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Martin-Gall V, Neil A, Macintyre K, Rehman S, Nguyen TP, Harding B, Gall S. Tobacco retail availability and smoking-A systematic review and meta-analysis. Drug Alcohol Rev 2024. [PMID: 39228169 DOI: 10.1111/dar.13936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Revised: 07/23/2024] [Accepted: 08/05/2024] [Indexed: 09/05/2024]
Abstract
ISSUES Health policy makers worldwide have adopted evidence-based legislation, largely directed at consumers, to reduce tobacco-related harm. It is suggested that limiting supply by decreasing retail availability can also reduce cigarette smoking. To inform policy makers this systematic literature review assesses whether reducing availability is associated with smoking behaviours. APPROACH Systematic literature searches of five databases were carried out up to January 2023. Included studies had at least one exposure (tobacco retail density, proximity or mixed measures thereof) and outcomes of smoking behaviour. Meta-analysis of effect estimates were undertaken if there were at least three studies with similar population, exposure and outcome measures. KEY FINDINGS Sixty-two studies were included, and positive associations were found between tobacco outlet density and cigarette smoking in pregnancy, youth, adults and cessation. Meta-analyses were undertaken for retail density and ever smoking (odds ratio [OR] 1.20; 95% confidence interval [CI] 1.04, 1.37; I2 = 87.3%), and current youth smoking (OR 1.23; 95% CI 1.08, 1.40; I2 = 0.0%), adult smoking (OR 1.11; 95% CI 1.01, 1.22; I2 = 74.8%); and mixed measures of retail availability near schools and current youth smoking (OR 1.03; 95% CI 1.01, 1.05; I2 = 0.0%). IMPLICATIONS AND CONCLUSION There is evidence higher tobacco retail density is consistently associated with cigarette smoking in pregnant women, young people and adults when ecological studies are included in meta-analysis. Meanwhile, evidence synthesis reveals restrictive tobacco retail laws based on proximity or mixed measures near home or very near school may not reduce smoking except in men who smoke heavily. Mechanisms to reduce retailer density should be thus considered part of tobacco control strategies.
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Affiliation(s)
- Veronica Martin-Gall
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
- Public Health Services, Department of Health, Hobart, Australia
| | - Amanda Neil
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Kate Macintyre
- Tasmanian School of Medicine, University of Tasmania, Hobart, Australia
| | - Sabah Rehman
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Thuy Phuong Nguyen
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Ben Harding
- Public Health Services, Department of Health, Hobart, Australia
| | - Seana Gall
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
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2
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Canty R, Gartner CE, Hoek J, Hefler M. Global policy scan of commercial combustible tobacco product retailing regulations by WHO region. Tob Control 2024:tc-2023-058523. [PMID: 39059815 DOI: 10.1136/tc-2023-058523] [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: 11/23/2023] [Accepted: 06/03/2024] [Indexed: 07/28/2024]
Abstract
BACKGROUND/AIMS Regulatory schemes for tobacco retailing help restrict the supply and availability of smoked tobacco products. Tobacco retailer density and the proximity of tobacco outlets to youth spaces, such as schools, are greater in more disadvantaged areas. Exposure to tobacco retailing normalises smoking and increases ease of access, thus increasing smoking uptake and undermining quitting. To inform future policy, we conducted a global scan of combustible tobacco retail regulatory schemes (We use the term schemes to refer to any kind of relevant initiative, policy, regulations or legislation that we found). METHODS All types of English language records concerning the regulation of commercial tobacco product availability were considered, including peer-reviewed journal articles, key reports and policy documents. The key features of regulatory schemes were documented. In addition, we contacted key informants in different countries and regions for advice on additional sources and undertook targeted searching in regions where we initially found little data. RESULTS/FINDINGS Although many countries have well-established and comprehensive tobacco control programmes, tobacco retail policy that actively addresses the availability of tobacco is underutilised. Many jurisdictions have implemented a minimum purchase age and restricted point-of-sale advertising and marketing. Other tobacco retailing regulations also included licensing systems with licence fees, caps on licences and restrictions on store location, type and retailer density/proximity. A very small number of jurisdictions have ended tobacco retailing altogether. CONCLUSIONS At a minimum, policy-makers should implement licensing schemes, licence caps and proximity limits and invest in robust monitoring systems and compliance enforcement. Tobacco products' ubiquity is incompatible with its status as a dangerous addictive substance and does not align with tobacco endgame goals.
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Affiliation(s)
- Ruth Canty
- Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
- NHMRC Centre for Research Excellence on Achieving the Tobacco Endgame, School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
| | - Coral E Gartner
- NHMRC Centre for Research Excellence on Achieving the Tobacco Endgame, School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
- School of Public Health, The University of Queensland Faculty of Medicine, Herston, Queensland, Australia
| | - Janet Hoek
- NHMRC Centre for Research Excellence on Achieving the Tobacco Endgame, School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
- Public Health, University of Otago, Dunedin, New Zealand
| | - Marita Hefler
- Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
- NHMRC Centre for Research Excellence on Achieving the Tobacco Endgame, School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
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3
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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.
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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
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Zheng C, Feng Z, Pearce J. A longitudinal analysis of the impact of the local tobacco retail availability and neighbourhood deprivation on male smoking behaviours in Shanghai, China. Health Place 2024; 85:103171. [PMID: 38181462 PMCID: PMC10922680 DOI: 10.1016/j.healthplace.2023.103171] [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: 06/01/2023] [Revised: 12/05/2023] [Accepted: 12/18/2023] [Indexed: 01/07/2024]
Abstract
Some evidence from Western high-income countries suggests local tobacco retail availability and neighbourhood deprivation may influence smoking behaviours. However, this assertion has not been considered in China, where 44% of males continue to smoke. Data were analysed from Chinese males (n = 2054) who participated in Waves 3-5 (2009-2015) of the International Tobacco Control (ITC) China Survey by linking information on tobacco retail availability (estimated through population weighted Kernel Density of tobacco retailers in 2019) and neighbourhood deprivation (calculated as a composite score derived from the 2010 Chinese census) across Shanghai. Generalised Estimating Equation models were fitted to examine the impacts of local tobacco availability and neighbourhood deprivation on smoking behaviours (current smoking versus current non-smoking, quitting versus current smoking, longer durations of smoking abstinence versus current smoking) using the longitudinal data. Examining the impacts separately, participants living in neighbourhoods with greater availability and higher levels of deprivation were less likely to maintain longer durations of smoking abstinence in both unadjusted and adjusted models. Neighbourhood deprivation, but not availability, was found to be associated with higher odds of being a current smoker. Examining the impacts jointly, neighbourhood deprivation was still positively associated with current smoking and negatively associated with longer durations of smoking abstinence, but the negative association between availability and longer durations of smoking abstinence disappeared. The findings offer some evidence that greater tobacco retail availability and deprivation are obstacles on prolonged smoking cessation among males in Shanghai, China. Policymakers should consider small-area level place-based restrictions in China, such as reducing the availability of tobacco, as part of a comprehensive tobacco control strategy aimed at addressing the high prevalence of smoking.
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Affiliation(s)
- Chunyu Zheng
- Centre for Research on Environment, Society and Health, School of GeoSciences, University of Edinburgh, UK.
| | - Zhiqiang Feng
- Centre for Research on Environment, Society and Health, School of GeoSciences, University of Edinburgh, UK; Scottish Centre for Administrative Data Research, University of Edinburgh, UK.
| | - Jamie Pearce
- Centre for Research on Environment, Society and Health, School of GeoSciences, University of Edinburgh, UK.
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Ziesing S, Ettridge K, Dono J, Luppino A, Miller C. Is it time to increase the cost of tobacco licences after 10 years of stagnation? Aust N Z J Public Health 2023; 47:100080. [PMID: 37739846 DOI: 10.1016/j.anzjph.2023.100080] [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: 06/05/2023] [Revised: 07/19/2023] [Accepted: 07/23/2023] [Indexed: 09/24/2023] Open
Abstract
OBJECTIVE Reducing tobacco licences is one potential lever to reduce tobacco-related harms. A 15-fold increase in annual tobacco retailer licence fees in 2007 led to a 24% decline in the number of licences in 2009. This study investigates the changes in tobacco licences over a subsequent decade in the absence of real fee increases. METHODS The South Australian (SA) government tobacco licencing system databases for 2009 and 2020 were audited, measuring changes in the number and distribution of tobacco and vending machine licences by outlet type, disadvantage, and remoteness. RESULTS The number of tobacco licences declined by 33.1% overall. Large reductions were observed in food service venues (65.2%) and hotel/motels (37.2%). In 2020, most licences were in service stations (25.1%), hotel/motels (22.9%), and supermarkets (22.2%). Despite proportional reductions across all disadvantage quintiles, the most disadvantaged areas continued to have the largest number of tobacco licensees. Vending machines declined by 63.6% and remained concentrated in hotels/motels (91.4%). CONCLUSIONS Since a 15-fold licence fee increase in 2007 effectively reduced tobacco retailers from 2007-2009, the decline since has been incremental. IMPLICATIONS FOR PUBLIC HEALTH Increasing tobacco licence fees is a straightforward and effective measure to reduce tobacco availability and should be re-prioritised.
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Affiliation(s)
- Samuel Ziesing
- Health Policy Centre, South Australian Health and Medical Research Institute, Adelaide, 5000, SA, Australia
| | - Kerry Ettridge
- Health Policy Centre, South Australian Health and Medical Research Institute, Adelaide, 5000, SA, Australia; School of Psychology, University of Adelaide, Adelaide, 5000, SA, Australia
| | - Joanne Dono
- Health Policy Centre, South Australian Health and Medical Research Institute, Adelaide, 5000, SA, Australia; School of Psychology, University of Adelaide, Adelaide, 5000, SA, Australia
| | - Ashley Luppino
- Health Policy Centre, South Australian Health and Medical Research Institute, Adelaide, 5000, SA, Australia
| | - Caroline Miller
- Health Policy Centre, South Australian Health and Medical Research Institute, Adelaide, 5000, SA, Australia; School of Public Health, University of Adelaide, Adelaide, 5000, SA, Australia.
