Retail Density Research Articles

Association of Local Cannabis Policy and Retail Availability With Cannabis Use and Problematic Cannabis Use Among Adolescents in Northern California.

Objectives. To examine whether local cannabis policies and retail availability are associated with cannabis use and problematic cannabis use (PCU) among adolescents in Northern California. Methods. The sample comprised adolescents aged 13 to 17 years screened for past-year cannabis use during well-child visits in 2021. Exposures included local bans on cannabis storefront retailers, policy protectiveness, and retail proximity and density. Outcomes included self-reported past-year cannabis use and PCU diagnoses. Modified Poisson regression models adjusted for sociodemographics. Results. The sample (n = 103 134) was 51.1% male with a median age of 15 years (interquartile range [IQR] = 14-16 years); 5.5% self-reported cannabis use, and 0.3% had diagnosed PCU. Adolescents had a lower prevalence of cannabis use in jurisdictions that banned storefront retailers (adjusted prevalence rate [APR] = 0.857; 95% confidence interval [CI] = 0.814, 0.903 vs allowed), banned delivery (APR = 0.751; 95% CI = 0.710, 0.795 vs allowed), or had more policy protections (APR range = 0.705-0.800). Lower PCU prevalence was also found among those in jurisdictions that banned (vs allowed) storefront retailers (APR = 0.786; 95% CI = 0.629, 0.983) or delivery (APR = 0.783; 95% CI = 0.616, 0.996). Longer drive time and lower density of storefront retailers were associated with a lower cannabis use prevalence. Conclusions. More protective cannabis policies and less retail availability were associated with a lower prevalence of adolescent cannabis use and PCU. (Am J Public Health. 2024;114(S8):S654-S663. https://doi.org/10.2105/AJPH.2024.307787).

Public and professional stakeholders' perceptions of alcohol advertising and availability policies: A qualitative study.

Reducing alcohol availability and restricting alcohol advertising are effective ways to reduce harm from alcohol. Implementation of public health policies involves collaboration between different stakeholders, and is influenced by public opinion. This paper explores public and professional stakeholders' perceptions of alcohol advertising and availability policies. It is the first to capture consensus and divergence in narratives of these stakeholders. We conducted semi-structured interviews with 14 stakeholders from third sector organisations, government, public health and alcohol licensing in Scotland. We conducted 11 online focus groups with 45 participants, living in neighbourhoods in Scotland characterised by varying levels of urbanity, deprivation and retail density change. We gave participants a list of policies and discussed their views on acceptability, feasibility and likely success. Despite general consensus that regulation of alcohol advertising is an important priority, public stakeholders were concerned about the feasibility of advertising interventions and potential unintended consequences. While professional stakeholders were in favour of regulating alcohol availability, public stakeholders had misgivings about feasibility and effectiveness. When prompted to discuss specific interventions, similar views about protecting children and achieving cultural change emerged. This study highlights the importance of policy makers and other stakeholders to consider public stakeholders' opinions on alcohol policy and understanding that their views may be influenced by competing framings of alcohol problems. Attempts to increase support for alcohol control policies need to consider people's concerns about the effectiveness and potential unintended consequences of these policies, and the wider social context of alcohol consumption.

The impact of tobacco retailers density reduction on smoking status of Belgian adults

Abstract Background Smoking being one of most impactful risk factors for causing non-communicable diseases (NCD) and consequently attributable death, represents an enormous public health issue. New policy interventions aimed at reducing smoking prevalence are planned in the Belgian Tobacco Free Generation plan. Within the plan, it is aimed to reduce the number of outlets that sell tobacco products, as a higher tobacco retail density (TRD) is believed to be linked to higher smoking prevalence. Using health impact assessment (HIA), this study aims to evaluate the policy before it is set in place. Methods For this intervention a 17% reduction in density was estimated according to the scoping review would be associated with an 0.39 percentage point reduction in prevalence. The Potential Impact Fraction (PIF) was calculated to assess the change in proportion of current smokers. Time series and projections of the Belgium Health Interview Survey provided data on the smoking status from 1997 untill 2040. The relative risk were retrived from the Global Burden of Disease 2021 study. Using data from the Belgian Burden of Disease Study, the avoidable burden was estimated. Results The policy is expected to reduce the density by 17 % by 2025, which results in a PIF for lung cancer of 0.92%, decreasing to 0.82% in 2040. The smoking prevalence would decrease from 12.62% to 12.23%. We estimated that this intervention would avoid the burden of more than 300 lung cancer cases and around 100 deaths in 2040. Conclusions The HIA in this study suggests that reducing TRD has a potential to contribute to achieving the objectives in Tobacco Free Generation plan. However, it should be noted that the impact is rather small, lower than 1% for most diseases. In addition, the actual impact may vary depending on the specific implementation of the policy and future smoking trends. Further research is needed to refine the effect size estimate based on the actual policy intervention details. Key messages • Reducing tobacco retail density can reduce the burden of smoking. • Modeling limitations need further research to refine HIA results.

