Predictors of tobacco outlet density nationwide: a geographic analysis
- 1LaSalle University, Graduate Clinical Counseling Psychology, Philadelphia, Pennsylvania, USA
- 2Cancer Control Research Program, Norris Cotton Cancer Center, Lebanon, New Hampshire, USA
- 3Pediatrics, Dartmouth Medical School, Lebanon, New Hampshire, USA
- 4Community and Family Medicine, Dartmouth Medical School, Lebanon, New Hampshire, USA
- Correspondence to Dr Daniel Rodriguez, 1900 West Olney Avenue, Philadelphia, PA 19141, USA;
Contributors HC was responsible for the preparation of the data for analysis. All authors participated in writing this paper.
- Received 30 June 2011
- Accepted 14 March 2012
- Published Online First 4 April 2012
Objective To elucidate how demographics of US Census tracts are related to tobacco outlet density (TOD).
Method The authors conducted a nationwide assessment of the association between socio-demographic US Census indicators and the density of tobacco outlets across all 64 909 census tracts in the continental USA. Retail tobacco outlet addresses were determined through North American Industry Classification System codes, and density per 1000 population was estimated for each census tract. Independent variables included urban/rural; proportion of the population that was black, Hispanic and women with low levels of education; proportion of families living in poverty and median household size.
Results In a multivariate analysis, there was a higher TOD per 1000 population in urban than in rural locations. Furthermore, higher TOD was associated with larger proportions of blacks, Hispanics, women with low levels of education and with smaller household size. Urban–rural differences in the relation between demographics and TOD were found in all socio-demographic categories, with the exception of poverty, but were particularly striking for Hispanics, for whom the relation with TOD was 10 times larger in urban compared with rural census tracts.
Conclusions The findings suggest that tobacco outlets are more concentrated in areas where people with higher risk for negative health outcomes reside. Future studies should examine the relation between TOD and smoking, smoking cessation, as well as disease rates.
Funding This work was supported by the National Institutes of Health (CA077026). EB is supported by the National Institute on Aging 1K23AG036934.
Competing interests None.
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement We are able to provide any detail needed to other researchers to explain the processes necessary to calculate tobacco outlet density. We are willing to share our determination of tobacco outlet density at the census tract level for a nominal processing fee. Our continuous density US map allow us to determine point densities for researchers interested in using this variable, again for a nominal processing fee. For other access to the data, prospective researchers should contact Dr James D Sargent.