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Usidame B, Xie Y, Thrasher JF, Lozano P, Elliott MR, Fong GT, Fleischer NL. Differential impact of the Canadian point-of-sale tobacco display bans on quit attempts and smoking cessation outcomes by sex, income and education: longitudinal findings from the ITC Canada Survey. Tob Control 2023; 32:599-606. [PMID: 35017260 PMCID: PMC9271527 DOI: 10.1136/tobaccocontrol-2021-056805] [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: 05/25/2021] [Accepted: 12/27/2021] [Indexed: 11/04/2022]
Abstract
SIGNIFICANCE This study examines the differential effects of Canadian point-of-sale (POS) tobacco display bans across provinces on quit attempts and smoking cessation, by sex, education and income. METHODS We analysed survey data from five waves (waves 4-8) of the International Tobacco Control Canada Survey, a population-based, longitudinal survey, where provinces implemented display bans between 2004 and 2010. Primary outcomes were quit attempts and successful cessation. We used generalised estimating equation Poisson regression models to estimate associations between living in a province with or without a POS ban (with a 24-month threshold) and smoking outcomes. We tested whether these associations varied by sex, education and income by including interaction terms. RESULTS Across survey waves, the percentage of participants in provinces with POS bans established for more than 24 months increased from 5.0% to 95.8%. There was no association between POS bans and quit attempts for provinces with bans in place for 0-24 months or more than 24 months, respectively (adjusted relative risk (aRR)=0.99, 95% CI: 0.89 to 1.10; 1.03, 95% CI: 0.88 to 1.20). However, we found a differential impact of POS bans on quit attempts by sex, whereby bans were more effective for women than men for bans of 0-24 months. Participants living in a province with a POS ban for at least 24 months had a higher chance of successful cessation (aRR=1.49; 95% CI: 1.08 to 2.05) compared with those in a province without a ban. We found no differences in the association between POS bans and quit attempts or cessation by education or income, and no differences by sex for cessation. CONCLUSION POS bans are associated with increased smoking cessation overall and more quit attempts among women than men.
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Affiliation(s)
- Bukola Usidame
- Epidemiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Yanmei Xie
- Epidemiology, University of Michigan, Ann Arbor, Michigan, USA
| | - James F Thrasher
- Health Promotion, Education, and Behavior, University of South Carolina, Columbia, South Carolina, USA
- National Institute of Public Health, Cuernavaca, Mexico
| | - Paula Lozano
- Center for Asian Health Equity, The University of Chicago Medicine, Chicago, Illinois, USA
| | - Michael R Elliott
- Biostatistics, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Geoffrey T Fong
- Department of Psychology, University of Waterloo, Waterloo, Ontario, Canada
- Ontario Institute for Cancer Research, Toronto, Ontario, Canada
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Khamees A, Awadi S, Rawashdeh S, Talafha M, Alzoubi M, Almdallal W, al‐Eitan S, Saeed A, Al‐Zoubi RM, Al‐Zoubi MS. The impact of COVID-19 pandemic lockdown on smoking habits and lifestyle: A cross-sectional study. Health Sci Rep 2023; 6:e1392. [PMID: 37396557 PMCID: PMC10314099 DOI: 10.1002/hsr2.1392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 06/19/2023] [Accepted: 06/20/2023] [Indexed: 07/04/2023] Open
Abstract
Background and Aims Throughout the COVID-19 lockdown, the resultant psychological disturbances led to more tobacco consumption and deteriorated smoking behaviors among smokers. In this study, we aimed to investigate the impact of the COVID-19 pandemic on the smoking behaviors of the Jordanian population. Methods A cross-sectional online survey was designed using the Google Forms service and distributed by social media platforms. Responses were collected starting from November 12, 2020, until November 24, 2020. Results A total of 2511 respondents completed the survey, 77.3% were females. Males were significantly smoking more than females (p < 0.0001). Smoking was significantly more common among respondents who were older than 18 years old, married, held master's and PhD degrees, and working in non-health-related fields (p < 0.0001). Participants who smoke were more likely to adopt an unhealthy lifestyle during the pandemic. Females who started smoking last year were 2.6-fold more than males (p < 0.0001). We also noticed that there is a significant relationship between those who started smoking and are <18 years, living in a family consisting of seven members or more, being unemployed, having a diploma or bachelor's degree in a health-related major, having no chronic illnesses, increasing of daily meals or night meals, almost daily sugar intake, starting to follow social media account concerning physical activity, exercising once or twice a week, and sleeping more hours per day since the beginning of the pandemic (p < 0.01). Conclusion The results of our study showed that the lockdown had a significant impact on people's lifestyles including smoking habits. Most of our sample's smoker participants experienced a change in their smoking level mostly, an increase. While those who had a decrease in their smoking level experienced a somehow healthier lifestyle regarding nutrition and other aspects.
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Affiliation(s)
- Almu'atasim Khamees
- Faculty of MedicineYarmouk UniversityIrbidJordan
- Department of SurgeryKing Hussein Cancer CenterAmmanJordan
| | - Sajeda Awadi
- Faculty of MedicineYarmouk UniversityIrbidJordan
| | | | - Muna Talafha
- Faculty of MedicineYarmouk UniversityIrbidJordan
| | - Mai Alzoubi
- Faculty of MedicineYarmouk UniversityIrbidJordan
| | | | | | - Ahmad Saeed
- Faculty of MedicineYarmouk UniversityIrbidJordan
| | - Raed M. Al‐Zoubi
- Surgical Research Section, Department of SurgeryHamad Medical CorporationDohaQatar
- Department of Biomedical Sciences, College of Health Sciences, QU‐HealthQatar UniversityDohaQatar
- Department of ChemistryJordan University of Science and TechnologyIrbidJordan
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Raskind IG, Vishwakarma M, Schleicher NC, Andersen-Rodgers E, Henriksen L. The changing retail landscape for tobacco: dollar stores and the availability of cheap cigarettes among tobacco-related priority populations. Tob Control 2022; 31:e140-e147. [PMID: 34607887 PMCID: PMC8977398 DOI: 10.1136/tobaccocontrol-2020-056389] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Accepted: 08/10/2021] [Indexed: 12/14/2022]
Abstract
INTRODUCTION Dollar stores are rapidly altering the retail landscape for tobacco. Two of the three largest chains sell tobacco products in more than 24 000 stores across the USA. We sought to examine whether dollar stores are more likely to be located in disadvantaged neighbourhoods and whether dollar stores charge less for cigarettes than other tobacco retailers. METHODS Data were collected from a statewide random sample of licensed tobacco retailers in California (n=7678) in 2019. Logistic regression modelled odds of a census tract containing at least one dollar store as a function of tract demographics. Linear mixed models compared price of the cheapest cigarette pack by store type, controlling for tract demographics. RESULTS Census tracts with lower median household income, rural status and higher proportions of school-age youth were more likely to contain at least one dollar store. The cheapest cigarette pack cost less in dollar stores compared with all store types examined except tobacco shops. Estimated price differences ranged from $0.32 (95% CI: 0.14 to 0.51) more in liquor stores and $0.39 (95% CI: 0.22 to 0.57) more in convenience stores, to $0.82 (95% CI: 0.64 to 1.01) more in small markets and $1.86 (95% CI: 1.61 to 2.11) more in stores classified as 'other'. CONCLUSIONS Dollar stores may exacerbate smoking-related inequities by contributing to the availability of cheaper cigarettes in neighbourhoods that are lower income, rural and have greater proportions of youth. Pro-equity retail policies, such as minimum price laws and density reduction policies, could mitigate the health consequences of dollar stores' rapid expansion.
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Affiliation(s)
- Ilana G Raskind
- Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, California, USA
| | - Monika Vishwakarma
- Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, California, USA
| | - Nina C Schleicher
- Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, California, USA
| | | | - Lisa Henriksen
- Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, California, USA
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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.
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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
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10
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Travis N, Levy DT, McDaniel PA, Henriksen L. Tobacco retail availability and cigarette and e-cigarette use among youth and adults: a scoping review. Tob Control 2022; 31:e175-e188. [PMID: 34301839 PMCID: PMC9126034 DOI: 10.1136/tobaccocontrol-2020-056376] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 06/28/2021] [Indexed: 12/18/2022]
Abstract
OBJECTIVE States and localities are formulating strategies to reduce the widespread retail availability of tobacco products. Evidence of associations between retailer density/proximity and tobacco use outcomes can help inform those strategies. We conducted a scoping review on tobacco retail availability and cigarette/e-cigarette use in adults and youth, and considered variations in spatial units, measures of retailer exposure and outcomes across studies. METHODS A systematic search for studies examining the association between retailer density/proximity and youth and adult cigarette/e-cigarette use was conducted across MEDLINE (PubMed), Web of Science and Google Scholar through 27 August 2020 with no restrictions. RESULTS Thirty-five studies were included in our qualitative synthesis. While there were differences in neighbourhood definitions (eg, egocentric vs administrative), there is evidence for a positive association between higher retailer density in egocentric neighbourhoods around homes and current smoking in adults and adolescents. Administrative unit measures in some studies showed associations with adult current smoking, and adolescent lifetime and current smoking. Studies on tobacco outlet proximity to homes obtained mixed results. Density/proximity of tobacco outlets around schools showed no or inverse association with adolescent smoking, but suggests higher susceptibility to smoking. Evidence of an association between e-cigarette retail availability and e-cigarette use is limited due to a small number of studies. CONCLUSION The current literature provides limited empirical evidence of the association between tobacco retailer availability and smoking or e-cigarette use. More research with uniform measures of environmental exposure to tobacco retailers is needed to allow for greater comparability between studies.