Time-varying exposure to food retailers and cardiovascular disease hospitalization and mortality in the netherlands: a nationwide prospective cohort study.

Very few studies to date investigated the prospective association of changes in exposure to the food environment with cardiovascular disease (CVD) risk. We aim to explore if time-varying exposure to the food environment was associated with hospitalization and mortality due to total and specific types of CVD in The Netherlands. In this prospective cohort study, 4,641,435 Dutch adults aged 35 + years who did not change residence in 2002-2018 were identified through registry data. Exposure to the food environment was defined as time-varying Food Environment Healthiness Index (FEHI) scores (range: - 5 to 5) and time-varying kernel density of specific food retailers (e.g., fast food outlets, supermarkets) around the home location between 2004 and 2018. The main outcome measures were hospitalization and mortality due to overall CVD, stroke, HF, and CHD occurring between 2004 and 2020, based on hospital and death registries. In Cox regression models, each unit increase in the FEHI was associated with a lower hospitalization and mortality of CVD (hospitalization hazard ratio (HRh) = 0.90 (0.89 to 0.91), mortality hazard ratio (HRm) = 0.85 (0.82 to 0.89)), CHD (HRh = 0.88 (0.85 to 0.91), HRm = 0.80 (0.75 to 0.86)), stroke (HRh = 0.89 (0.84 to 0.93)), HRm = 0.89 (0.82 to 0.98)), and HF (HRh = 0.90 (0.84-0.96), HRm = 0.84 (0.76 to 0.92)). Increased density of local food shops, fast food outlets, supermarkets, and convenience stores and decreased density of food delivery outlets and restaurants were associated with a higher risk of CVD, CHD, stroke, and HF hospitalization and mortality. In this observational longitudinal study, changes in exposure to a healthier food environment over 14years were associated with a risk reduction in CVD hospitalization and mortality, in particular in urbanized areas and for younger adults and those with higher incomes.

Tobacco retail availability and smoking-A systematic review and meta-analysis.

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. 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. 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%). 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.

Tobacco retailer density and its association with birth outcomes in the USA: 2000–2016

IntroductionSignificant progress has been made in reducing maternal exposure to tobacco smoke and subsequent adverse birth outcomes, however, reductions may require strategies that reduce the availability of tobacco retailers. In...

Association between density of food retailers and fitness centers and gestational diabetes mellitus in Eastern Massachusetts

Association between density of food retailers and fitness centers and gestational diabetes mellitus in Eastern Massachusetts

Supply and demand effects between tobacco retailer density and smoking prevalence

ObjectivePlaces with more tobacco retailers have higher smoking prevalence levels, but whether this is because retailers locate where people who smoke live or whether tobacco availability prompts tobacco use is...

Correlation Among Neighborhood-level Measures of the Tobacco Retail Environment.

Tobacco retailer density and distance to tobacco retailers are understood to influence tobacco-related behaviors; however, there is no general agreement on how to best characterize or measure the tobacco retail environment (TRE). In this data-driven analysis, we examine similarities among neighborhood-level measures of the TRE and assess how geographic resolution of the neighborhood units may affect them. We used locations of likely tobacco retailers in the United States (US) to calculate multiple retailer count, density, and distance measures. Measures were calculated at the Census block group, tract, and county (including county equivalents) levels of geographic aggregation. Spearman's correlation was used to evaluate similarity among the TRE measures. At the block group and tract level, correlation among all TRE measures ranged from slightly negative (ρ = -0.03) to nearly perfect (ρ = 0.99). At both levels of aggregation, distance-based TRE measures were highly correlated (ρ > 0.76). At the block group level, simple count of retailers was highly correlated with the density measures (ρ > 0.83), and at the tract level, simple count was moderately to highly correlated with the density measures (ρ > 0.5). Findings were generally similar at the county level; a notable deviation was that retailers per person was negatively correlated with all other TRE measures (range from ρ = -0.08 to ρ = -0.32). Some common measures were not correlated, suggesting they capture different aspects of the TRE; similarity among the various measures also varied by level of geographic aggregation. Because the tobacco retail environment shapes people's tobacco-related behaviors, using appropriate measures to characterize it at a neighborhood-level is paramount. Our work highlights both the similarities and differences among a set of common measures, thereby suggesting the measures may be capturing different aspects of the overall retail environment. Our findings regarding geographic level of aggregation underscore the importance of neighborhood definition in any tobacco retail environment analysis.

