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Neighbourhood inequities in the availability of retailers selling tobacco products: a systematic review
  1. Amanda Y Kong1,2,
  2. Joseph G L Lee3,4,
  3. Sarah M Halvorson-Fried4,5,
  4. Kerry B Sewell6,
  5. Shelley Diane Golden4,5,
  6. Lisa Henriksen7,
  7. Lily Herbert2,
  8. Kurt M Ribisl4,5
  1. 1Department of Family and Preventive Medicine, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
  2. 2Stephenson Cancer Center, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
  3. 3Department of Health Education and Promotion, College of Health and Human Performance, East Carolina University, Greenville, North Carolina, USA
  4. 4University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, North Carolina, USA
  5. 5Department of Health Behavior, University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, North Carolina, USA
  6. 6Laupus Health Sciences Library, East Carolina University, Greenville, North Carolina, USA
  7. 7Stanford Prevention Research Center, Stanford University School of Medicine, Palo Alto, Stanford, California, USA
  1. Correspondence to Dr Amanda Y Kong, Department of Family and Preventive Medicine, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA; Amanda-Kong{at}OUHSC.edu

Abstract

Objective To examine inequities in tobacco retailer availability by neighbourhood-level socioeconomic, racial/ethnic and same-sex couple composition.

Data sources We conducted a 10 November 2022 search of PubMed, PsycINFO, Global Health, LILACS, Embase, ABI/Inform, CINAHL, Business Source Complete, Web of Science and Scopus.

Study selection We included records from Organisation for Economic Co-operation and Development member countries that tested associations of area-level measures of tobacco retailer availability and neighbourhood-level sociodemographic characteristics. Two coders reviewed the full text of eligible records (n=58), including 41 records and 205 effect sizes for synthesis.

Data extraction We used dual independent screening of titles, abstracts and full texts. One author abstracted and a second author confirmed the study design, location, unit of analysis, sample size, retailer data source, availability measure, statistical approach, sociodemographic characteristic and unadjusted effect sizes.

Data synthesis Of the 124 effect sizes related to socioeconomic inequities (60.5% of all effect sizes), 101 (81.5%) indicated evidence of inequities. Of 205 effect sizes, 69 (33.7%) tested associations between retailer availability and neighbourhood composition of racially and ethnically minoritised people, and 57/69 (82.6%) documented inequities. Tobacco availability was greater in neighbourhoods with more Black, Hispanic/Latine and Asian residents (82.8%, 90.3% and 40.0% of effect sizes, respectively). Two effect sizes found greater availability with more same-sex households.

Conclusions There are stark inequities in tobacco retailer availability. Moving beyond documenting inequities to partnering with communities to design, implement, and evaluate interventions that reduce and eliminate inequities in retail availability is needed to promote an equitable retail environment.

PROSPERO registration number CRD42019124984.

  • Advertising and Promotion
  • Disparities
  • Priority/special populations
  • Socioeconomic status

Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information.

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Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information.

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Footnotes

  • X @AmandaYKong, @KurtRibisl

  • Contributors AYK conceptualised the study, developed the protocol, coded the data, abstracted the data, conducted the analyses, created the figures and led the drafting of the manuscript. JGLL conceptualised the study, developed the protocol, coded the data, assisted with data abstraction and assisted with drafting of the manuscript. SMH-F confirmed the data extraction. KBS developed and implemented the literature search. SDG, L Henriksen and KMR conceptualised the study and developed the protocol. L Herbert created the figures. All authors provided critical feedback, edited the manuscript and approved its final submission. AYK accepts full responsibility for the work and/or the conduct of the study, had access to the data, and controlled the decision to publish.

  • Funding Research reported in this publication was supported by the National Cancer Institute (NCI) of the National Institutes of Health for Advancing Science & Practice in the Retail Environment (ASPiRE) (P01CA225597) and P30CA225520. Additional support was provided by the Oklahoma Tobacco Settlement Endowment Trust (STCST00400_FY24). SMH-F was further supported by the Cancer Control Education Program, a grant from the UNC Lineberger Comprehensive Cancer Center (NCI: T32CA057726). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health and funders.

  • Competing interests AYK and KMR serve as paid expert consultants in litigation against the tobacco industry. JGLL and KMR hold a royalty interest in tobacco retailer mapping system owned and licensed by the University of North Carolina at Chapel Hill. The software was not used in this research.

  • 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.