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Affiliation(s)
- Nargiz Travis
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, USA
| | - David T Levy
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, USA
| | - Patricia A McDaniel
- Department of Social and Behavioral Sciences, University of California, San Francisco, California, USA
| | - Lisa Henriksen
- Stanford Prevention Research Center, Stanford University School of Medicine, Palo Alto, California, USA
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11
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Galstyan E, Galimov A, Meza L, Huh J, Berg CJ, Unger JB, Baezconde-Garbanati L, Sussman S. An Assessment of Vape Shop Products in California before and after Implementation of FDA and State Regulations. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15827. [PMID: 36497899 PMCID: PMC9738621 DOI: 10.3390/ijerph192315827] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Revised: 11/20/2022] [Accepted: 11/24/2022] [Indexed: 06/17/2023]
Abstract
Vape shops specialize in sales of e-cigarettes and related products. This study examines whether vape shops adapted their products and services in response to changes in federal and state policies that affect the tobacco retail environment between 2014-2022. In this multicohort study, four waves of study data were used to examine the trends in products sold in vape shops in Southern California. Items sold were assessed through systematic store product observations and included categories of e-cigarettes, device modification equipment, and other products (e.g., Cannabidiol (CBD), paraphernalia). Descriptive statistics are reported. The availability of disposable devices increased from 18% at Wave 1 to 98% of shops at Wave 4. Pod mods were first observed in 79% of the shops beginning at Wave 3. Device modification drills later become obsolete, from 60% at Wave 1 to 0 by Wave 4; self-service sampling displays declined from 83% of shops to 9%. Vape shops did not carry CBD products until Wave 3 (2017/2018), when 19.0% of shops carried CBD products and 72.9% at Wave 4. Future research should examine how e-cigarette retailers and manufacturers respond to changing state and federal regulations to better understand the implications of regulatory efforts.
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Affiliation(s)
- Ellen Galstyan
- Institute for Health Promotion and Disease Prevention Research, Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA 90007, USA
| | - Artur Galimov
- Institute for Health Promotion and Disease Prevention Research, Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA 90007, USA
| | - Leah Meza
- Institute for Health Promotion and Disease Prevention Research, Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA 90007, USA
| | - Jimi Huh
- Institute for Health Promotion and Disease Prevention Research, Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA 90007, USA
| | - Carla J. Berg
- Department of Prevention and Community Health, Milken Institute School of Public Health, GW Cancer Center, George Washington University, Science & Engineering Hall, 800 22nd St. NW, #7000C, Washington, DC 20052, USA
| | - Jennifer B. Unger
- Institute for Health Promotion and Disease Prevention Research, Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA 90007, USA
| | - Lourdes Baezconde-Garbanati
- Institute for Health Promotion and Disease Prevention Research, Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA 90007, USA
| | - Steve Sussman
- Institute for Health Promotion and Disease Prevention Research, Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA 90007, USA
- Department of Psychology, University of Southern California, Los Angeles, CA 90007, USA
- School of Social Work, University of Southern California, Los Angeles, CA 90007, USA
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12
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Karriker-Jaffe KJ, Henriksen L, Smith EA, McDaniel PA, Malone RE, Kerr WC. Relapse to problem drinking or trading up to spirits? Using U.S. national cross-sectional survey data to highlight possible negative impacts of potential tobacco retail changes. Subst Abuse Treat Prev Policy 2022; 17:72. [PMID: 36320048 PMCID: PMC9623940 DOI: 10.1186/s13011-022-00498-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 10/01/2022] [Accepted: 10/07/2022] [Indexed: 06/16/2023] Open
Abstract
BACKGROUND According to the National Alcohol Beverage Control Association, twelve states in the United States (U.S.) have government retail monopolies on spirits/liquor sales. With a new federal minimum legal sales age for tobacco (raised from 18 to 21, the minimum legal sales age for alcohol), we examine possible unintended consequences of a hypothetical policy change restricting retail tobacco sales to state-run spirits/liquor stores in alcohol control states, which has been proposed as a tobacco endgame strategy. METHODS We used cross-sectional survey data from 14,821 randomly-selected adults ages 21 and older who responded to the 2015 or 2020 U.S. National Alcohol Survey (51.8% female; 65.8% identified as non-Hispanic White, 12.4% as Black or African American, 14.2% as Hispanic or Latinx; 34.0% had a low level of education), including 2,274 respondents (18.9%) residing in one of the alcohol control states (representing 42.2 million (M) adults ages 21+). We estimated associations between tobacco measures (lifetime smoking status, lifetime daily smoking, past-year daily smoking) and alcohol measures (drinking status, beverage choices, lifetime alcohol use disorder (AUD) status, recovery status) overall and for specific subgroups. RESULTS In control states, 55.1% of people who smoked daily in the past year also reported lifetime AUD, including an estimated 3.56 M adults ages 21 + who reported prior (but not current) AUD. The association of daily smoking with lifetime AUD was stronger among those with low education compared to those with higher education. Further, 58.8% of people in recovery from an alcohol and/or drug problem (1.49 M adults ages 21+) smoked daily, and this was more marked among women than men in control states. CONCLUSION There could be negative consequences of an endgame strategy to restructure tobacco retail sales, including increased risk for relapse to drinking among people who smoke daily, especially among women and people with low levels of education. Strategies to mitigate unintended harms would be needed if such a policy were implemented.
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Affiliation(s)
- Katherine J Karriker-Jaffe
- Center on Behavioral Health Epidemiology, Implementation & Evaluation Research, RTI International, 2150 Shattuck Avenue, Suite 800, 94704, Berkeley, CA, USA.
| | - Lisa Henriksen
- Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, 94305, Stanford, CA, USA
| | - Elizabeth A Smith
- Department of Social & Behavioral Sciences, School of Nursing, University of California, San Francisco, 94143, San Francisco, CA, USA
| | - Patricia A McDaniel
- Department of Social & Behavioral Sciences, School of Nursing, University of California, San Francisco, 94143, San Francisco, CA, USA
| | - Ruth E Malone
- Department of Social & Behavioral Sciences, School of Nursing, University of California, San Francisco, 94143, San Francisco, CA, USA
| | - William C Kerr
- Alcohol Research Group, Public Health Institute, 94608, Emeryville, CA, USA
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13
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The Reshaping of the E-Cigarette Retail Environment: Its Evolution and Public Health Concerns. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148518. [PMID: 35886373 PMCID: PMC9319677 DOI: 10.3390/ijerph19148518] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 06/27/2022] [Accepted: 07/02/2022] [Indexed: 02/04/2023]
Abstract
E-cigarette use represents a public health controversy in the US and globally. Despite the potential of e-cigarettes to support cigarette cessation, their use increases health risks and risk for addiction, particularly in young people. Various federal, state, and local laws have impacted tobacco retail in general and e-cigarettes in particular. In the US, 2019–2020 federal laws increased in the minimum legal sales age for tobacco to 21 and banned flavored cartridge-based e-cigarettes. Many states and localities were early adopters of Tobacco 21 and implemented more comprehensive flavor restrictions than the federal ban. Meanwhile, cannabis retail is increasingly being legalized in the US—while cannabis-based product regulation has notable gaps at the federal, state, and local levels. These regulatory complexities have impacted specialized retailers selling e-cigarettes, including “vape shops” that exclusively sell e-cigarettes, “smoke shops” that sell e-cigarettes and other tobacco (and potentially CBD/THC and other un- or under-regulated products), and online retail. This commentary outlines public health concerns related to: (1) youth access; (2) consumer exposure to a broader range of tobacco products and marketing in retail settings where they may seek products to aid in cigarette cessation (i.e., such broad product exposure could hinder cessation attempts); (3) consumer exposure to un-/under-regulated products (e.g., delta-8-THC, kratom); and (4) federal, state, and local regulations being undermined by consumer access to prohibited products online and via the mail. These concerns underscore the need for ongoing surveillance of how retailers and consumers respond to regulations.
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14
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Akinola LS, Rahman Y, Ondo O, Gonzales J, Bagdas D, Jackson A, Davidson-Wert N, Damaj MI. Genotypic Differences in the Effects of Menthol on Nicotine Intake and Preference in Mice. Front Neurosci 2022; 16:905330. [PMID: 35769694 PMCID: PMC9234577 DOI: 10.3389/fnins.2022.905330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Accepted: 05/17/2022] [Indexed: 11/13/2022] Open
Abstract
Menthol has been shown to exacerbate elements of nicotine addiction in humans and rodents; however, the mechanisms mediating its effects are not fully understood. This study examined the impact of genetic factors in menthol’s effects on oral nicotine consumption by comparing two inbred mouse strains with differing sensitivities to nicotine. C57BL/6J (B6J) mice are nicotine-preferring, while DBA/2J (D2J) mice are not. While the effects of menthol on oral nicotine consumption have been highlighted in B6J mice, it is unknown if they extend to the D2J strain as well. Consequently, adolescent (PND 21) and adult (PND 63), male and female D2J mice were subjected to the nicotine two-bottle choice (2BC) paradigm with orally and systemically administered menthol. Then, we evaluated its impact on nicotine pharmacological responses in conditioned reward and nociception after systemic administration and, lastly, investigated the potential involvement of the TAAR1 gene and α7 nAChRs in menthol’s effects. Menthol failed to enhance oral nicotine consumption in adult and adolescent female and male D2J mice. Moreover, this lack in effect was not due to nicotine concentration, oral aversion to menthol, or basal preference for nicotine. Menthol also failed to augment nicotine reward or enhance nicotine-induced antinociception in D2J mice, demonstrating that genetic background plays a significant role in sensitivity to menthol’s effects on nicotine. Furthermore, TAAR1 or α7 nAChRs did not seem to mediate menthol’s differential effects in D2J mice. These findings support the existence of genotype-specific mechanisms that may contribute to the variable effects of menthol in different populations.