Global policy scan of commercial combustible tobacco product retailing regulations by WHO region

Background/aimsRegulatory 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,...

Exploring associations of population characteristics and tobacco and vape retailer density and proximity in Australia: a scoping review

ObjectiveThis scoping review synthesises Australian evidence on associations between tobacco and vape retailer density/proximity and various population measures and smoking behaviour to identify research gaps and inform future policy and...

Unveiling rural and Appalachian disparities in cigarette smoking through the social vulnerability index and other county-level characteristics.

Mitigating tobacco-related disparities in the Appalachian region and rural areas is crucial. This study seeks to gauge cigarette smoking prevalence in Virginia counties, uncover rurality and Appalachian-linked disparities, and explore local drivers of these gaps. A 2011-2019 Virginia BRFSS data were used to estimate county-level cigarette smoking rates in adults aged 18 or older. Counties were categorized as urban/rural and Appalachian/non-Appalachian, with a focus on rural-Appalachian. Disparities in cigarette smoking rates and associated factors were analyzed via the Blinder-Oaxaca decomposition method. The study assessed 4 dimensions of the Centers for Disease Control and Prevention's social vulnerability index (SVI): socioeconomic, minority status, household composition, and housing. Additionally, county-specific factors such as tobacco agriculture, physician availability, coal mining, and tobacco retailer density were examined. Rural areas exhibited a 6.18% higher cigarette smoking prevalence compared to urban areas (P<.001). SVI dimensions accounted for 53.2% of the disparity, county features explained 16.4%, and 30.4% remained unexplained. Appalachian areas had a 6.79% higher cigarette smoking prevalence than non-Appalachian areas (P<.001). SVI dimensions explained 51.4% of the disparity, county features accounted for 21.8%, leaving 26.8% unexplained. Rural-Appalachian areas showed a 7.8% higher cigarette smoking prevalence (P<.001). SVI dimensions contributed to 51.7% of the disparity, county features explained 9.6%, and 38.7% remained unexplained. Substantial disparities in cigarette smoking prevalence exist in underserved areas of Virginia, including rural, Appalachian, and rural-Appalachian regions. While SVI dimensions, physician availability, tobacco agriculture, and coal mining contribute, yet notable gaps remain unexplained. Targeted interventions must tackle unique challenges in disadvantaged areas to reduce smoking and promote health equity.

Flavored Tobacco Sales Restrictions and Youth E-cigarette Behavior: Impact by Tobacco Retailer Density in Diverse Communities in California.

Factors that impact flavored tobacco sales restriction (flavor restrictions) effectiveness on youth e-cigarette behavior are unclear. Tobacco retailer density (retailer density) is a health equity issue with greater retailer density in high-minority, low-income areas. We examined the association between flavor restrictions and youth e-cigarette behavior by retailer density across diverse communities in the California Bay Area. We analyzed data from the California Healthy Kids Survey using a difference-in-differences (DID) strategy. We compared pre- and post-policy changes in e-cigarette access and use one-year post-implementation among high school students in the Bay Area with a flavor restriction (n = 20 832) versus without (n = 66 126). Separate analyses were conducted for students in cities with low and high retailer density, with a median cutoff of 3.3 tobacco retailers/square mile. Students with high retailer density were more likely to identify as a minority and have parents with lower education. Among students with low retailer density, flavor restrictions were associated with 24% lower odds in the pre- to post-policy increase in ease of access relative to unexposed students (DID = 0.76, 95% CI: 0.58, 0.99). Among students with high retailer density, flavor restrictions were associated with 26% higher odds in ease of access (DID: 1.26, 95% CI: 1.02, 1.56) and 57% higher odds of current use (DID = 1.57, 95% CI: 1.31, 1.87). Flavor restrictions had positive impacts on youth e-cigarette access in low, but not high retailer density cities. From a health equity perspective, our results underscore how flavor restrictions may have uneven effects among vulnerable groups. In diverse communities in the California Bay Area, our results suggest a protective association between flavored tobacco sales restrictions and youth access to e-cigarettes in low, but not high tobacco retailer density cities one-year post-implementation. These results underscore how flavor restrictions may have uneven effects, and when implemented in high retailer density areas, may disproportionately place already vulnerable groups at heightened exposure to e-cigarette use and access. In high retailer density areas, additional tobacco control efforts may need to be included with flavor restriction implementation, such as increased education, youth prevention and cessation programs, policies to reduce tobacco retailer density, or stronger tobacco retailer enforcement or compliance monitoring.

