Modeling and mapping changes in tobacco outlet density
Initial Award Abstract
The tobacco industry’s primary venues for marketing cigarettes to current and future smokers are convenience stores, small grocery or “corner” stores, gas stations, liquor stores, supermarkets and pharmacies, all of which we refer to as tobacco outlets. Tobacco outlet density measures the concentration of outlets in a specified area that may be defined by census or other boundaries, such as the distance from a school.
Using zoning ordinances to limit alcohol outlet density in communities has reduced alcohol consumption and alcohol-related problems. There is considerable interest in replicating this strategy to benefit tobacco control. Unfortunately, the available evidence makes it difficult to determine whether restricting the number or location of tobacco outlets in a neighborhood is a plausible strategy to reduce smoking among individuals who live there. Cross-sectional studies confirm higher rates of current smoking among adults and adolescents who live in areas with higher tobacco outlet density than in areas with lower outlet density. However, no longitudinal study of these associations has yet been conducted.
An important obstacle to designing a longitudinal study is a lack of understanding about how tobacco outlet density changes over time. How are the concentration and composition of tobacco outlets changing in California? How are these changes associated with neighborhood demographics? Which neighborhoods face the greatest increases? The proposed research will answer these important questions.
The aims of this exploratory research are to model changes in tobacco outlet density in California’s urban areas and in high school neighborhoods, to relate these changes to neighborhood demographics, and to map “hotspots” with greater than expected outlet density. Urban areas are a focus of this research because the highest concentration of tobacco outlets are in neighborhoods with a higher proportion of racial/ethnic minorities and the tobacco industry’s marketing practices target these groups with ads and promotions, particularly for menthol cigarettes. School neighborhoods are a focus of this research because adolescents frequently visit tobacco outlets near school and school smoking prevalence is correlated positively with the density of tobacco outlets nearby.
Specifically, we propose to link annual licensing data for tobacco retailers from the state Board of Equalization (2005-2009) and the City of Los Angeles (2001-2008) with intercensus estimates of neighborhood demographics, such as race/ethnicity, proportion of residents under 18, immigrant concentration, and material deprivation. Multilevel modeling will predict change in outlet density over time and examine how the rate of change varies with neighborhood demographics. Licensing data from the City of Los Angeles span a longer time period, making it possible to test for a curvilinear relationship between time and outlet density in this subset of urban-area neighborhoods. This exploratory research would lay the foundation for a future California award application—a longitudinal study to examine whether decreases in tobacco outlet density predict decreases in smoking prevalence.
Although geospatial analyses are used increasingly to describe the complex relationships between environment and health, no previous study has used such tools to examine how tobacco outlet density changes over time. An innovative feature of the proposed research is mapping hotspots with greater than expected increases in tobacco outlet density given model-based predictions. These maps will identify for public health and policy planners which urban areas and high school neighborhoods may derive the greatest benefit from interventions, such as employing land use policy to control the number and location of tobacco outlets. Such policies are consistent with the state’s mission to limit and regulate the activities and influences of the tobacco industry and to create a social milieu and legal climate that make tobacco less desirable, less acceptable, and less accessible to Californians. |