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Affiliation(s)
- Lois S. Akinola
- Department of Pharmacology and Toxicology, Medical College of Virginia, Virginia Commonwealth University, Richmond, VA, United States
- *Correspondence: Lois S. Akinola,
| | - Yumna Rahman
- Department of Pharmacology and Toxicology, Medical College of Virginia, Virginia Commonwealth University, Richmond, VA, United States
| | - Olivia Ondo
- Department of Pharmacology and Toxicology, Medical College of Virginia, Virginia Commonwealth University, Richmond, VA, United States
| | - Jada Gonzales
- Department of Pharmacology and Toxicology, Medical College of Virginia, Virginia Commonwealth University, Richmond, VA, United States
| | - Deniz Bagdas
- Department of Psychiatry, School of Medicine, Yale University, New Haven, CT, United States
- Yale Tobacco Center of Regulatory Science, Yale School of Medicine, New Haven, CT, United States
| | - Asti Jackson
- Department of Psychiatry, School of Medicine, Yale University, New Haven, CT, United States
- Yale Tobacco Center of Regulatory Science, Yale School of Medicine, New Haven, CT, United States
| | - Nicole Davidson-Wert
- Department of Pharmacology and Toxicology, Medical College of Virginia, Virginia Commonwealth University, Richmond, VA, United States
| | - M. Imad Damaj
- Department of Pharmacology and Toxicology, Medical College of Virginia, Virginia Commonwealth University, Richmond, VA, United States
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15
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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 2022; 6:752-764. [PMID: 36570619 PMCID: PMC9783014 DOI: 10.1080/23748834.2021.1935141] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [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.
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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,Address for correspondence: Dr. Scott D. Siegel, 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
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16
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Pastor Esplá E, Castelló Faus C, Jordá Baldó A, Boira Enrique I, Chiner Vives E. COVID-19 and smoking: An opportunity to quit. Arch Bronconeumol 2021; 57:784-785. [PMID: 34703073 PMCID: PMC8531400 DOI: 10.1016/j.arbr.2021.10.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Esther Pastor Esplá
- Sección de Neumología, Hospital Universitario San Juan de Alicante, Alicante, Spain
| | - Carmen Castelló Faus
- Sección de Neumología, Hospital Universitario San Juan de Alicante, Alicante, Spain
| | - Ariana Jordá Baldó
- Medicina Familiar y Comunitaria, Hospital Universitario Virgen del Puerto Plasencia, Plasencia, Cáceres, Spain
| | | | - Eusebi Chiner Vives
- Sección de Neumología, Hospital Universitario San Juan de Alicante, Alicante, Spain
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17
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Morrison CN, Lee JP, Giovenco DP, West B, Hidayana I, Astuti PAS, Mooney SJ, Jacobowitz A, Rundle A. The geographic distribution of retail tobacco outlets in Yogyakarta, Indonesia. Drug Alcohol Rev 2021; 40:1315-1324. [PMID: 33779016 DOI: 10.1111/dar.13285] [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: 12/14/2020] [Revised: 03/05/2021] [Accepted: 03/08/2021] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Tobacco smoking prevalence in Indonesia is among the highest in the world. Research worldwide identifies that physical access to tobacco through retail outlets is related to increased tobacco smoking. Tobacco outlet density is very high in many Indonesian cities, so tobacco access may contribute to the high prevalence of tobacco use in that country. The aim of this study was to examine distributions of tobacco outlets in one Indonesian city, Yogyakarta, in relation to social and physical environmental conditions. METHODS For this cross-sectional ecological study, we virtually audited randomly selected street segments (n = 1099) using Google Street View. The outcome of interest was a count of tobacco advertising banners (indicating the presence of retail outlets). Exposures were physical environmental conditions (scales of main roads, physical decay, presence of schools, mosques, churches) and social conditions measured at the neighbourhood level (concentrated disadvantage, age composition, population density). RESULTS Tobacco banners were present on 36.4% of sampled street segments, including 55 (37%) of 147 streets with schools; a total of 1381 banners were identified. Multilevel negative binomial regression models for street segments nested within neighbourhoods found the prevalence of tobacco banners per 100 m was lower near schools (RR = 0.66, 95% CI 0.45, 0.97) and was not associated with other exposure measures. DISCUSSION AND CONCLUSIONS Retail tobacco outlets are ubiquitous in Yogyakarta. Although they are relatively less prevalent on streets with schools, the high absolute values and wide spatial distribution means all residents of Yogyakarta are exposed to tobacco outlets.
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Affiliation(s)
- Christopher N Morrison
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, USA
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
| | - Juliet P Lee
- Prevention Research Center, Pacific Institute for Research and Evaluation, Berkeley, USA
| | - Daniel P Giovenco
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, USA
| | - Brooke West
- Columbia School of Social Work, Columbia University, New York, USA
| | - Irma Hidayana
- Department of Health and Behavior Studies, Teachers College, Columbia University, New York, USA
| | - Putu A S Astuti
- Department of Public Health and Preventive Medicine, Faculty of Medicine, Universitas Udayana, Bali, Indonesia
| | - Stephen J Mooney
- Department of Epidemiology, University of Washington, Seattle, USA
| | - Ahuva Jacobowitz
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, USA
| | - Andrew Rundle
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, USA
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18
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Kong J, Cho SI. Effect of tobacco outlet density on quit attempts in Korea: a multi-level analysis of the 2015 Korean Community Health Survey. Epidemiol Health 2021; 43:e2021048. [PMID: 34525776 PMCID: PMC8510837 DOI: 10.4178/epih.e2021048] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 08/03/2021] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES This study aimed to examine whether the regional density of tobacco outlets in Korea was associated with the likelihood of attempting to quit among smokers METHODS This study was designed as a secondary data analysis of a cross-sectional study. Data from the 2015 Korean Community Health Survey and tobacco outlet registrations in 17 metropolitan cities and provinces with 254 communities in Korea were used for the analysis. In total, 41,013 current smokers (≥19 years of age) were included. Multi-level logistic regression analysis was conducted to investigate regional differences associated with smokers’ attempts to quit and to evaluate the effects of individual and regional characteristics on quit attempts. RESULTS Higher tobacco outlet density was associated with lower odds of attempting to quit. Smokers who resided in districts with the highest tobacco outlet density were 18% less likely to attempt quitting (odds ratio, 0.82; 95% confidence interval, 0.70 to 0.98) than smokers who resided in the regions with the lowest tobacco outlet density (intraclass correlation coefficient, 0.030). CONCLUSIONS This study showed that quit attempts were related to community-level factors, such as tobacco outlet density, as well as other individual factors. These findings support the implementation of national policies restricting the number of tobacco outlets within communities or zones and limiting tobacco marketing in tobacco outlets.
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Affiliation(s)
- Jaehyung Kong
- National Tobacco Control Centre, Korea Health Promotion Institute, Seoul, Korea
| | - Sung-Il Cho
- Department of Public Health Sciences, Graduate School of Public Health and Institute of Health and Environment, Seoul National University, Seoul, Korea
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19
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Melody SM, Martin-Gall VA, Veitch MG. Why Tasmanian retailers stop selling tobacco and implications for tobacco control. Tob Control 2021; 30:583-586. [PMID: 32769212 DOI: 10.1136/tobaccocontrol-2019-055588] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 06/01/2020] [Accepted: 06/02/2020] [Indexed: 01/02/2023]
Abstract
INTRODUCTION The retail availability of tobacco is at odds with the health harms associated with tobacco smoking and undermines tobacco control efforts. Evidence suggests ease of access to tobacco through retail outlets contributes to smoking prevalence. OBJECTIVE This study aimed to understand why retailers stop selling tobacco and explore possible implications for tobacco control. METHODS The Tobacco Licensing Database maintained by the Department of Health Tasmania was used to identify and recruit past retailers who no longer held licences. Semistructured interviews were conducted to explore business demographics and the reasons they stopped selling tobacco. Interview findings were analysed using a thematic framework. RESULTS Twenty former tobacco retailers participated, representing all business types except specialist tobacconists and large supermarkets. Retailers gave multiple reasons for ending tobacco sales, related to business considerations, security, tobacco regulations, ethics and health. Most often, the decision was business-related; health or ethical considerations were rarely a factor. Most retailers felt they played no role in mitigating tobacco-related harm. CONCLUSIONS This study provides insights into factors that make tobacco sales unattractive or unfeasible for low-volume outlets and may inform supply-focused tobacco control policy. A campaign that emphasises the possible business benefits of ending tobacco sales in favour of other higher-margin products may support retailers to transition away from tobacco sales. The regulatory obligations of selling tobacco are disincentives and create a less favourable retail environment.
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Affiliation(s)
- Shannon M Melody
- Department of Health Tasmania, Hobart, Tasmania, Australia
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | | | - Mark G Veitch
- Department of Health Tasmania, Hobart, Tasmania, Australia
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20
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Siegel SD, Brooks M, Curriero FC. Operationalizing the Population Health Framework: Clinical Characteristics, Social Context, and the Built Environment. Popul Health Manag 2021; 24:454-462. [PMID: 34406088 DOI: 10.1089/pop.2020.0170] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
As a framework, population health emphasizes health outcomes for entire populations, the broad range of determinants of these outcomes, and the comparative effectiveness of medical and public health interventions. In practice, however, many contemporary population health programs instead focus on small subsets of patients who account for a disproportionate share of health care utilization, often with disappointing results. The authors proposed a new approach to operationalize population health in clinical settings, with the example of tobacco use. Electronic health record (EHR) data from a mid-Atlantic health system were used to: (1) define and describe a hospital-based population of current smokers, (2) analyze the demographic characteristics of the population to consider how the social context may impact treatment, and (3) join EHR data with public licensing data on tobacco retail locations to assess the relationship between the built environment and smoking status. Out of a total of 20,310 unique adult admissions to the health system, 3749 (18.5%) were current smokers. Compared to never smokers, current smokers were significantly younger, more likely to be male, more likely to be Black/African American, less likely to be Hispanic/Latino/a, and more likely to be on Medicaid or be self-pay. Current vs. former smokers had significantly higher exposure to tobacco retail locations, even after adjusting for demographic and other covariates. By defining populations around leading modifiable medical determinants of health, and accounting for the larger context of sociodemographic factors and the built environment, health systems can invest in comprehensive programs designed to produce the greatest population health returns.
