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GIS tools for surveillance and regulation of flavored OTPs

Institution: Stanford University
Investigator(s): Lisa Henriksen, Ph.D.
Award Cycle: 2013 (Cycle 22) Grant #: 22RT-0142 Award: $566,132
Subject Area: Industry Influence/Policy
Award Type: Research Project Awards

Initial Award Abstract

Marketing of other tobacco products (cigars, smokeless, and e-cigs) are increasing visible in California stores. Regulation of OTPs lags far behind cigarettes and this failure poses a serious threat to public health, particularly for adolescents. OTPs are still sold in appealing flavors, such as apple, cherry, chocolate, and vanilla, a strategy tobacco companies use to make their products more palatable and attractive to new users. Distinct patterns in the retail availability and marketing of flavored tobacco products likely contribute to income, race and age disparities in product use. Menthol cigarettes have been the focus of much research about target marketing, but too little is known about the retail environment for flavored OTPs. To address this gap in the literature, we propose to:

Aim 1: Examine the availability and promotion of flavored OTPs in relation to school proximity and neighborhood demography

Our research takes advantage of planned changes to the California Tobacco Advertising Study, which will monitor the availability, promotion, and price of snus, e-cigs, and little cigars/cigarillos in a representative sample of licensed tobacco retailers (n=600). With these new data, we will test the hypothesis that the availability and promotion of flavored OTPs are more prevalent in tobacco retailers near schools, using state-of-the-art techniques to measure their proximity.

Reducing adolescents’ exposure to retail tobacco marketing is a new objective of Healthy People 2020 and school neighborhoods are a particularly important focus of federal, state, and local efforts to achieve this. State and local governments have the authority to ban the sale of flavored OTPs, but few have done so. An additional strategy to limit the retail availability of these products is to limit the number, type and location of tobacco retailers, particularly in school neighborhoods. Although creating public support and political will to adopt strict regulations may be easier to accomplish in neighborhoods where tobacco retailer density is already excessive, no such definition exists. For this reason, we propose to:

Aim 2: Define a “tobacco swamp” and examine the school characteristics that are associated with a higher likelihood of being located in such areas Combining data from retailer licensing records, school enrollment and neighborhood demography, our spatial analyses will compare multiple definitions of tobacco swamps (e.g., in relation to population density, household tobacco expenditures, and distance from schools) and evaluate model statistics and resulting area maps. A multiple logistic regression will be used to examine the school characteristics (e.g., enrollment size and race/ethnicity, percent eligible for free or reduced-price meals, parent education) that are associated with being located in a tobacco swamp.

Given the importance of school neighborhoods to state and local regulatory efforts, it is surprising that basic policy-relevant questions have not been answered: What proportion of retailers would be affected by a sales or advertising ban within 1,000 of schools? Is their presence related to particular school or neighborhood demographics? How does the availability and promotion of flavored OTPs differ for tobacco retailers near schools? The proposed research will answer these questions at the state level, and provide public health departments, policy makers, and tobacco control researchers and advocates with a much-needed resource to answer these questions at the local level. To this end, we propose to:

Aim 3: Create an interactive Web tool, MapCollaborator™ for Tobacco Control, that would improve state and local capacity to monitor the retail environment for tobacco products The proposed project will provide the first access to spatial data for school boundaries and tobacco retailers in California. Users will be able to determine how many and which tobacco retailers are within 1,000 feet of schools; identify where tobacco swamps exist relative to schools, and evaluate the potential impact of policies to regulate the retail environment for tobacco.