships between tobacco retailer density and chronic obstructive pulmonary disease (COPD) related outcomes in a sample of 1510 counties across the United States. Higher retailer density was associated with a 19% (IRR, 1.19; 95% CI, 1.12-1.27) higher COPD-related hospital discharge rate and 30% (IRR, 1.30; 95% CI 1.21-1.39) higher total COPD-related hospital costs per population. The tobacco retailer environment may be an important target for reducing smoking-related health burdens and costs.
Collapse
Affiliation(s)
- 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
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, 135 Dauer Drive, Chapel Hill, NC 27599-7435, USA; Lineberger Comprehensive Cancer Center, University of North Carolina, 101 Manning Drive, Chapel Hill, NC 27599-7295, USA
| | - Nisha C Gottfredson
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, 135 Dauer Drive, Chapel Hill, NC 27599-7440, 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
| | - Paul L Delamater
- Lineberger Comprehensive Cancer Center, University of North Carolina, 101 Manning Drive, Chapel Hill, NC 27599-7295, USA; Department of Geography, University of North Carolina, Carolina Hall, Chapel Hill, NC 27599-7435, USA
| | - 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
| |
Collapse
|
43
|
Glasser AM, Roberts ME. Retailer density reduction approaches to tobacco control: A review. Health Place 2021; 67:102342. [PMID: 33526207 PMCID: PMC7856310 DOI: 10.1016/j.healthplace.2020.102342] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 04/05/2020] [Accepted: 04/10/2020] [Indexed: 11/18/2022]
Abstract
Tobacco retailer density is consistently associated with poor tobacco-use outcomes. The aim of this review was to synthesize the international evidence on density reduction policies. Searches in multiple databases resulted in 31 studies covering various policy approaches evaluated for their impact on retailer density. Findings indicate that bans on tobacco sales in pharmacies reduced retailer density, but perhaps not equitably. Prohibiting sale of tobacco near schools produced greater density reductions in higher-risk neighborhoods. Policies in combination were most effective. Future studies should measure the impact of these policies on tobacco use. Density-reduction policies offer a promising approach to tobacco control.
Collapse
Affiliation(s)
- Allison M Glasser
- The Ohio State University, College of Public Health, Columbus, OH, USA.
| | - Megan E Roberts
- The Ohio State University, College of Public Health, Columbus, OH, USA
| |
Collapse
|
44
|
Venugopal PD, Morse AL, Tworek C, Chang HW. Socioeconomic Disparities in Vape Shop Density and Proximity to Public Schools in the Conterminous United States, 2018. Health Promot Pract 2020; 21:9S-17S. [PMID: 31908194 DOI: 10.1177/1524839919887738] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
We conducted an environmental justice assessment examining the distribution of specialty vape shops in relation to where minority and low-income youth live and attend school. We collated and examined the density of vape shops in public school districts in 2018 throughout the conterminous United States using geographic information systems. We calculated the proximity of vape shops to public middle and high schools through nearest neighbor analysis in QGIS software. We examined the statistical relationships between the density of vape shops in school districts, and proximity to schools, with the proportion of racial/ethnic minorities and those living in poverty. We found that vape shops are more densely distributed, and are in closer proximity to schools, in school districts with higher proportions of Asian and Black or African American populations. However, vape shops were further away from schools in school districts with higher proportions of the population in poverty. The proximity and higher density of vape shops in relationship to schools in Asian and Black or African American communities may result in disproportionate health impacts due to greater access and exposure to vape products and advertisements. Our results may help school district administrators prioritize and target efforts to curb youth vaping (e.g., health education curricula) in these school districts with high density and closer proximity of vape shops to schools. Policy efforts, such as local ordinances restricting the promotion and sale of vaping products close to schools, could help prevent disproportionate human and environmental health impacts to minorities.