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Affiliation(s)
- Scott D Siegel
- Value Institute and Christiana Care Health System, Newark, Delaware, USA.,Helen F. Graham Cancer Center & Research Institute, Christiana Care Health System, Newark, Delaware, USA
| | - Madeline Brooks
- Value Institute and Christiana Care Health System, Newark, Delaware, USA
| | - Frank C Curriero
- Department of Epidemiology, Johns Hopkins Spatial Science for Public Health Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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21
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Marteau TM, Fletcher PC, Munafò MR, Hollands GJ. Beyond choice architecture: advancing the science of changing behaviour at scale. BMC Public Health 2021; 21:1531. [PMID: 34376159 PMCID: PMC8356415 DOI: 10.1186/s12889-021-11382-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 06/25/2021] [Indexed: 11/10/2022] Open
Abstract
Addressing the global threats to population and planetary health requires changing many behaviours at scale. This demands consideration not only of the effect size of an intervention but also its reach - the proportion of the population exposed to the intervention.We propose that a relatively under-researched and generally poorly specified set of interventions involving changes to physical micro-environments - often referred to as Choice Architecture - has the potential to make a significant contribution to meeting this urgent challenge.Realising the potential of Choice Architecture interventions requires integration of basic - i.e. laboratory-based - and applied - i.e. field-based - research, generating interventions that can be delivered at scale alongside advancing theory. We illustrate this with examples to highlight the complementarity of laboratory and field studies informed by and in turn updating the results of evidence synthesis. The examples comprise two sets of interventions - changing the relative availability of products and changing their size - to reduce consumption of meat, energy from food and alcohol across populations.
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Affiliation(s)
- Theresa M Marteau
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK.
| | - Paul C Fletcher
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Marcus R Munafò
- University of Bristol, School of Psychological Science, Bristol, UK
| | - Gareth J Hollands
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
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22
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Valiente R, Escobar F, Urtasun M, Franco M, Shortt NK, Sureda X. Tobacco Retail Environment and Smoking: A Systematic Review of Geographic Exposure Measures and Implications for Future Studies. Nicotine Tob Res 2021; 23:1263-1273. [PMID: 33155040 DOI: 10.1093/ntr/ntaa223] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 10/29/2020] [Indexed: 11/13/2022]
Abstract
INTRODUCTION To review the geographic exposure measures used to characterize the tobacco environment in terms of density of tobacco outlets and proximity to tobacco outlets, and its association with smoking-related outcomes. METHODS We used PubMed and Google Scholar to find articles published until December 2019. The search was restricted to studies that (1) measured the density of and/or proximity to tobacco outlets and (2) included associations with smoking outcomes. The extraction was coordinated by several observers. We gathered data on the place of exposure, methodological approaches, and smoking outcomes. RESULTS Forty articles were eligible out of 3002 screened papers. Different density and proximity measures were described. 47.4% density calculations were based on simple counts (number of outlets within an area). Kernel density estimations and other measures weighted by the size of the area (outlets per square kilometer), population, and road length were identified. 81.3% of the articles which assessed proximity to tobacco outlets used length distances estimated through the street network. Higher density values were mostly associated with higher smoking prevalence (76.2%), greater tobacco use and smoking initiation (64.3%), and lower cessation outcomes (84.6%). Proximity measures were not associated with any smoking outcome except with cessation (62.5%). CONCLUSION Associations between the density of tobacco outlets and smoking outcomes were found regardless of the exposure measure applied. Further research is warranted to better understand how proximity to tobacco outlets may influence the smoking outcomes. This systematic review discusses methodological gaps in the literature and provides insights for future studies exploring the tobacco environment. IMPLICATIONS Our findings pose some methodological lessons to improve the exposure measures on the tobacco outlet environment. Solving these methodological gaps is crucial to understand the influence of the tobacco environment on the smoking outcomes. Activity spaces should be considered in further analyses because individuals are exposed to tobacco beyond their residence or school neighborhood. Further studies in this research area demand density estimations weighted by the size of the area, population, or road length, or measured using Kernel density estimations. Proximity calculations should be measured through the street network and should consider travel times apart from the length distance.
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Affiliation(s)
- Roberto Valiente
- Department of Geology, Geography and Environmental Sciences, University of Alcalá, Alcalá de Henares, Madrid, Spain
- Public Health and Epidemiology Research Group, School of Medicine, University of Alcalá, Alcalá de Henares, Madrid, Spain
| | - Francisco Escobar
- Department of Geology, Geography and Environmental Sciences, University of Alcalá, Alcalá de Henares, Madrid, Spain
| | - María Urtasun
- Public Health and Epidemiology Research Group, School of Medicine, University of Alcalá, Alcalá de Henares, Madrid, Spain
- Cooperativa APLICA, Madrid, Spain
| | - Manuel Franco
- Public Health and Epidemiology Research Group, School of Medicine, University of Alcalá, Alcalá de Henares, Madrid, Spain
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
- Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, City University of New York, New York, NY
| | - Niamh K Shortt
- Centre for Research on Environment, Society and Health, School of Geosciences, University of Edinburgh, Edinburgh, UK
| | - Xisca Sureda
- Public Health and Epidemiology Research Group, School of Medicine, University of Alcalá, Alcalá de Henares, Madrid, Spain
- Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, City University of New York, New York, NY
- Tobacco Control Research Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, l'Hospitalet de Llobregat, Barcelona, Spain
- Consortium for Biomedical Research in Respiratory Diseases (CIBER en Enfermedades Respiratorias, CIBERES), Madrid, Spain
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23
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Yang H, Ma J. How the COVID-19 pandemic impacts tobacco addiction: Changes in smoking behavior and associations with well-being. Addict Behav 2021; 119:106917. [PMID: 33862579 PMCID: PMC9186053 DOI: 10.1016/j.addbeh.2021.106917] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 03/10/2021] [Accepted: 03/18/2021] [Indexed: 12/16/2022]
Abstract
This research investigated (1) how the coronavirus pandemic impacted tobacco addiction, (2) which smoker segments were more vulnerable, and (3) how the changes in tobacco consumption were associated with smokers' satisfaction with physical health and psychological well-being. Data from a large-scale cross-sectional study of adults in China were analyzed. Outcome measures were the quantity of cigarettes consumed per day prior to the COVID-19 pandemic, the quantity after the nationwide outbreak had been contained, satisfaction with physical health, and emotional well-being. Analyses revealed that, after the nationwide outbreak, more individuals quit (vs. started) smoking. Compared to their pre-COVID-19 consumption levels, smokers significantly reduced the quantity of cigarettes they consumed after the nationwide outbreak had been contained. However, there were substantial disparities across individuals: male (vs. female) smokers were less able to curb their smoking; smokers residing in urban (vs. rural) areas or with a longer smoking history were also less able to reduce their smoking. Importantly, a greater reduction in smoking was associated with higher satisfaction with physical health and better emotional well-being. Furthermore, a follow-up investigation revealed that concerns about increased COVID-19 health risks due to smoking were a primary factor driving smokers' behavior change. Overall, these results suggest that, to help smokers fight tobacco addiction and improve well-being, pandemic health policies need to take account of the differences in vulnerability across individuals and leverage the psychological factors that can facilitate behavior change.
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Affiliation(s)
- Haiyang Yang
- Johns Hopkins University, 100 International Drive, Baltimore, MD 21202, USA.
| | - Jingjing Ma
- Peking University, National School of Development, 5 Yiheyuan Road, Beijing 100871, China.
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24
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Tobacco Endgame Simulation Modelling: Assessing the Impact of Policy Changes on Smoking Prevalence in 2035. FORECASTING 2021. [DOI: 10.3390/forecast3020017] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Smoking causes substantial amount of mortality and morbidity. This article presents the findings from simulation models that projected the impact of five potential Tobacco Endgame strategies on smoking prevalence in Ontario by 2035 and expected impact of smoking prevalence “less than 5 by 35” on tax revenue. We used Ontario SimSmoke simulation for modelling the expected impact of four strategies: plain packaging, free cessation services, decreasing the number of tobacco outlets, and increasing tobacco taxes. Separate models were used to project the impact of increasing the minimum age to legally purchase tobacco to 21 years on smoking prevalence and impact of price and tax increase to achieve “less than 5 by 35” on taxation revenue. The combined effect of four strategies in Ontario SimSmoke Model are expected to reduce smoking prevalence by 8.5% in 2035. Increasing tobacco taxes had the greatest independent predicted decrease in smoking prevalence (2.8%) followed by raised minimum age for legal purchase to 21 years (2.4%), decreasing tobacco outlets (1.5%), free cessation services (0.7%), and plain packaging (0.6%). Increasing tobacco excise tax and prices are projected to have minimal impact on taxation revenue, with a decrease from 1.5 billion to 1.2 billion annual tax receipts.
