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Regulating the local availability of tobacco retailing in Madrid, Spain: a GIS study to evaluate compliance
  1. Roberto Valiente1,2,
  2. Xisca Sureda1,
  3. Usama Bilal1,3,
  4. Ana Navas-Acien4,
  5. Jamie Pearce5,
  6. Manuel Franco1,6,
  7. Francisco Escobar1,2
  1. 1 Social and Cardiovascular Epidemiology Research Group, School of Medicine, University of Alcalá, Alcalá de Henares, Spain
  2. 2 Department of Geology, Geography and Environmental Sciences, University of Alcalá, Alcalá de Henares, Spain
  3. 3 Urban Health Collaborative, Drexel Dornsife School of Public Health, Philadelphia, Pennsylvania, USA
  4. 4 Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York City, New York, USA
  5. 5 Centre for Research on Environment, Society and Health, School of GeoSciences, University of Edinburgh, Edinburgh, UK
  6. 6 Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
  1. Correspondence to Dr Xisca Sureda, Social and Cardiovascular Epidemiology Research Group, School of Medicine, University of Alcalá, Alcalá de Henares 28871, Spain; francisca.sureda{at}


Background In Spain, tobacco sales are limited to tobacco-exclusive stores and associated vending machines. A minimum of 150 m between stores is required, unless they exceed a legal sales threshold. Minimum distances to schools are recommended but not defined. We evaluated compliance with these regulations in Madrid, Spain.

Methods Information about tobacco-exclusive stores and their sales volume was obtained in 2014. We used geographic information system to identify stores closer than 150 m between them and examine whether they exceeded the sales threshold. We estimated distances between stores and schools, considering different distance intervals (<150 m, 150–300 m and >300 m) and calculations (crow flies and street network). We assessed the association of area-level demographic and socioeconomic characteristics with the distribution of tobacco stores.

Results 5.3% (34/638) of tobacco stores were within 150 m of each other. Among those, 76% (26/34) did not meet the regulation sales threshold. These stores were in areas with lower proportion of young population (<15 years) and higher proportion of people with university-level education. 75% (476/638) of stores were situated closer than 300 m to schools. No differences were identified in sociodemographic and economic characteristics by the store distance to schools.

Conclusion Most tobacco stores are compliant with the regulations in Spain. However, these regulations are insufficient to reduce tobacco availability. More restrictive regulations are needed to limit the geographic distribution of tobacco retailers, and health criteria should also be considered in the current legislation. The evaluation of the Spanish regulatory model may provide useful insights for other jurisdictions looking to decrease the tobacco retail availability.

  • tobacco availability
  • tobacco stores distribution
  • tobacco retail regulations
  • proximity analysis
  • schools

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  • XS and FE contributed equally.

  • Contributors RV, XS and FE conceive the original idea. RV geocoded, prepared the databases and analysed the data with the advice of FE and XS. FE supervised both GIS analyses and cartographic outputs. XS designed and supervised tobacco epidemiological methods and quantitative analytical procedures. All authors contributed substantially to the interpretation of the data and manuscript review and approved its final version. XS and MF are the guarantors.

  • Funding This study has been supported by a predoctoral fellowship offered to trainee researchers from the University of Alcalá (RV). The Heart Healthy Hoods project was funded by the European Research Council under the European Union’s Seventh Framework Programme (FP7/2007– 2013/ERC Starting Grant Heart Healthy Hoods Agreement no. 623 336893). This study is also funded by the Instituto de Salud Carlos III, Subdirección General de Evaluación y Fomento de la Investigación, Government of Spain (PI15/02146).

  • Disclaimer The funding sources have no any involvement in the study design; in the collection, analysis or interpretation of data; in the writing of this work; or in the decision to submit the manuscript for publication.

  • Competing interests None declared.

  • Patient consent Not required.

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