Collapse
Affiliation(s)
| | - Aura Lee Morse
- United States Food and Drug Administration, Beltsville, MD, USA
| | - Cindy Tworek
- United States Food and Drug Administration, Beltsville, MD, USA
| | | |
Collapse
|
45
|
Houston-Ludlam AN, Waldron M, Lian M, Cahill AG, McCutcheon VV, Madden PAF, Bucholz KK, Heath AC. Marital status, partner acknowledgment of paternity, and neighborhood influences on smoking during first pregnancy: findings across race/ethnicity in linked administrative and census data. Drug Alcohol Depend 2020; 217:108273. [PMID: 32971390 PMCID: PMC8075321 DOI: 10.1016/j.drugalcdep.2020.108273] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 08/26/2020] [Accepted: 08/29/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND Improving prediction of cigarette smoking during pregnancy (SDP), including differences by race/ethnicity and geography, is necessary for interventions to achieve greater and more equitable SDP reductions. METHODS Using individual-level data on singleton first births, 2010-2017 (N = 182,894), in a US state with high SDP rates, we predicted SDP risk as a function of reproductive partner relationship (marital status, paternity acknowledgement), maternal and residential census tract sociodemographics, and census tract five-year SDP rate. RESULTS SDP prevalence was 12.7% (white non-Hispanics, WNH), 6.8% (Black/African Americans, AA), 19.5% (Native American, NA), 4.7% (Hispanic, H), and 2.8% (Asian, AS). In WNH and AA, with similar trends in other groups, after adjustment for non-linear effects of maternal age and education and for census tract risk-factors, there was a consistent risk-ordering of SDP rates by reproductive partner relationship: married/with paternity acknowledged < unmarried/acknowledged < unmarried/unacknowledged < married/unacknowledged. Associations with census tract SDP rate, adjusted for maternal and census tract sociodemographics, were stronger for AA and H (OR 2.65-2.67) than for NA (OR = 1.91), WNH (OR = 1.75), or AS (NS). AA SDP was increased in tracts having a higher proportion of WNH residents and was reduced in comparison with WNH at every combination of age, education and partner relationship. CONCLUSIONS Inattention to differences by race/ethnicity may obscure SDP risk factors. Despite marked race/ethnic differences in unmarried-partner cohabitation rates, failure to acknowledge paternity emerged as an important and consistent risk-predictor. Census-tract five-year SDP rates have heterogeneous origins, but the association of AA SDP risk with increased racial heterogeneity suggests an important influence of neighbor risk behaviors.
Collapse
Affiliation(s)
- Alexandra N Houston-Ludlam
- Department of Psychiatry, Washington University School of Medicine, 660 S Euclid, CB 8134, St. Louis, MO, 63110, USA; Medical Scientist Training Program, Washington University School of Medicine, 660 S Euclid, CB 8226, St. Louis, MO, 63110, USA; Human and Statistical Genetics, Division of Biology and Biomedical Sciences, Washington University School of Medicine, 660 S Euclid, CB 8134, St. Louis, MO, 63110, USA.
| | - Mary Waldron
- Department of Psychiatry, Washington University School of Medicine, 660 S Euclid, CB 8134, St. Louis, MO, 63110, USA; School of Education, Indiana University, 201 N. Rose Ave, Bloomington, IN, 47405, USA
| | - Min Lian
- Department of Medicine, Washington University School of Medicine, 660 S Euclid, CB 8134, St. Louis, MO, 63110, USA
| | - Alison G Cahill
- Department of Women's Health, University of Texas at Austin, Dell Medical School, 1301 W 38th St Suite 705, Austin, TX, 78705, USA
| | - Vivia V McCutcheon
- Department of Psychiatry, Washington University School of Medicine, 660 S Euclid, CB 8134, St. Louis, MO, 63110, USA
| | - Pamela A F Madden
- Department of Psychiatry, Washington University School of Medicine, 660 S Euclid, CB 8134, St. Louis, MO, 63110, USA
| | - Kathleen K Bucholz
- Department of Psychiatry, Washington University School of Medicine, 660 S Euclid, CB 8134, St. Louis, MO, 63110, USA
| | - Andrew C Heath
- Department of Psychiatry, Washington University School of Medicine, 660 S Euclid, CB 8134, St. Louis, MO, 63110, USA
| |
Collapse
|
46
|
King JL, Wagoner KG, Suerken CK, Song EY, Reboussin BA, Spangler J, Walker S, Ross JC, Wolfson M, Sutfin EL. Are Waterpipe Café, Vape Shop, and Traditional Tobacco Retailer Locations Associated with Community Composition and Young Adult Tobacco Use in North Carolina and Virginia? Subst Use Misuse 2020; 55:2395-2402. [PMID: 32969275 PMCID: PMC8073526 DOI: 10.1080/10826084.2020.1823417] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
PURPOSE We examined whether waterpipe café, vape shop, and traditional tobacco retailer (e.g. stores selling cigarettes, cigars, smokeless tobacco) locations were associated with census tract composition and tobacco use among young adults in North Carolina and Virginia. Methods: We identified waterpipe cafés, vape shops, and traditional tobacco retailers in North Carolina and Virginia and conducted multivariable analyses between community characteristics (gender, race, ethnicity, education, college enrollment, and poverty) and density per 1000 population. Using fall 2017 data from 1099 young adults residing in North Carolina and Virginia, we conducted logistic regression analyses to determine whether tobacco retailer density and proximity were associated with tobacco use. Results: Waterpipe café, vape shop, and traditional retailer density were higher in communities with more people who were Hispanic, college-educated, and college-enrolled (each p < .05). Waterpipe café and traditional retailer density were higher in communities with more people living below the poverty level (each p < .05). Waterpipe café density was higher in communities with more people who were male (p < .05), while traditional retailer density was lower (p < .05). Waterpipe café and vape shop proximity were associated with increased likelihood of waterpipe tobacco use in the past 6 months (each p < .05; unadjusted). Traditional retailer proximity and waterpipe café, vape shop, and traditional retailer density were not associated with tobacco use. Conclusions: Waterpipe cafés and vape shops are located in both impoverished and college-educated communities in North Carolina and Virginia, similar to where traditional tobacco retailers are located. Further research is needed to examine associations with tobacco use.