Association between density of food retailers and fitness centers and gestational diabetes mellitus in Eastern Massachusetts, USA: population-based study

Few studies have investigated the relationship between the food and physical activity environment and odds of gestational diabetes mellitus (GDM). This study quantifies the association between densities of several types of food establishments and fitness centers with the odds of having GDM. The density of supermarkets, fast-food restaurants, full-service restaurants, convenience stores and fitness centers at 500, 1000 and 1500m (m) buffers was counted at residential addresses of 68,779 pregnant individuals from Eastern Massachusetts during 2000-2016. The 'healthy food index' assessed the relative availability of healthy (supermarkets) vs unhealthy (fast-food restaurants, convenience stores) food retailers. Multivariable logistic regression quantified the cross-sectional association between exposure variables and the odds of having GDM, adjusting for individual and area-level characteristics. Effect modification by area-level socioeconomic status (SES) was assessed. In fully adjusted models, pregnant individuals living in the highest density tertile of fast-food restaurants had higher GDM odds compared to those living in the lowest density tertile (500m: odds ratio (OR):1.17 95% CI: [1.04, 1.31]; 1000m: 1.33 95% CI: [1.15, 1.53]); 1500m: 1.18 95% CI: [1.01, 1.38]). Greater residential density of supermarkets was associated with lower odds of GDM (1000m: 0.86 95% CI: [0.74, 0.99]; 1500m: 0.86 95% CI: [0.72, 1.01]). Similarly, living in the highest fitness center density tertile was associated with decreased GDM odds (500m:0.87 95% CI: [0.76, 0.99]; 1500m: 0.89 95% CI: [0.79, 1.01]). There was no evidence of effect modification by SES and no association found between the healthy food index and GDM odds. In Eastern Massachusetts, living near a greater density of fast-food establishments was associated with higher GDM odds. Greater residential access to supermarkets and fitness centers was associated with lower the odds of having GDM. NIH.

Walkability index for world heritage cities in developing countries

Walkability principles are an important part in the planning process of cities that face urban problems such as gentrification, pollution, and decay of their built heritage. The proposed factors – connectivity, proximity, land use mix, and retail density – form a comprehensive framework for evaluating walkability that transcends the boundaries of historical cities. These factors, while initially identified within historical contexts, possess inherent qualities that render them universally adaptable to various urban landscapes. By leveraging these factors, urban planners gain insights into the intricate fabric of pedestrian experiences in cities. They serve as universal evaluative tools, applicable not only to historical cities but also to burgeoning metropolises and smaller urban centres. This work introduces a novel approach to assessing the Walkability Index for World Heritage Cities, utilizing a Multiple Criteria Spatial Decision Support System (GIS-MCDA) structured in four stages. The approached methodology is particularly valuable for governments and decision-makers in developing countries of the Global South, where limitations in data and available tools are common challenges. The insights gained from this study can guide the improvement of policies, enable more precise implementation of sustainable mobility infrastructure, and motivate the pursuit or maintenance of UNESCO World Heritage nominations. The case study focused on the Historical Centre of Arequipa, Peru, a city designated as a UNESCO World Heritage site. The results of this study demonstrate the effectiveness of the proposed approach in such contexts, owing to its specificity and the integration of both objective and subjective elements.

