Tobacco retailer density and smoking behavior in a rural Australian jurisdiction without a tobacco retailer licensing system.

John Baker,Mohd Masood,Stephen Begg,Muhammad Aziz Rahman,Lukar Thornton

doi:10.18332/tid/134190

Abstract

INTRODUCTIONAn emerging body of research has developed around tobacco retailer density and its contribution to smoking behavior. This cross-sectional study aimed to determine the association between tobacco retailer density and smoking behavior in a rural Australian jurisdiction without a tobacco retailer licensing system in place.METHODSA local government database (updated 2018) of listed tobacco retailers (n=93) was accessed and potential unlisted tobacco retailers (n=230) were added using online searches. All retailers (n=323) were visited in 2019 and GPS coordinates of retailers that sold tobacco (n=125) were assigned to suburbs in ArcMap. A community survey conducted in the Local Government Area provided smoking and sociodemographic data amongst adult respondents (n=8981). Associations between tobacco retailer density (calculated as the number of retailers per km2 based on respondents’ suburb of residence) and daily, occasional and experimental smoking were assessed using multilevel logistic regression analysis. Separate models with and without covariates were undertaken.RESULTSWithout adjusting for possible confounders, living in suburbs with greater retailer density did not increase the odds of daily smoking (OR=1.01; 95% CI: 0.92–1.12), occasional smoking (OR=1.05; 95% CI: 0.94–1.18), or experimental smoking (OR=0.98; 95% 0.92– 1.05). However, after adjustment, living in suburbs with greater retailer density increased the odds of occasional smoking behavior (AOR=1.37; 95% CI: 1.10–1.71) but not daily or experimental smoking.CONCLUSIONSThis study found a significant positive association between tobacco retailer density and the likelihood of occasional smoking in a rural Australian jurisdiction without a tobacco retailer licensing system in place. The findings strengthen calls for the introduction of a comprehensive, positive tobacco retailer licensing system to provide a framework for improving compliance with legislation and to reduce the overall availability of tobacco products in the community.

Highlights

An emerging body of research has developed around tobacco retailer density and its contribution to smoking behavior
Tobacco retailers per km[2], mean (SD) Suburb-level Index of Relative Socio-Economic Disadvantage (IRSD) quintile Most disadvantaged Q2 Q3 Q4 Least disadvantaged Health status Excellent Very good Good Fair Poor Age 18–34 35–49 50–69 ≥70 Sex Male Female Financial position Prosperous/very comfortable Reasonably comfortable Just getting along Poor/very poor Education level Bachelor’s or higher Completed Year 12 Did not complete Year 12 Alcohol consumption Daily Less than daily Does not drink ATSI status Aboriginal or Torres Strait Islander Does not identify as ATSI
It found that tobacco retailer density was associated with occasional smoking behavior, but not daily or experimental smoking behaviors

Summary

Introduction

An emerging body of research has developed around tobacco retailer density and its contribution to smoking behavior. An emerging body of research has developed around the retail availability of tobacco products and its contribution to a range of smoking behaviors including experimentation, uptake and continuation, and the undermining of cessation attempts amongst existing smokers who want to quit. This literature has focused primarily on tobacco retailer density and how this might influence smoking behavior. Several systematic reviews[14,15,16,17] and a meta-analysis[18] have documented statistically significant associations between tobacco retailer density and smoking behavior amongst both youth and adults, around participants’ homes and activity spaces

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