Background Neighbourhood tobacco retail access may influence adolescent tobacco use. In India, we examined the association between neighbourhood tobacco retail access and cognitive risks for tobacco use during early adolescence.
Methods In 2019–2020, a population-based sample (n=1759) of adolescents aged 13–15 years was surveyed from 52 neighbourhoods in Mumbai and Kolkata. Neighbourhood tobacco retail access was measured as the frequency of visits to tobacco retailers, mapped tobacco retailer density and perceived tobacco retailer density. We estimated associations between neighbourhood tobacco retail access and cognitive risks for tobacco use (perceived ease of access to tobacco, perceived peer tobacco use and intention to use tobacco).
Results There was high neighbourhood tobacco retail access. Tobacco retailer density was higher in lower income neighbourhoods (p<0.001). Adolescent frequency of tobacco retailer visits was positively associated with cognitive tobacco use risks. Mapped tobacco retailer density was associated with perceived ease of access in Kolkata but not in Mumbai, and it was not associated with perceived peer tobacco use nor intention. Perceived tobacco retailer density was associated with perceived ease of access and perceived peer use, but not with intention. In Kolkata, higher perceived retailer density and frequency of tobacco retailer visits were negatively associated with perceived ease of access.
Conclusions Efforts to reduce neighbourhood tobacco retail access in India may reduce cognitive tobacco use risk factors in young adolescents. The frequency of tobacco retailer visits and perceived tobacco retailer density increased cognitive risks, though there were some exceptions in Kolkata that further research may explain.
- global health
- advertising and promotion
- priority/special populations
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Deidentified data may be available upon reasonable request.
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Contributors RM conceptualised the paper, guided the spatial and statistical analysis and wrote the paper. MJK conducted the statistical analysis and drafted the data analysis section. TR provided guidance on the sampling, weighting and statistical analysis plan. JA conducted the spatial analysis. MSP oversaw research activities in India. MJK, NP, PCG, WJM, TR, H-FH, SN, MD, SA, JA and MSP critically reviewed the drafts of the paper. RM is responsible for the overall content as guarantor.
Funding The National Cancer Institute of the National Institutes of Health under award number R01CA201415 (Multiple PIs: RM and MSP) supported the research reported in this paper.
Disclaimer The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.