Main characteristics of studies on the associations between tobacco retailer density/proximity and adult smoking outcomes
| First author | Country and data collection period | Design | Sample size (n) | Participants | Tobacco product | Spatial units | Density measure | Proximity measure | Main outcome variables | Control variables | Observed associations |
| Barnes et al 36 | Australia (Western Australia) 2003–2009 | CS | 12 270 (smokers and non-smokers) | Adults 18+ (mean age 53) | Cigarettes | Egocentric buffers | Number of tobacco outlets within 1600 m (0.5 mile) street network buffers from home | N/A | Current smoking (daily or occasional) | Individual level: age, sex, highest level of education, household income Socioeconomic Index for Areas | Increase in density positively associated with being a current smoker versus past smoker. OR: 1.01; 95% CI: 1.00 to 1.01 |
| Cantrell et al 43 | USA 2013 | CS | 4288 (smokers and non-smokers) | Young adults aged 18–24; 25–34 | Cigarettes and non-combustible tobacco products (incl. e-cigarettes) | Census tracts | Number of tobacco outlets per 10 km of roadway | N/A | Product initiation | Individual level: age, sex, race, education, depression Census tract level: population, % below poverty, % Hispanic, % non-Hispanic black State level: smoking prevalence, level of clean indoor air laws | Increase in density positively associated with initiation of cigarette use in ages 25–34. OR: 3.75, 95% CI: 1.18 to 11.90, p<0.05. No association with initiation of non-combustible products (incl. e-cigarettes). |
| Cantrell et al 45 | USA 2008–2010 | L | 2377 smokers | Adults aged 18–49 | Cigarettes | Egocentric buffers | Number of tobacco outlets within: (a) 500 m; (b) 1 km and (c) 1.6 km of road network buffers around homes | Shortest street network distance in metres from participant’s residence to the nearest outlet categorised into quartiles | Smoking abstinence >30 days | Individual level: age, sex, race, marital status, heaviness of smoking, tobacco-related disease, education, awareness of media campaign, living with a smoker, mental health condition Census tract level: % of African-Americans,% Hispanic, % below poverty | Density within 500 m negatively associated with abstinence (OR: 0.94; 95% CI: 0.90 to 0.98; p<0.01) only in high poverty areas. Farther distance (proximity) to retailers was positively associated with abstinence only in high-poverty areas (OR: 2.80; 95% CI:1.51 to 5.19; p<0.001 for a proximity of about 900 m vs <500 m). |
| Chaiton et al 25 | Canada: Ontario 2005–2008; 2011 | L | 2414 past month daily smokers | Adults 18+ (mean age not reported) | Cigarettes | Egocentric buffers | Number of outlets within 500 m circular buffer with a straight-line radius from participants’ homes |
| Quit attempts, relapse | Individual level: age, sex, marital status, having kids under 18 in household, education, region, perceived addiction, use of quit aids, heaviness of smoking index Census level: household income, % immigrants | Increased density negatively associated with quit attempts only in high-income neighbourhoods (OR: 0.54, 95% CI: 0.35 to 0.85, p<0.05). Presence of at least one retailer within 500 m positively associated with relapse (OR: 1.11, 95% CI: 1.00 to 1.23, p<0.05). |
| Chuang et al 46 | USA: California 1979–1990 | CS | 8121 (smokers/non-smokers) | Adults aged 25–74 | Cigarettes |
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| Straight-line distance from home to the nearest convenience store in miles | Number of cigarettes a day | Individual level: age, sex, race, SES (education, household income) Census level: neighbourhood SES | High census-level density positively associated with smoking (β=0.174, SE=0.077, p<0.05). Density as count in ego-hoods showed no association. Proximity negatively associated with smoking (β=−0.154, SE=0.066, p<0.05). No associations for any three measures in a model adjusted for neighbourhood SES. |
| Fleischer et al 26 | Canada (10 provinces) 2005–2011 | L | 4388 smokers (abstinence outcome); 866 smokers (relapse outcome) | Adults (mean age 47 and 53, depending on the wave and sample) | Cigarettes | Egocentric buffers | Number of outlets within 1 km street network buffers around home addresses or postal code centroids | Straight-line distance from home to the nearest outlet in kilometres | 30-day abstinence, relapse | Individual level: age, sex, education, income Province level: province, cigarette price, point-of-sale bans | No associations |
| Halonen et al 35 | Finland 1997–2005 | L | 8751 smokers | Adults (mean age 50) | Cigarettes | Egocentric buffers; area-level neighbourhoods as coordinates on the 250 m map squares | Number of outlets within 0.5 km straight-line and street network buffers around homes | Straight-line and walking distances from home to the nearest outlet | Cessation | Individual level: age, sex, occupational status (proxy for SES), marital status, alcohol use, smoking intensity Registry level: housing tenure (proxy for SES), baseline diseases Area level: neighbourhood SES, population density | Having one versus no outlets within 0.5 km negatively associated with cessation only in moderate/heavy male smokers (PR: 0.63, 95% CI: 0.49 to 0.81, p<0.05). Proximity of <0.50 km (vs ≥0.50 km) negatively associated with cessation only in moderate/heavy male smokers (PR: 0.73, 95% CI: 0.60 to 0.88, p<0.05). |