A new commercial boundary dataset for metropolitan areas in the USA and Canada, built from open data

The purpose of this study is to define the geographic boundaries of commercial areas by creating a consistent definition, combining various commercial area types, including downtowns, retail centres, financial districts, and other employment subcentres. Our research involved the collection of office, retail and job density data from 69 metropolitan regions across USA and Canada. Using this data, we conducted an unsupervised image segmentation model and clustering methods to identify distinctive commercial geographic boundaries. As a result, we identified 23,751 commercial areas, providing a detailed perspective on the commercial landscape of metropolitan areas in the USA and Canada. In addition, the generated boundaries were successfully validated through comparison with previously established commerce-related boundaries. The output of this study has implications for urban and regional planning and economic development, delivering valuable insights into the overall commercial geography in the region. The commercial boundary and used codes are freely available on the School of Cities Github, and users can reuse, reproduce and modify the boundaries.

Restricting supply of tobacco products to pharmacies: a scoping review

ObjectiveWe synthesised the published literature on proposals to restrict tobacco supply to pharmacies, covering (1) policy concept/rationale/attempts, (2) policy impact and implementation and (3) policy and research recommendations.Data sourcesWe searched...

Tobacco Quitline utilization compared with cigarette smoking prevalence in Virginia across rurality and Appalachian Status, 2011–2019

IntroductionWhile cigarette smoking rates have declined, rural and Appalachian populations in the United States have not seen similar decreases. Quitline programs are promising strategies in reducing disparities in these areas, but research on their usage is limited. MethodsWe employed Small Area Estimation on the Virginia Behavioral Risk Factor Surveillance System (2011–2019) to estimate county-level smoking prevalence and utilized The Quit Now Virginia Quitline data (2011–2019) to estimate Quitline users. We analyzed differences in Quitline utilization by rurality and Appalachian status using statistical t-tests. Stepwise regression assessed the absolute estimate of county features, including poverty rate, tobacco retailer density, physician availability, coal mining industry, and tobacco agriculture, on Quitline usage. ResultsWhile the average smoking rate overall was 15.3 %, only 7.4 % of smokers accessed Quitline services from 2011 to 2019. Appalachian regions exhibited higher smoking rates (20.9 %) and lower quitline usage (4.8 %) compared to non-Appalachian areas (14 % smoking prevalence, 8 % quitline usage). Rural regions had higher smoking prevalence (19.0 %) than urban areas (12.9 %), but no significant difference in Quitline utilization (7.6 % vs. 7.2 %, p = 0.7). Stepwise regression revealed counties with more tobacco agriculture had 3.2 % (p = 0.04) lower Quitline utilization. Also, more physicians availability in the county was associated with 3.9 % higher Quitline usage (p = 0.03) and Appalachian counties exhibited a 3.6 % lower Quitline usage rate compared to non-Appalachian counties. ConclusionA significant gap exists between cigarette smoking prevalence and Quitline utilization, particularly in underserved rural and Appalachian areas, despite no clear barriers to accessing this remote cessation resource. ImplicationThe study underscores persistent disparities in smoking rates, with rural and Appalachian regions in the United States facing higher smoking prevalence and limited utilization of Quitline services. Despite no clear barriers to access, the gap between smoking prevalence and Quitline usage remains significant, particularly in underserved areas. Tailoring interventions to address regional disparities and factors like tobacco agriculture and physician availability is essential to reduce smoking rates and improve Quitline utilization in these communities.

Direct and spillover effects of a new tramway line on the commercial vitality of peripheral streets: a synthetic-control approach

Abstract In cities, the creation of public transport infrastructure such as light rails can cause changes on a very detailed spatial scale, with different stories unfolding next to each other within the same urban neighbourhood. We study the direct effect of a light rail line built in Florence (Italy) on the retail density of the street where it was built and its spillover effect on other streets in the treated street’s neighbourhood. To this aim, we investigate the use of the synthetic control group (SCG) methods in panel comparative case studies where interference between the treated and the untreated units is plausible, an issue still little researched in the SCG methodological literature. We frame our discussion in the potential outcomes approach. Under a partial interference assumption, we formally define relevant direct and spillover causal effects.

Impact of regulatory tightening of the Hungarian tobacco retail market on availability, access and cigarette smoking prevalence of adolescents

IntroductionPolicies that reduce tobacco retail density to decrease tobacco use among the youth are critical for the tobacco endgame. This paper reviews a Hungarian tobacco regulatory measure, which, since 2013,...