Collapse
Affiliation(s)
- Jessica L. King
- Department of Health & Kinesiology, College of Health, University of Utah, Salt Lake City, Utah, USA
| | - Kimberly G. Wagoner
- Department of Social Sciences & Health Policy, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Cynthia K. Suerken
- Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Eunyoung Y. Song
- Department of Social Sciences & Health Policy, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Beth A. Reboussin
- Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - John Spangler
- Department of Family Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Stephannie Walker
- Department of Social Sciences & Health Policy, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Jennifer Cornacchione Ross
- Department of Social Sciences & Health Policy, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Mark Wolfson
- Department of Social Medicine, Population, and Public Health, School of Medicine, University of California, Riverside, California, USA
| | - Erin L. Sutfin
- Department of Social Sciences & Health Policy, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| |
Collapse
|
47
|
Stokes AC, Wilson AE, Lundberg DJ, Xie W, Berry KM, Fetterman JL, Harlow AF, Cozier YC, Barrington-Trimis JL, Sterling KL, Benjamin EJ, Blaha MJ, Hamburg NM, Bhatnagar A, Robertson RM. Racial/Ethnic Differences in Associations of Non-cigarette Tobacco Product Use With Subsequent Initiation of Cigarettes in US Youths. Nicotine Tob Res 2020; 23:900-908. [PMID: 32948872 PMCID: PMC8150136 DOI: 10.1093/ntr/ntaa170] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 09/17/2020] [Indexed: 12/22/2022]
Abstract
Introduction Understanding which non-cigarette tobacco products precede smoking in youth across different racial/ethnic groups can inform policies that consider tobacco-related health disparities. Methods We used nationally representative, longitudinal data from the Population Assessment of Tobacco and Health Study waves 1–4. The sample was a dynamic cohort of cigarette-naïve youth aged 12–17 years. Mixed-effects models were used to assess non-cigarette product (e-cigarette, cigar product, or other product) use with cigarette use over 1-year intervals. Results Of the 28 788 observations pooled across waves 1–4, respondents were 48.7% non-Hispanic white, 13.9% non-Hispanic black, and 23.1% Hispanic. Odds of cigarette initiation over 1-year follow-up were higher among youth with prior use of e-cigarettes (odds ratio [OR], 2.76; 95% confidence interval [CI], 2.21–3.45), cigars (OR, 2.00; 95% CI, 1.42–2.80), or other products (OR, 1.66; 95% CI, 1.28–2.14) compared to never users. At the population level, 20.6% of cigarette initiation was attributable to e-cigarette use among white youth and 21.6% among Hispanic youth, while only 3.5% of cigarette initiation was attributable to e-cigarette use among black youth. In contrast, 9.1% of cigarette initiation for black youth was attributable to cigar use compared to only 3.9% for both white and Hispanic youth. Conclusions Prior use of e-cigarettes, cigars, and other non-cigarette products were all associated with subsequent cigarette initiation. However, white and Hispanic youth were more likely to initiate cigarettes through e-cigarette use (vs. cigar or other product use), while black youth were more likely to initiate cigarettes through cigar use (vs. e-cigarette or other product use). Implications Our findings suggest that previous studies on effects of non-cigarette tobacco products may overlook the critical role of cigar products as a pathway into cigarette smoking among US youth, particularly black youth. While our data support the importance of e-cigarette use as a pathway into smoking, regulatory actions aimed at addressing youth e-cigarette use alone may contribute to disparities in black versus white tobacco use and further exacerbate inequities in tobacco-related disease. Thus, contemporary policy development and discourse about the effects of non-cigarette tobacco products on cigarette initiation should consider cigar and other non-cigarette products as well as e-cigarettes.