| Kirchner et al 51 | USA: Minnesota 2012 | CS | 1201 non-daily smokers (NDS) | Adults aged 25+ (mean age 41.38) | Cigarettes | Residential ZIP codes (n=1054) | Number of outlets per square mile categorised in quartiles | N/A | 6-month quit intentions | Individual level: age, race, sex, education, household income, number of cigarettes/day, number of days smoked, time to first cigarette | Price-sensitive NDS residing in areas with higher (vs lower) outlet density less likely to hold quit intentions (likelihood ratio test statistic=G2=66.1, p<0.001). |
| Kirst et al 27 | Canada: Toronto 2009–2011 | CS | 2412 (smokers and non-smokers) | Adults aged 25–54 | Cigarettes | Census tract (n=87) | Number of outlets per km2 | N/A | Past 30-day smoking | Individual level: income, sex, age, marital status, immigrant status, education level, household income Census tract level: neighbourhood disorder, neighbourhood income | No association |
| Marashi-Pour et al 3 | Australia: NSW 2009–2011 | CS | 31 260 (smokers and non-smokers) | Adults 16+ (median age 58) | Cigarettes | Census collection districts (n=11 811) | Mean number of outlets per 1000 persons within each census collection district or postal area | N/A | Current smoking (daily or occasional) | Individual level: age, sex, country of birth, Aboriginal status Census level: neighbourhood SES, % males, % born in Australia, % minors | High density positively associated with smoking (OR=1.11; 95% CI: 1.02 to 1.21; p=0.018). |
| Pearce et al 38 | Scotland 2008–2011 | CS | 28 751 (smokers and non-smokers) | Adults aged 16+ (mean age not provided) | Cigarettes | Postal codes (n=152 400) | Proximity-weighted estimate of the outlet density per km2 for each postal code | N/A | Current smoker, ex-smoker | Individual level: age, sex, ethnicity, education, household income Area level: rurality | Highest (vs lowest) density positively associated with being a current smoker (dy/dx=0.07; 95% CI: 0.05 to 0.10; p<0.01) and negatively associated with being an ex-smoker (dy/dx=−0.05; 95% CI: −0.09 to –0.02; p<0.01) |
| Pearce et al 32 | New Zealand 2002–2003 | CS | 12 529 (smokers and non-smokers) | Adults aged 15+ (mean age not provided) | Cigarettes | Census mesh blocks (n=1178) represented by their population-weighted centroids | N/A | Travel time by car (min) to the nearest outlet along the road network, categorised in quartiles (worst/worse/better/best access) | Everyday smoking | Individual level: age, sex, ethnicity, social class Census block level: neighbourhood deprivation, rurality | Best access to supermarkets (OR=1.23, 95% CI:1.06 to 1.42) and convenience stores (OR=1.19, 95% CI:1.03 to 1.38) positively associated with smoking. No associations in a model adjusted for neighbourhood deprivation and rurality. |
| Pulakka et al 34 | Finland 2008/2012; 2003/2012 | L | 20 729 (smokers and ex-smokers) | Adults aged 18–75 | Cigarettes | N/A | Change in walking distance from home to the nearest outlet address (difference between baseline and follow-up distance) | Smoking cessation and relapse | Individual level: age, sex, education (proxy for SES), marital status, recent financial hardship, recent death or illness in family, employment status, chronic diseases | Increase in distance (proximity) positively associated with smoking cessation (pooled OR: 1.16; 95% CI: 1.05 to 1.28; p=0.004) and not associated with smoking relapse. | |
| Shareck et al 28 | Canada: Montreal 2011–2012 | CS | 921 (individuals who smoked at least one cigarette in their lifetime) | Young adults aged 18–25 | Cigarettes | Egocentric buffers | Number of outlets in 500 m street network buffers from home/across activity spaces (AS), categorised in tertiles (low/medium/high) | Walking distance to the nearest outlet from home/AS location, categorised in tertiles (closest/intermediate/furthest) | Smoking cessation | Individual level: age, sex, education, time since smoking onset, number of years smoked, occupation Area level: neighbourhood deprivation | Positive for low (vs high) residential density (PR=1.28; 95% CI: 1.10 to 1.50; p<0.05) and density in AS (PR: 1.28; 95% CI: 1.08 to 1.51; p<0.05). Positive for the furthest (vs closest) proximity to AS (PR: 1.21; 95% CI: 1.02 to 1.43; p<0.05). No association with proximity to homes. |
| Shareck et al 29 | Canada: Montreal 2011–2012 | CS | 1994 (smokers and non-smokers) | Young adults aged 18–25 | Cigarettes | Egocentric buffers | Number of outlets in 500 m street network buffers from home/across AS, categorised in tertiles (low/medium/high) | Shortest walking distance to the nearest outlet from home/AS location, categorised in tertiles (closest/intermediate/furthest) | Current smoking (defined as smoking daily or occasional) | Individual level: age, sex, education status and attainment. Census level: neighbourhood deprivation | Positive for high (vs low) residential density (PR: 1.53; 95% CI: 1.23 to 1.91; p<0.05) and density in AS (PR: 1.46; 95% CI: 1.26 to 1.70; p<0.05). Positive for closest (vs furthest) proximity to AS (PR: 1.42; 95% CI: 1.09 to 1.86; p<0.05). No association with proximity to homes. |
CS, cross-sectional; L, longitudinal; N/A, not applicable; NSW, New South Wales; PR, prevalence ratio; SES, socioeconomic status.