Content area
Full Text
Objectives. To evaluate changes in licensed tobacco retailers and retailer density 5 years before and 3 years after novel tobacco retailer licensing regulations were implemented in a large, urban area.
Methods. We used administrative tobacco license data (n = 23 806 licenses, 2012- 2019) to calculate (1) annual retailer density by district (n = 18), (2) density by district and school income status, and (3) retailers within 500 feet of schools (n = 673) before and after regulations.
Results. Observed tobacco retailer density declined by 20.3% (from 1.97 to 1.57 per 1000 daytime residents) 3 years after regulation implementation. Regression results showed a decline in the trend of retailers per 1000 daytime population (b = -0.19; 95% confidence interval[CI] = -0.23, -0.14) that was modestly but significantly greater in low-income districts (interaction b = -0.18; 95% CI = -0.25, -0.11) and a 12% decline in the rates of retailers near schools (rate ratio = 0.88; 95% CI = 0.85, 0.92) following implementation of the regulations. We did not observe similar density changes in comparable cities.
Conclusions. Tobacco retailer licensing strategies can be an effective policy approach to reduce the availability of tobacco and tobacco marketing, lessen socioeconomic disparities in tobacco retailer density, and decrease the number of tobacco outlets near schools. (Am J Public Health. 2020;110:547-553. doi:10.2105/AJPH.2019.305512)
Tobacco use remains the leading cause of mortality and cancer in the United States, accounting for 1 in 5 deaths annually and 29% to 40% of all cancer deaths.1,2 Despite consistent declines in smoking over the past 50 years, tobacco-related health disparities have worsened.3 Research demonstrates that marketing at the point of sale is overwhelmingly concentrated in economically disadvantaged and high-minority areas.4-8 Given that point-of-sale marketing and price discounts accounted for 86% of tobacco industry marketing expenditures in 2017,9 disparities in tobacco retailer density-and consequently in point-of-sale marketing- are particularly problematic. High retailer density has also been associated with decreased cessation success,10-12 more cigarettes smoked per day, increased youth tobacco experimentation and use,13 and more favorable social norms about tobacco.13,14
Novel policy strategies, particularly tobacco retailer licensing policies at the state or local level, are of increasing interest. Policies include but are not limited to tobacco retail license density caps (e.g., 1 tobacco retailer per 1000 people...