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25
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Pastor Esplá E, Castelló Faus C, Jordá Baldó A, Boira Enrique I, Chiner Vives E. COVID-19 and Smoking: An Opportunity to Quit. Arch Bronconeumol 2021; 57:S0300-2896(21)00109-5. [PMID: 33832793 PMCID: PMC7986316 DOI: 10.1016/j.arbres.2021.03.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 03/09/2021] [Accepted: 03/11/2021] [Indexed: 12/27/2022]
Affiliation(s)
- Esther Pastor Esplá
- Sección de Neumología, Hospital Universitario San Juan de Alicante, Sant Joan d'Alacant, Alicante, España.
| | - Carmen Castelló Faus
- Sección de Neumología, Hospital Universitario San Juan de Alicante, Sant Joan d'Alacant, Alicante, España
| | - Ariana Jordá Baldó
- Medicina Familiar y Comunitaria, Hospital Universitario Virgen del Puerto Plasencia, Plasencia, Cáceres, España
| | - Ignacio Boira Enrique
- Sección de Neumología, Hospital Universitario San Juan de Alicante, Sant Joan d'Alacant, Alicante, España
| | - Eusebi Chiner Vives
- Sección de Neumología, Hospital Universitario San Juan de Alicante, Sant Joan d'Alacant, Alicante, España
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26
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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.
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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
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27
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Affiliation(s)
- Theresa M Marteau
- Department of Public Health and Primary Care, Behaviour and Health Research Unit, University of Cambridge, UK
| | - Harry Rutter
- Department of Social and Policy Sciences, University of Bath, Bath, UK
| | - Michael Marmot
- Institute of Health Equity, University College London, UK
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28
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Ghenadenik AE, Gauvin L, Frohlich KL. Smoking in Young Adults: A Study of 4-Year Smoking Behavior Patterns and Residential Presence of Features Facilitating Smoking Using Data From the Interdisciplinary Study of Inequalities in Smoking Cohort. Nicotine Tob Res 2021; 22:1997-2005. [PMID: 32052039 DOI: 10.1093/ntr/ntaa035] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 02/10/2020] [Indexed: 11/14/2022]
Abstract
INTRODUCTION Young adults have the highest prevalence of smoking among all age groups in most industrialized countries and exhibit great variability in smoking behavior. Differences in associations between features in residential environments and smoking initiation, prevalence, and cessation have been extensively examined in the literature. Nonetheless, in many cases, findings remain inconsistent. This paper proposes that a potential driver of these inconsistencies is an almost exclusive focus on point-specific smoking outcomes, without consideration for the different behavior patterns that this age group may experience over time. AIMS AND METHODS Based on data from the Interdisciplinary Study of Inequalities in Smoking cohort of 18- to 25-year-old Montreal residents (n = 1025), we examined associations between 4-year smoking patterns measured at three timepoints and proximal presence/density of tobacco retail outlets and presence of smoker accommodation facilities in Montreal, Canada. Associations were tested using two-level multinomial and logistic models. RESULTS In fully adjusted models, compared to never-smokers, residents of areas with a higher density of tobacco retail were more likely to (1) be characterized as established smokers, (2) have experienced repeated changes in smoking status (being "switchers") during the 4-year study period, and (3) be former smokers. CONCLUSIONS From a conceptual standpoint, these findings highlight the importance of acknowledging and examining smoking behavior patterns among young adults. Furthermore, specific pattern-feature associations may point to unique mechanisms by which features could influence smoking behavior patterns. These findings require replication and extension, including testing hypotheses regarding tobacco retail density's role in sustaining smoking and in influencing changes in smoking status. IMPLICATIONS Results from this study highlight the importance of describing and examining different young adult smoking behavior patterns and how they may be influenced by residential environment features such as the density of tobacco retail. Findings suggest that young adults residing in areas with a higher density of tobacco retailers are more likely to have experienced repeated changes in smoking status and to be established smokers. Further research in this area is needed to advance knowledge of the putative mechanisms by which residential features may influence smoking behavior patterns and to ultimately orient policy and interventions seeking to curb smoking at the local level.
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Affiliation(s)
- Adrian E Ghenadenik
- Département de médecine sociale et préventive, École de santé publique (ESPUM), Université de Montréal, Montreal, Canada.,Institut de recherche en santé publique de l'Université de Montréal (IRSPUM), Montreal, Canada.,Centre de recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montreal, Canada
| | - Lise Gauvin
- Département de médecine sociale et préventive, École de santé publique (ESPUM), Université de Montréal, Montreal, Canada.,Centre de recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montreal, Canada
| | - Katherine L Frohlich
- Département de médecine sociale et préventive, École de santé publique (ESPUM), Université de Montréal, Montreal, Canada.,Institut de recherche en santé publique de l'Université de Montréal (IRSPUM), Montreal, Canada
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29
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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.
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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
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30
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Cunningham JA, Chaiton M, Leatherdale ST, Godinho A, Schell C. Targeting mailed nicotine patch distribution interventions to rural regions of Canada: protocol for a randomized controlled trial. BMC Public Health 2020; 20:1757. [PMID: 33228625 PMCID: PMC7684960 DOI: 10.1186/s12889-020-09810-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 10/30/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Quitting smoking is the most effective way of reducing the risk of cancer among smokers. One way of helping people stop smoking is to provide them with free Nicotine Replacement Therapy (NRT), such as when NRT is sent to people by postal mail as part of a mass distribution initiative. Our previous research indicated that there may be a substantial impact on increasing quit rates of a mailed NRT intervention in rural areas. The current research seeks to confirm this finding and to understand the social determinants of health driving these anticipated large effects. METHODS/DESIGN Telephone numbers will be randomly selected from across rural regions of Canada in order to recruit adult smokers interested in completing a smoking survey and willing to be interviewed again in 6 months. The survey will ask participants about their smoking history, demographic characteristics, and a hypothetical question: would they be interested in receiving nicotine patches if they were provided to them free of charge? Half of the smokers interested in receiving nicotine patches will be selected by chance and offered the NRT package. The other half of smokers will not be offered the nicotine patches. In addition, the municipality where each participant lives will be identified and, once the relevant general population data becomes available, attempts will be made to link participant data to relevant municipal characteristics (e.g., smoking rates, availability of health services). Characteristics of the participants and the municipalities in which they live will be used to explain why the nicotine patch intervention may have a larger impact in some rural regions compared to others. DISCUSSION The findings from the proposed RCT are timely and of high relevance as the distribution of nicotine patches has substantial potential to combat the public health problem of cigarette related cancer, other diseases, and premature death from tobacco use. Targeting such tobacco cessation initiatives to rural regions may substantially increase the impact of this intervention, helping to optimize the use of limited prevention resources while aiming to save the maximum number of lives. CLINICAL TRIALS REGISTRATION ClinicalTrials.gov NCT04606797 , October, 27, 2020.
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Affiliation(s)
- John A. Cunningham
- Centre for Addiction and Mental Health, 33 Ursula Franklin St, Toronto, Ontario M5S 2S1 Canada
- Department of Psychiatry, University of Toronto, Toronto, M5T 1R8 Canada
- Research School of Population Health, the Australian National University, Canberra, 2601 Australia
| | - Michael Chaiton
- Centre for Addiction and Mental Health, 33 Ursula Franklin St, Toronto, Ontario M5S 2S1 Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, M5T 3M7 Canada
| | - Scott T. Leatherdale
- School of Public Health and Health Systems, University of Waterloo, Waterloo, N2L 3G1 Canada
| | - Alexandra Godinho
- Centre for Addiction and Mental Health, 33 Ursula Franklin St, Toronto, Ontario M5S 2S1 Canada
| | - Christina Schell
- Centre for Addiction and Mental Health, 33 Ursula Franklin St, Toronto, Ontario M5S 2S1 Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, M5T 3M7 Canada
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31
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Shareck M, Datta GD, Vallée J, Kestens Y, Frohlich KL. Is Smoking Cessation in Young Adults Associated With Tobacco Retailer Availability in Their Activity Space? Nicotine Tob Res 2020; 22:512-521. [PMID: 30418634 DOI: 10.1093/ntr/nty242] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Accepted: 11/07/2018] [Indexed: 11/14/2022]
Abstract
INTRODUCTION The presence of tobacco retailers in residential neighborhoods has been inversely associated with residents' likelihood of quitting smoking. Few studies have yet explored whether this association holds when accounting for tobacco retailers found in the multiple environments where people conduct their daily activities, that is, their activity space. METHODS We analyzed cross-sectional data from 921 young adults (18- to 25-years old) participating in the Interdisciplinary Study of Inequalities in Smoking (Montreal, Canada). Respondents self-reported sociodemographic, smoking, and activity location data. Log-binomial regression was used to estimate prevalence ratios (PRs) for the association between smoking cessation and (1) the number of tobacco retailers (counts), and (2) the distance to the closest retailer (proximity) in participants' residential neighborhood and activity space. RESULTS Smoking cessation was positively associated with low and intermediate tertile levels of tobacco retailer counts in both the residential neighborhood and activity space, and with the furthest distance level in the activity space [PR (95% CI) = 1.21 (1.02 to 1.43)]. CONCLUSIONS Individuals encounter resources in the course of their regular daily activities that may hamper smoking cessation. This study highlights the relevance of considering the tobacco retail environment of both individuals' residential neighborhood and activity space to understand its association with smoking cessation. IMPLICATIONS This article contributes to the literature on the association between the tobacco retail environment and smoking cessation in young adults by moving beyond the residential neighborhood to also assess individuals' access to tobacco retailers in the multiple areas where they regularly spend time, that is, their activity space. Findings suggest that lower numbers of tobacco retailers in both the residential neighborhood and activity space, and further distance to tobacco retailers in the activity space are associated with increased smoking cessation.
