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Potential impacts of spatial restrictions on tobacco retail availability in China: a simulation study in Shanghai
  1. Chunyu Zheng1,
  2. Jamie Pearce1,
  3. Zhiqiang Feng1,2
  1. 1Centre for Research on Environment, Society and Health (CRESH), School of GeoSciences, The University of Edinburgh, Edinburgh, UK
  2. 2Scottish Centre for Administrative Data Research, The University of Edinburgh, Edinburgh, UK
  1. Correspondence to Chunyu Zheng, Centre for Research on Environment, Society and Health (CRESH), School of GeoSciences, The University of Edinburgh, Edinburgh EH8 9XP, UK; C.Zheng{at}


Objectives Regulating tobacco retail availability provides promising new opportunities for effective tobacco control. This study simulates the potential impacts of introducing spatial restrictions on the availability of tobacco in Shanghai, the largest city in China.

Methods Twelve stakeholder-informed simulation scenarios under four types of spatial restrictions were considered: (1) capping, (2) ban of sales, (3) minimum spacing and (4) school-buffer exclusion zone. Tobacco retailer data for Shanghai (n=19 413) were used. The main outcome was per cent reduction in retail availability measured by population-weighted kernel density estimation across neighbourhoods, and impacts on social inequality in availability were estimated using the Kruskal-Wallis test and effect size estimation. All analyses were further stratified by three levels of urbanity to examine geographical disparities in overall effectiveness and equity of the simulation scenarios.

Results All simulation scenarios have the potential to reduce availability, with overall reductions ranging from 8.60% to 85.45%. Compared with the baseline, the effect size regarding the association between availability and neighbourhood deprivation quintiles suggests that the most effective scenario, ‘500 m minimum spacing’ between retailers, increased the social inequality in availability (p<0.001). Conversely, school-buffer scenarios were both effective and equitable. Additionally, the effectiveness and the equity impact of scenarios varied by urbanity level.

Conclusion Spatial restrictions offer potential new policy opportunities to reduce retail availability, but some may increase social inequality in accessing tobacco. For effective tobacco control, policymakers should consider the overall and equity impacts of spatial restrictions when developing comprehensive tobacco retail regulations.

  • disparities
  • public policy
  • end game
  • low/middle income country

Data availability statement

Data are available upon reasonable request.

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Data availability statement

Data are available upon reasonable request.

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  • Contributors All authors contributed substantially to the design of the research. Acting as guarantor, CZ collected the data, carried out the data analysis and wrote the manuscript in collaboration with JP and ZF. All authors contributed critical feedback and helped shape the research, analysis and manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

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

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.