Spatial and Economic Proximity of Cigarette Sales to School Children in Mongolia.

Background: The Western Pacific Region has the highest rate of cigarette smoking in the world. In this region, Mongolia has ratified the WHO FCTC treaty and, as part of treaty implementation, has monitored school tobacco use in children using the 2014 Global Youth Tobacco Survey (GYTS) and 2019 GYTS. Our objective was to examine the spatial and economic factors associated with cigarette use in schoolchildren of Mongolia. Methods: The 2014 and 2019 GYTS are the most recent and comprehensive national surveys of tobacco use in schoolchildren in Mongolia and are cross-sectional, stratified, multi-stage cluster surveys of 13-15 year-old schoolchildren (7,298 in 2014, 4,146 in 2019) selected from urban and rural schools. For each survey, we conducted logistic regression modelling to examine whether spatial (proximity of cigarette sales to schools), economic (pocket money available to school children), and other environmental/contextual factors were predictors of cigarette use (all, single sticks) in schoolchildren. Results: We found that 1)the prevalence of vendors selling cigarettes near schools increased from 65% in the 2014 GYTS to 94% in the 2019 GYTS, 2) sales of cigarettes near schools were associated with increased current smoking of all cigarettes and this effect increased from a marginal 31% increase in odds in 2014 (OR [95% confidence interval(CI)]=1.31 [0.99, 1.73]) to a 416% increase in odds in 2019 (OR [95% CI]=5.16[3.31, 8.05]), 3) sales of cigarettes near schools were associated with a substantial increase in odds of smoking single cigarettes in 2014 (OR [95% CI]=1.87 [1.14,3.06]) and in 2019 (OR[95% CI]=2.70 [1.42, 5.12]). We also found that smoking of all cigarettes was higher when student pocket money exceeded the price of the cigarette pack (approximately 1.8 USD) and also when parents and/or peers were smokers. Conclusions: Despite the 2012 National Tobacco Laws banning sales of cigarettes and single cigarettes to schoolchildren near schools, the most recent national surveys (2014-2019) have shown that these sales are increasing. We provide new findings indicating that despite the higher pricing of cigarette packs (relative to the region), illicit sales of single cigarettes are targeting schoolchildren near their schools.

Assessing the Impact of the Massachusetts Temporary Flavor Ban on Licensed Tobacco Retailers.

Introduction: In 2019, the state of Massachusetts signed into law the first statewide sales restrictions of flavored ENDS/tobacco products for both physical and online shops in response to a previous executive order to curb E-Cigarette, or Vaping Product, Use Associated Lung Injury (EVALI) cases that were surging throughout the nation. Methodology: This study obtained licensure data from the Massachusetts Department of Revenue, to observe the changes in retail licensure comparing the pre ban (October 2018-August 2019) and post ban periods (October 2020- August 2021). A series of linear regression tests were conducted on both periods using census tract data to explore potential associations with sociodemographic covariates, including median age, median household income, and population proportion by gender, age, and race/ethnicity groups. Results: Analysis of the Massachusetts post-ban period (October 2020-August 2021) found that new tobacco retail licenses issued decreased by 52.9% (n = 968) when compared to the pre-ban period (October 2018-August 2019) of 1831. A significant positive association was discovered between change in new retailer count and proportion male population (2.48 ± 1.05, P = .018) as well as proportion Hispanic population (1.19 ± .25, P < .001) at the census tract level. Conclusion/Discussion: Our analysis indicates that, following the temporary MA flavor sales ban, the total number of licenses decreased, though decreases were more pronounced for new licenses when compared to continuing licenses. Higher increases in new tobacco retailer density were significantly associated with concentration of male and Hispanic populations.

The relationship between alcohol outlets and crime is not an artefact of retail geography.

BACKGROUND AND AIMS: In previous research, the spatial distribution of alcohol outlets has been shown to be related to the spatial distribution of crime. However, the spatial distribution of alcohol outlets is also related to the spatial distribution of other retail (and non-retail) activities. We measured whether a residual relationship between alcohol outlets and crime remains statistically significant after controlling for retail density. DESIGN AND SETTING: A cross-sectional analysis of area unit data for Hamilton, New Zealand. MEASUREMENTS: We constructed index measures of retail density using principal component analysis, based on counts of retail outlets (non-alcohol outlets alone and all outlets in total). We estimated the relationship between outlets and police calls-for-service using negative binomial regression, controlling for social deprivation, population and demographics. In our primary analysis, we employed a two-stage process that first accounted for the correlation between calls-for-service and retail density in a negative binomial regression model, then tested for correlation between alcohol outlet counts and the first-stage residuals. FINDINGS: The spatial distributions of retail outlets of all types were highly correlated with each other, and all types of retail outlets (alcohol and non-alcohol) were correlated with crime, after controlling for social deprivation, population and demographics. After controlling for index measures of retail density and other controls, statistically significant semipartial correlations remained with counts of alcohol outlets of all types. For example, in our preferred specification, which controlled for non-alcohol retail density in the first stage, an additional off-licence alcohol outlet was associated with 97.34 (95% confidence interval = 36.66-158.0) additional police calls-for service. CONCLUSIONS: There is a positive relationship between the spatial distribution of alcohol outlets and the spatial distribution of crime that appears to persist even after controlling for non-alcohol retail density. The relationship between alcohol outlets and crime is not simply an artefact of retail geography.