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Affiliation(s)
- Martine Shareck
- Division of Social and Behavioural Health Sciences, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Geetanjali D Datta
- Centre de recherche du Centre hospitalier de l'Université de Montréal (CRCHUM), Montreal, Quebec, Canada.,Département de médecine sociale et préventive, Ecole de santé publique de l'Université de Montréal, Montreal, Quebec, Canada
| | - Julie Vallée
- Centre National de la Recherche Scientifique (CNRS), UMR Géographie-Cités, Paris, France
| | - Yan Kestens
- Centre de recherche du Centre hospitalier de l'Université de Montréal (CRCHUM), Montreal, Quebec, Canada.,Département de médecine sociale et préventive, Ecole de santé publique de l'Université de Montréal, Montreal, Quebec, Canada
| | - Katherine L Frohlich
- Département de médecine sociale et préventive, Ecole de santé publique de l'Université de Montréal, Montreal, Quebec, Canada.,Institut de recherche en santé publique de l'Université de Montréal (IRSPUM), Montreal, Quebec, Canada
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32
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McDaniel PA, Malone RE. Tobacco industry and public health responses to state and local efforts to end tobacco sales from 1969-2020. PLoS One 2020; 15:e0233417. [PMID: 32442202 PMCID: PMC7244130 DOI: 10.1371/journal.pone.0233417] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Accepted: 05/05/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND In June 2019, Beverly Hills, California, became the first American city in the 21st century to pass an ordinance ending the sale of most tobacco products, including cigarettes, and it is unlikely to be the last. Knowledge of previous efforts to ban tobacco sales in the US, both successful and unsuccessful, may help inform tobacco control advocates' approach to future efforts. METHODS We retrieved and analyzed archival tobacco industry documents. We confirmed and supplemented information from the documents with news media coverage and publicly available state and local government materials, such as meeting minutes and staff reports, related to proposed bans. RESULTS We found 22 proposals to end the sale of cigarettes or tobacco products from 1969-2020 in the US. Proposals came from five states, twelve cities or towns, and one county. Most came from elected officials or boards of health, and were justified on public health grounds. In opposing tobacco sales bans, the tobacco industry employed no tactics or arguments that it did not also employ in campaigns against other tobacco control measures. Public health groups typically opposed sales ban proposals on the grounds that they were not evidence-based. This changed with Beverly Hills' 2019 proposal, with public health organizations supporting this and other California city proposals because of their likely positive health impacts. This support did not always translate into passage of local ordinances, as some city council members expressed reservations about the impact on small businesses. CONCLUSION Tobacco control advocates are likely to encounter familiar tobacco industry tactics and arguments against tobacco sales ban proposals, and can rely on past experience and the results of a growing body of retail-related research to counter them. Considering how to overcome concerns about harming retailers will likely be vital if other jurisdictions are to succeed in ending tobacco sales.
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Affiliation(s)
- Patricia A. McDaniel
- Department of Social and Behavioral Sciences, School of Nursing, University of California San Francisco, San Francisco, CA, United States of America
| | - Ruth E. Malone
- Department of Social and Behavioral Sciences, School of Nursing, University of California San Francisco, San Francisco, CA, United States of America
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33
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Luke DA, Ornstein JT, Combs TB, Henriksen L, Mahoney M. Moving From Metrics to Mechanisms to Evaluate Tobacco Retailer Policies: Importance of Retail Policy in Tobacco Control. Am J Public Health 2020; 110:431-433. [PMID: 32159978 PMCID: PMC7067099 DOI: 10.2105/ajph.2020.305578] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/15/2020] [Indexed: 11/04/2022]
Affiliation(s)
- Douglas A Luke
- Douglas A. Luke, Joseph T. Ornstein, and Todd B. Combs are with the Center for Public Health Systems Science, Brown School, Washington University, St. Louis, MO. Lisa Henriksen is with the Stanford Prevention Research Center, School of Medicine, Stanford University, Stanford, CA. Maggie Mahoney is a tobacco policy and legal consultant in Minneapolis, MN
| | - Joseph T Ornstein
- Douglas A. Luke, Joseph T. Ornstein, and Todd B. Combs are with the Center for Public Health Systems Science, Brown School, Washington University, St. Louis, MO. Lisa Henriksen is with the Stanford Prevention Research Center, School of Medicine, Stanford University, Stanford, CA. Maggie Mahoney is a tobacco policy and legal consultant in Minneapolis, MN
| | - Todd B Combs
- Douglas A. Luke, Joseph T. Ornstein, and Todd B. Combs are with the Center for Public Health Systems Science, Brown School, Washington University, St. Louis, MO. Lisa Henriksen is with the Stanford Prevention Research Center, School of Medicine, Stanford University, Stanford, CA. Maggie Mahoney is a tobacco policy and legal consultant in Minneapolis, MN
| | - Lisa Henriksen
- Douglas A. Luke, Joseph T. Ornstein, and Todd B. Combs are with the Center for Public Health Systems Science, Brown School, Washington University, St. Louis, MO. Lisa Henriksen is with the Stanford Prevention Research Center, School of Medicine, Stanford University, Stanford, CA. Maggie Mahoney is a tobacco policy and legal consultant in Minneapolis, MN
| | - Maggie Mahoney
- Douglas A. Luke, Joseph T. Ornstein, and Todd B. Combs are with the Center for Public Health Systems Science, Brown School, Washington University, St. Louis, MO. Lisa Henriksen is with the Stanford Prevention Research Center, School of Medicine, Stanford University, Stanford, CA. Maggie Mahoney is a tobacco policy and legal consultant in Minneapolis, MN
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34
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Kong AY, Myers AE, Isgett LF, Ribisl KM. Neighborhood racial, ethnic, and income disparities in accessibility to multiple tobacco retailers: Mecklenburg County, North Carolina, 2015. Prev Med Rep 2020; 17:101031. [PMID: 32021758 PMCID: PMC6993011 DOI: 10.1016/j.pmedr.2019.101031] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 10/09/2019] [Accepted: 12/15/2019] [Indexed: 01/25/2023] Open
Abstract
•Existing studies assess an individual's proximity to a single tobacco retailer.•Measuring proximity to more than one retailer may better capture accessibility.•Disparities in multi-retailer proximity exist by neighborhood race and income.•Policies to address disparities in tobacco retailer exposure are needed.
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Affiliation(s)
- Amanda Y. Kong
- Gillings School of Global Public Health, Department of Health Behavior, University of North Carolina, 135 Dauer Drive, 302 Rosenau Hall, CB #7440, Chapel Hill, NC, 27599-7440, USA
- Counter Tools, 205 Lloyd Street #210 & 211, Carrboro, NC, 27510, USA
| | - Allison E. Myers
- Counter Tools, 205 Lloyd Street #210 & 211, Carrboro, NC, 27510, USA
- College of Public Health and Human Sciences, Oregon State University, 160 SW 26th Street, Corvallis, OR, 97331, USA
| | - Lisa F. Isgett
- Counter Tools, 205 Lloyd Street #210 & 211, Carrboro, NC, 27510, USA
| | - Kurt M. Ribisl
- Gillings School of Global Public Health, Department of Health Behavior, University of North Carolina, 135 Dauer Drive, 302 Rosenau Hall, CB #7440, Chapel Hill, NC, 27599-7440, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina, 101 Manning Dr, Chapel Hill, NC, 27514, USA
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35
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Golden SD, Kuo TM, Kong AY, Baggett CD, Henriksen L, Ribisl KM. County-level associations between tobacco retailer density and smoking prevalence in the USA, 2012. Prev Med Rep 2019; 17:101005. [PMID: 31934535 PMCID: PMC6951276 DOI: 10.1016/j.pmedr.2019.101005] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Revised: 09/15/2019] [Accepted: 09/27/2019] [Indexed: 11/23/2022] Open
Abstract
We examine whether county-level tobacco retailer density and adult smoking prevalence are positively associated in the United States and determine whether associations differ in metropolitan vs. nonmetropolitan counties. We merged a list of likely tobacco retailers from the 2012 National Establishment Time-Series with smoking prevalence data from the Behavioral Risk Factor Surveillance System for 2828 US counties, as well as state tobacco policy information and county-level demographic data for the same year. We modeled adult smoking prevalence as a function of tobacco retailer density, accounting for clustering of counties within states. Average density in US counties was 1.25 retailers per 1000 people (range = 0.3–4.5). Smoking prevalence was 0.86 percentage points higher in the most retailer-dense counties, compared to the least. This association, however, was only significant for metropolitan counties. Metropolitan counties in the highest tobacco retailer density quartile had smoking prevalence levels that were 1.9 percentage points higher than metropolitan counties in the lowest density quartile. Research should examine whether policies limiting the quantity, type and location of tobacco retailers could reduce smoking prevalence.
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Affiliation(s)
- Shelley D. Golden
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, 135 Dauer Drive, Chapel Hill, NC 27599-7440, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina, 101 Manning Drive, Chapel Hill, NC 27599-7295, USA
- Corresponding author at: Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, 135 Dauer Drive, Chapel Hill, NC 27599-7440, USA.
| | - Tzy-Mey Kuo
- Lineberger Comprehensive Cancer Center, University of North Carolina, 101 Manning Drive, Chapel Hill, NC 27599-7295, USA
| | - Amanda Y. Kong
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, 135 Dauer Drive, Chapel Hill, NC 27599-7440, USA
| | - Christopher D. Baggett
- Lineberger Comprehensive Cancer Center, University of North Carolina, 101 Manning Drive, Chapel Hill, NC 27599-7295, USA
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, 135 Dauer Drive, Chapel Hill, NC 27599-7435, USA
| | - Lisa Henriksen
- Stanford Prevention Research Center, 3300 Hillview Ave Suite 120, Palo Alto, CA 94304, USA
| | - Kurt M. Ribisl
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, 135 Dauer Drive, Chapel Hill, NC 27599-7440, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina, 101 Manning Drive, Chapel Hill, NC 27599-7295, USA
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36
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Smith EA, Malone RE. An argument for phasing out sales of cigarettes. Tob Control 2019; 29:703-708. [PMID: 31542777 PMCID: PMC7591796 DOI: 10.1136/tobaccocontrol-2019-055079] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Revised: 08/21/2019] [Accepted: 08/26/2019] [Indexed: 11/04/2022]
Abstract
The successes of tobacco control in some countries and locales have led to discussions of ending the tobacco epidemic, often called the 'endgame'. In this paper, we recommend articulating the endgame goal as phasing out sales of cigarettes, a goal once called 'unthinkable'. We develop a logic and argumentation for ending cigarette sales intended to move the discussion beyond the shadow of 'prohibition', proposing an approach that appeals to consumer protection standards and suggesting that the effort be led by low-prevalence communities. While phasing out cigarettes will not happen everywhere all at once, and may unfold differently along several lines, we argue that the gradual phase-out approach we propose will reduce the likelihood of the negative consequences often predicted to come with such a policy. To continue permitting widespread sales of the single most deadly consumer product in history is a public health failure that must be addressed.