Collapse
Affiliation(s)
- Andrew C Stokes
- American Heart Association Tobacco Regulation and Addiction Center, Dallas, TX.,Department of Global Health, Boston University School of Public Health, Boston, MA
| | - Anna E Wilson
- Department of Global Health, Boston University School of Public Health, Boston, MA
| | - Dielle J Lundberg
- Department of Global Health, Boston University School of Public Health, Boston, MA
| | - Wubin Xie
- Department of Global Health, Boston University School of Public Health, Boston, MA
| | - Kaitlyn M Berry
- Department of Epidemiology, University of Minnesota, Minneapolis, MN
| | - Jessica L Fetterman
- American Heart Association Tobacco Regulation and Addiction Center, Dallas, TX.,Evans Department of Medicine and Whitaker Cardiovascular Institute, Boston University School of Medicine, Boston, MA
| | - Alyssa F Harlow
- Department of Epidemiology, Boston University School of Public Health, Boston, MA
| | - Yvette C Cozier
- Department of Epidemiology, Boston University School of Public Health, Boston, MA
| | | | - Kymberle L Sterling
- School of Public Health, University of Texas Health Sciences Center, Dallas, TX
| | - Emelia J Benjamin
- American Heart Association Tobacco Regulation and Addiction Center, Dallas, TX.,Evans Department of Medicine and Whitaker Cardiovascular Institute, Boston University School of Medicine, Boston, MA.,Department of Epidemiology, Boston University School of Public Health, Boston, MA
| | - Michael J Blaha
- American Heart Association Tobacco Regulation and Addiction Center, Dallas, TX.,Department of Medicine, The Johns Hopkins University, Baltimore, MD
| | - Naomi M Hamburg
- American Heart Association Tobacco Regulation and Addiction Center, Dallas, TX.,Evans Department of Medicine and Whitaker Cardiovascular Institute, Boston University School of Medicine, Boston, MA
| | - Aruni Bhatnagar
- American Heart Association Tobacco Regulation and Addiction Center, Dallas, TX.,Department of Medicine, University of Louisville, Louisville, KY
| | | |
Collapse
|
48
|
Ruglass LM, Root JC, Dambreville N, Shevorykin A, Sheffer CE, Melara RD. Examining differences in attentional bias to smoking-related cues among black and white cigarette smokers: An event-related potential pilot study. Neurosci Lett 2020; 735:135241. [PMID: 32659312 PMCID: PMC8075105 DOI: 10.1016/j.neulet.2020.135241] [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: 01/07/2020] [Revised: 07/04/2020] [Accepted: 07/07/2020] [Indexed: 10/23/2022]
Abstract
Black cigarette smokers experience higher craving, lower cessation rates, and increased health complications from tobacco use than Whites. We examined psychophysiological and behavioral differences in attentional bias to smoking cues between Black and White smokers. Thirty-one participants (Blacks, n = 20; MAge = 45 and Whites, n = 11, MAge = 47.64) discriminated line orientations while ignoring temporally flanking lines and smoking-related, positive-, negative-, and neutral-images as behavioral responses and event-related potentials (ERPs) were recorded. Results revealed a three-way interaction in reaction time among Group (White, Black), Congruity (congruent vs. incongruent flankers) and Cue (smoking-related, positive, negative) factors, F(2,58) = 3.63, p = .03, MSe = .001, η2 = .002. Smoking-related cues yielded the largest congruity effects in Whites, but the smallest congruity effects in Blacks. Random presentation of smoking-related cues (re: baseline) weakened P1 ERP amplitude (125 ms after stimulus onset) in Whites, but not Blacks (Cue x Group x Task, F(3,87) = 3.44, p < .05, MSe = 65.96, η2 = .01), suggesting an early sensory effect of smoking cues in Whites. The difference between Whites and Blacks in P2 amplitude (226 ms; amplitude weaker in Whites) was greatest to the smoking-related cues (Cue x Group, F(3,87) = 2.81, p < .05, MSe = 60.68, η2 = .01), indicating a stronger draw in attention from smoking cues in Whites. Findings suggest White and Black smokers respond differently to smoking-related cues during early sensory processing. Findings need to be replicated.