Sociodemographic Disparities in the Tobacco Retail Environment in Washington, DC: A Spatial Perspective.

Objective: Studies assessing sociodemographic disparities in the tobacco retail environment have relied heavily on non-spatial analytical techniques, resulting in potentially misleading conclusions. We utilized a spatial analytical framework to evaluate neighborhood sociodemographic disparities in the tobacco retail environment in Washington, DC (DC) and the DC metropolitan statistical area (DC MSA). Methods: Retail tobacco availability for DC (n=177) and DC MSA (n=1,428) census tract was assessed using adaptive-bandwidth kernel density estimation. Density surfaces were constructed from DC (n=743) and DC MSA (n=4,539) geocoded tobacco retailers. Sociodemographics were obtained from the 2011-2015 American Community Survey. Spearman's correlations between sociodemographics and retail density were computed to account for spatial autocorrelation. Bivariate and multivariate spatial lag models were fit to predict retail density. Results: DC and DC MSA neighborhoods with a higher percentage of Hispanics were positively correlated with retail density (rho = .3392, P = .0001 and rho = .1191, P = .0000, respectively). DC neighborhoods with a higher percentage of African Americans were negatively correlated with retail density (rho = -.3774, P = .0000). This pattern was not significant in DC MSA neighborhoods. Bivariate and multivariate spatial lag models found a significant inverse relationship between the percentage of African Americans and retail density (Beta = -.0133, P = .0181 and Beta = -.0165, P = .0307, respectively). Conclusions: Associations between neighborhood sociodemographics and retail density were significant, although findings regarding African Americans are inconsistent with previous findings. Future studies should analyze other geographic areas, and account for spatial autocorrelation within their analytic framework.

Positive association between neighborhood retail alcohol outlet access and hospital admissions for alcohol withdrawal syndrome in New Orleans.

Objectives: We used treatment for alcohol withdrawal syndrome as an objective surrogate marker to investigate the relationship between alcohol-related health outcomes and home neighborhood alcohol outlet density and alcohol advertising density.Methods: Mixed effects logistic regression examined whether alcohol outlet density or alcohol advertisement density within either one-quarter mile or one-half mile of individuals' home address was associated with treatment for alcohol withdrawal.Results: Adjusted models showed outlet and advertising density, particularly off-sale outlet density within one-quarter mile of the home, increased the risk of hospital admission for alcohol withdrawal syndrome (AOR = 1.15).Conclusion/impact: These data inform public policy initiatives to reduce the harmful effects of alcohol by regulating the neighborhood alcohol environment.

Exploring Student Food Behaviour in Relation to Food Retail over the Time of Implementing Ontario's School Food and Beverage Policy.

BACKGROUND: Canadian provincial policies, like Ontario's School Food and Beverage Policy (P/PM 150), increasingly mandate standards for food and beverages offered for sale at school. Given concerns regarding students leaving school to purchase less healthy foods, we examined student behaviours and competitive food retail around schools in a large urban region of Southern Ontario. METHODS: Using a geographic information system (GIS), we enumerated food outlets (convenience stores, fast-food restaurants, full-service restaurants) within 500, 1000 and 1500 m of all 389 regional schools spanning years of policy implementation. Consenting grade 6-10 students within 31 randomly selected schools completed a web-based 24-h diet recall (WEB-Q) and questionnaire. RESULTS: Food outlet numbers increased over time (p < 0.01); post-policy, within 1000 m, they averaged 27.31 outlets, with a maximum of 65 fast-food restaurants around one school. Of WEB-Q respondents (n = 2075, mean age = 13.4 ± 1.6 years), those who ate lunch at a restaurant/take-out (n = 84, 4%) consumed significantly more energy (978 vs. 760 kcal), sodium (1556 vs. 1173 mg), and sugar (44.3 vs. 40.1 g). Of elementary and secondary school respondents, 22.1% and 52.4% reported ever eating at fast food outlets during school days. CONCLUSIONS: Students have easy access to food retail in school neighbourhoods. The higher energy, sodium and sugar of these options present a health risk.

Cigarette availability and price in low and high socioeconomic areas.

OBJECTIVE: To determine whether tobacco retailer density and cigarette prices differ between low and high socioeconomic status suburbs in South-East Queensland. METHODS: A survey of retail outlets selling cigarettes was conducted in selected suburbs over a two-day period. The suburbs were identified by geographical cluster sampling based on their Index of Relative Socio-economic Advantage and Disadvantage score and size of retail complex within the suburb. All retail outlets within the suburb were visited and the retail prices for the highest ranking Australian brands were recorded at each outlet. RESULTS: A significant relationship was found between Index of Relative Socioeconomic Advantage and Disadvantage score (in deciles) and the number of tobacco retail outlets (r=0.93, p=0.003), with the most disadvantaged suburbs having a greater number of tobacco retailers. Results also demonstrate that cigarettes were sold in a broader range of outlets in suburbs of low SES. The average price of the packs studied was significantly lower in the most disadvantaged suburbs compared to the most advantaged. While cigarettes were still generally cheaper in the most disadvantaged suburbs, the difference was no longer statistically significant when the average price of cigarette packs was compared according to outlet type (supermarket, newsagent, etc). CONCLUSIONS: In South-East Queensland, cigarettes are more widely available in the most disadvantaged suburbs and at lower prices than in the most advantaged suburbs.