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Affiliation(s)
- Elizabeth A Smith
- Social and Behavioral Sciences, University of California San Francisco, San Francisco, California, USA
| | - Ruth E Malone
- Social and Behavioral Sciences, University of California San Francisco, San Francisco, California, USA
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Akinola LS, Mckiver B, Toma W, Zhu AZX, Tyndale RF, Kumar V, Damaj MI. C57BL/6 Substrain Differences in Pharmacological Effects after Acute and Repeated Nicotine Administration. Brain Sci 2019; 9:brainsci9100244. [PMID: 31546627 PMCID: PMC6827359 DOI: 10.3390/brainsci9100244] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 09/18/2019] [Accepted: 09/19/2019] [Indexed: 01/16/2023] Open
Abstract
Tobacco smoking is the major cause of disability and death in the United States and around the world. In addition, tobacco dependence and addiction express themselves as complex behaviors involving an interplay of genetics, environment, and psychological state. Mouse genetic studies could potentially elucidate the novel genes and/or gene networks regulating various aspects of nicotine dependence. Using the closely related C57BL/6 (B6) mice substrains, recent reports have noted phenotypic differences within C57BL/6J (B6J) and C57BL/6N (B6N) mice for some drugs of abuse: alcohol, opiates, and cocaine. However, the differences in nicotine’s effects have not yet been described in these substrains. We examined the phenotypic differences in these substrains following the acute and repeated administration of nicotine in several pharmacological measures, including locomotion (after acute and repeated exposure), body temperature, nociception, and anxiety-like behaviors. We report substrain differences in the pharmacological effects of acute and repeated nicotine administration in the B6 substrains. Overall, we show enhanced nicotine sensitivity to locomotion, hypothermia, antinociception, and anxiety-like behaviors in the B6J mouse substrain compared to B6N. In the repeated administration paradigm, both the B6N and B6J substrains showed no sensitized locomotor responses after repeated exposure to nicotine at the two doses tested. This study thus provides evidence that the B6 mouse substrains may be useful for genetic studies to elucidate some of the genetic variants involved in tobacco dependence and addiction.
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Affiliation(s)
- Lois S Akinola
- Department of Pharmacology and Toxicology, and Translational Research Initiative for Pain and Neuropathy, Medical College of Virginia Campus, Virginia Commonwealth University, Richmond, VA 23298, USA.
| | - Bryan Mckiver
- Department of Pharmacology and Toxicology, and Translational Research Initiative for Pain and Neuropathy, Medical College of Virginia Campus, Virginia Commonwealth University, Richmond, VA 23298, USA.
| | - Wisam Toma
- Department of Pharmacology and Toxicology, and Translational Research Initiative for Pain and Neuropathy, Medical College of Virginia Campus, Virginia Commonwealth University, Richmond, VA 23298, USA.
| | - Andy Z X Zhu
- Takeda Pharmaceutical Company Limited, Cambridge, MA 02139, USA.
| | - Rachel F Tyndale
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health (CAMH), Department of Pharmacology and Toxicology, and Psychiatry, University of Toronto, Toronto, ON, Canada.
| | - Vivek Kumar
- The Jackson Laboratory, Bar Harbor, ME 04609, USA.
| | - M Imad Damaj
- Department of Pharmacology and Toxicology, and Translational Research Initiative for Pain and Neuropathy, Medical College of Virginia Campus, Virginia Commonwealth University, Richmond, VA 23298, USA.
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Clemens T, Dibben C, Pearce J, Shortt NK. Neighbourhood tobacco supply and individual maternal smoking during pregnancy: a fixed-effects longitudinal analysis using routine data. Tob Control 2018; 29:tobaccocontrol-2018-054422. [PMID: 30389809 PMCID: PMC6952837 DOI: 10.1136/tobaccocontrol-2018-054422] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Revised: 09/21/2018] [Accepted: 10/15/2018] [Indexed: 11/06/2022]
Abstract
BACKGROUND Tobacco policy is increasingly focusing on the 'tobacco endgame' which commits to eradicating tobacco use (prevalence below 5%) within the next two decades. Strategies for achieving the endgame are likely to include addressing the supply of tobacco products, yet current evidence to support this approach is primarily cross-sectional. METHODS We use longitudinal smoking information from routine maternity records of all women who gave birth in Scotland between 2000 and 2015. We linked this data to the residential density of retailers selling tobacco products and the neighbourhood prevalence of smoking during pregnancy. In the analysis, individual mothers act as their own controls because we compare changes in their smoking behaviour between pregnancies to changes in exposure to tobacco retailing that arises from residential movement between pregnancies. RESULTS Adjusted ORs showed an increased risk of being a smoker associated with increases in exposure to retailer density (OR 1.67, 95% CI 1.27 to 2.20). CONCLUSIONS The results provide the strongest evidence to date of an association between the neighbourhood availability of tobacco and smoking, and the first to do so among pregnant women. These findings provide supportive evidence for interventions targeting the supply of tobacco products in achieving the endgame.
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Affiliation(s)
- Tom Clemens
- School of Geosciences, University of Edinburgh, Edinburgh, UK
| | - Chris Dibben
- School of Geosciences, University of Edinburgh, Edinburgh, UK
| | - Jamie Pearce
- School of Geosciences, University of Edinburgh, Edinburgh, UK
| | - Niamh K Shortt
- School of Geosciences, University of Edinburgh, Edinburgh, UK
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Robertson L, Marsh L. Estimating the effect of a potential policy to restrict tobacco retail availability in New Zealand. Tob Control 2018; 28:466-468. [DOI: 10.1136/tobaccocontrol-2018-054491] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Revised: 07/16/2018] [Accepted: 08/14/2018] [Indexed: 11/03/2022]
Abstract
IntroductionReducing tobacco retailer density is suggested to be a key component of tobacco endgames. Where tobacco retail reduction policies exist, ‘grandfathering’ is typically used, where existing retailers are exempt from restrictions aimed at reducing outlet density. We examined the possible impact on tobacco outlet density in New Zealand of a policy preventing new retail outlets from selling tobacco, but allowing existing retail outlets to continue selling tobacco until they ceased trading or relocated.MethodsWe obtained data on numbers of tobacco outlets and the number of outlet closures recorded annually from 2006 to 2016. We calculated the mean and the lowest and highest 3-year rolling average closure rates for each type of tobacco outlet. We projected decreases in the number of tobacco outlets that would hypothetically be permitted to sell tobacco from 2020 onwards and estimated when the combined number of tobacco outlets would decline by 50% and 95%.ResultsBased on mean annual closure rates, the total number of tobacco outlets would decrease by 50% by 2032 and a 95% reduction could be achieved by 2072. By 2025, the number of tobacco outlets would decrease by 27%; by 2050, this reduction would reach 84%.ConclusionA tobacco retail reduction policy that prevented new retail outlets from selling tobacco and grandfathered existing retailers would be unlikely to achieve New Zealand’s target of a 95% reduction in tobacco outlet density within several decades of being enacted. Nonetheless, this policy could achieve a 50% reduction in tobacco retail availability in the first decade of implementation.
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Fleischer NL, Lozano P, Wu YH, Hardin JW, Meng G, Liese AD, Fong GT, Thrasher JF. Disentangling the roles of point-of-sale ban, tobacco retailer density and proximity on cessation and relapse among a cohort of smokers: findings from ITC Canada Survey. Tob Control 2018. [PMID: 29519935 DOI: 10.1136/tobaccocontrol-2017-054081] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To examine how point-of-sale (POS) display bans, tobacco retailer density and tobacco retailer proximity were associated with smoking cessation and relapse in a cohort of smokers in Canada, where provincial POS bans were implemented differentially over time from 2004 to 2010. METHODS Data from the 2005 to 2011 administrations of the International Tobacco Control (ITC) Canada Survey, a nationally representative cohort of adult smokers, were linked via residential geocoding with tobacco retailer data to derive for each smoker a measure of retailer density and proximity. An indicator variable identified whether the smoker's province banned POS displays at the time of the interview. Outcomes included cessation for at least 1 month at follow-up among smokers from the previous wave and relapse at follow-up among smokers who had quit at the previous wave. Logistic generalised estimating equation models were used to determine the relationship between living in a province with a POS display ban, tobacco retailer density and tobacco retailer proximity with cessation (n=4388) and relapse (n=866). RESULTS Provincial POS display bans were not associated with cessation. In adjusted models, POS display bans were associated with lower odds of relapse which strengthened after adjusting for retailer density and proximity, although results were not statistically significant (OR 0.66, 95% CI 0.41 to 1.07, p=0.089). Neither tobacco retailer density nor proximity was associated with cessation or relapse. CONCLUSIONS Banning POS retail displays shows promise as an additional tool to prevent relapse, although these results need to be confirmed in larger longitudinal studies.
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Affiliation(s)
- Nancy L Fleischer
- Center for Social Epidemiology and Population Health, Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Paula Lozano
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - Yun-Hsuan Wu
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - James W Hardin
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - Gang Meng
- Department of Psychology, University of Waterloo, Waterloo, Ontario, Canada
| | - Angela D Liese
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - Geoffrey T Fong
- Department of Psychology, University of Waterloo, Waterloo, Ontario, Canada.,School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada.,Ontario Institute for Cancer Research, Toronto, Ontario, Canada
| | - James F Thrasher
- Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA.,Department of Tobacco Research, Center for Population Health Research, National Institute of Public Health, Cuernavaca, Mexico
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