Collapse
Affiliation(s)
- Lesia M Ruglass
- Department of Psychology, The City College of New York, 160 Convent Avenue, NAC 7/120, NY, NY 10031, United States
| | - James C Root
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 1300 York Avenue, NY, NY 10065, United States
| | - Naomi Dambreville
- Department of Psychology, The City College of New York, 160 Convent Avenue, NAC 7/120, NY, NY 10031, United States
| | - Alina Shevorykin
- Department of Psychology and Mental Health Counseling, Pace University, 861 Bedford Rd., Pleasantville, NY 10570, United States
| | - Christine E Sheffer
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, 665 Elm Street, Buffalo, NY 14203, United States
| | - Robert D Melara
- Department of Psychology, The City College of New York, 160 Convent Avenue, NAC 7/120, NY, NY 10031, United States
| |
Collapse
|
49
|
Anesetti-Rothermel A, Herman P, Bennett M, English N, Cantrell J, Schillo B, Hair EC, Vallone DM. Sociodemographic Disparities in the Tobacco Retail Environment in Washington, DC: A Spatial Perspective. Ethn Dis 2020; 30:479-488. [PMID: 32742153 DOI: 10.18865/ed.30.3.479] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Objective Studies assessing sociodemographic disparities in the tobacco retail environment have relied heavily on non-spatial analytical techniques, resulting in potentially misleading conclusions. We utilized a spatial analytical framework to evaluate neighborhood sociodemographic disparities in the tobacco retail environment in Washington, DC (DC) and the DC metropolitan statistical area (DC MSA). Methods Retail tobacco availability for DC (n=177) and DC MSA (n=1,428) census tract was assessed using adaptive-bandwidth kernel density estimation. Density surfaces were constructed from DC (n=743) and DC MSA (n=4,539) geocoded tobacco retailers. Sociodemographics were obtained from the 2011-2015 American Community Survey. Spearman's correlations between sociodemographics and retail density were computed to account for spatial autocorrelation. Bivariate and multivariate spatial lag models were fit to predict retail density. Results DC and DC MSA neighborhoods with a higher percentage of Hispanics were positively correlated with retail density (rho = .3392, P = .0001 and rho = .1191, P = .0000, respectively). DC neighborhoods with a higher percentage of African Americans were negatively correlated with retail density (rho = -.3774, P = .0000). This pattern was not significant in DC MSA neighborhoods. Bivariate and multivariate spatial lag models found a significant inverse relationship between the percentage of African Americans and retail density (Beta = -.0133, P = .0181 and Beta = -.0165, P = .0307, respectively). Conclusions Associations between neighborhood sociodemographics and retail density were significant, although findings regarding African Americans are inconsistent with previous findings. Future studies should analyze other geographic areas, and account for spatial autocorrelation within their analytic framework.
Collapse
Affiliation(s)
| | | | | | - Ned English
- NORC at the University of Chicago, Chicago, IL
| | | | | | - Elizabeth C Hair
- Schroeder Institute at Truth Initiative, Washington, DC.,Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Donna M Vallone
- Schroeder Institute at Truth Initiative, Washington, DC.,School of Global Public Health, New York University, New York, NY.,Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| |
Collapse
|
50
|
Pechey R, Hollands GJ, Carter P, Marteau TM. Altering the availability of products within physical micro-environments: a conceptual framework. BMC Public Health 2020; 20:986. [PMID: 32594907 PMCID: PMC7322874 DOI: 10.1186/s12889-020-09052-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Accepted: 06/04/2020] [Indexed: 01/10/2023] Open
Abstract
Altering the availability of products (e.g. food, alcohol or tobacco products) is one potential intervention to change behaviours to help reduce preventable premature deaths worldwide. However, research on these interventions lacks consistent conceptualisation, hindering clear reporting and cumulative synthesis. This paper proposes a conceptual framework – categorising intervention types and summarising constituent components – with which interventions can be reliably described and evidence synthesised. Three principal distinctions are proposed: interventions altering: (i) Absolute Availability (changing the overall number of options, while keeping the proportions comprised by any subsets of options constant); (ii) Relative Availability (changing the proportion comprised by a subset of options, yet keeping the overall number of options constant); (iii) Absolute and Relative Availability (changing both the overall number of options and the proportions comprised by subsets of options). These are subdivided into those targeting (a) a product or (b) a category of products. Mechanisms that might underlie each of these intervention types are discussed, and implications for future research highlighted. The proposed framework aims to facilitate study of a set of interventions that could contribute significantly to healthier behaviour across populations.
Collapse
Affiliation(s)
- Rachel Pechey
- Behaviour and Health Research Unit, Institute of Public Health, University of Cambridge, CB2 0SR, Cambridge, UK.
| | - Gareth J Hollands
- Behaviour and Health Research Unit, Institute of Public Health, University of Cambridge, CB2 0SR, Cambridge, UK
| | - Patrice Carter
- Centre for Outcomes Research and Effectiveness, Research Department of Clinical, Educational and Health Psychology, University College London, WC1E 7HB, London, UK
| | - Theresa M Marteau
- Behaviour and Health Research Unit, Institute of Public Health, University of Cambridge, CB2 0SR, Cambridge, UK
| |
Collapse
|