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Research paper
Tobacco outlet density and converted versus native non-daily cigarette use in a national US sample
  1. Thomas R Kirchner1,2,
  2. Andrew Anesetti-Rothermel3,
  3. Morgane Bennett2,4,
  4. Hong Gao1,
  5. Heather Carlos5,
  6. Taneisha S Scheuermann6,
  7. Lorraine R Reitzel7,
  8. Jasjit S Ahluwalia8
  1. 1College of Global Public Health, New York University, New York, New York, USA
  2. 2Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
  3. 3Steven A. Schroeder National Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington DC, USA
  4. 4Department of Evaluation Science and Research, Truth Initiative, Washington DC, USA
  5. 5Norris Cotton Cancer Center, Dartmouth College, Hanover, New Hampshire, USA
  6. 6Department of Preventive Medicine and Public Health, University of Kansas Medical School, Kansas City, Kansas, USA
  7. 7Department of Psychological, Health, & Learning Sciences, University of Houston, Houston, Texas, USA
  8. 8School of Public Health, Rutgers University, Piscataway, New Jersey, USA
  1. Correspondence to Dr Thomas R Kirchner, NYU College of Global Public Health, New York University, 41 E. 11th St., 7th Floor, New York, NY 10003, USA; tomkirchner{at}nyu.edu

Abstract

Objective Investigate whether non-daily smokers’ (NDS) cigarette price and purchase preferences, recent cessation attempts, and current intentions to quit are associated with the density of the retail cigarette product landscape surrounding their residential address.

Participants Cross-sectional assessment of N=904 converted NDS (CNDS). who previously smoked every day, and N=297 native NDS (NNDS) who only smoked non-daily, drawn from a national panel.

Outcome measures Kernel density estimation was used to generate a nationwide probability surface of tobacco outlets linked to participants’ residential ZIP code. Hierarchically nested log-linear models were compared to evaluate associations between outlet density, non-daily use patterns, price sensitivity and quit intentions.

Results Overall, NDS in ZIP codes with greater outlet density were less likely than NDS in ZIP codes with lower outlet density to hold 6-month quit intentions when they also reported that price affected use patterns (G2=66.1, p<0.001) and purchase locations (G2=85.2, p<0.001). CNDS were more likely than NNDS to reside in ZIP codes with higher outlet density (G2=322.0, p<0.001). Compared with CNDS in ZIP codes with lower outlet density, CNDS in high-density ZIP codes were more likely to report that price influenced the amount they smoke (G2=43.9, p<0.001), and were more likely to look for better prices (G2=59.3, p<0.001). NDS residing in high-density ZIP codes were not more likely to report that price affected their cigarette brand choice compared with those in ZIP codes with lower density.

Conclusions This paper provides initial evidence that the point-of-sale cigarette environment may be differentially associated with the maintenance of CNDS versus NNDS patterns. Future research should investigate how tobacco control efforts can be optimised to both promote cessation and curb the rising tide of non-daily smoking in the USA.

  • Environment
  • Cessation
  • Price

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/tobaccocontrol-2015-052487

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    Footnotes

    • Contributors TRK and JSA conceived the paper. TRK led the design of the study, processed the data set, conducted the primary analyses and wrote the paper. AA-R, HG and HC contributed to the statistical analyses and the writing of the Methods section. MB, TSS and LRR contributed to study design, writing and revisions to the paper.

    • Funding This work was funded by Pfizer's Global Research Awards for Nicotine Dependence (JSA). JSA is also supported by the National Institute for Minority Health Disparities (NCMHD/NIH-1P60MD003422). TRK is supported by the National Institute on Drug Abuse, National Cancer Institute and Office of Behavioral and Social Science Research (NIH—R01DA034734). The Norris Cotton Cancer Center's GeoSpatial Resource performed the kernel density estimation procedures.

    • Competing interests None declared.

    • Ethics approval University of Minnesota Institutional Review Board.

    • Provenance and peer review Not commissioned; externally peer reviewed.