Introduction International evidence from high-income countries demonstrates that the availability of tobacco tends to be greater in more urban and more deprived neighbourhoods. However, little is known about the socio-spatial disparities in other settings, including megacities in China. This study investigated the patterning of tobacco retailers across Shanghai by types of tobacco retailers, including the relationship with levels of urbanity and neighbourhood deprivation. Methods Tobacco retailer data (n = 19,413) was extracted from a web-scraped Points-of-Interest database. For all communities (n = 5,432) across Shanghai, neighbourhood tobacco retail availability was calculated using population-weighted kernel density estimation and grouped by quintiles of neighbourhood deprivation and a 3-level urban classification. Associations were analysed using the Kruskal-Wallis test and epsilon-squared. Results Across Shanghai, tobacco retail availability decreased from more urbanised areas to less urbanised areas. There was a statistical difference (p < 0.001) in the availability of tobacco retail across quintiles of deprivation, with the highest availability in the less deprived neighbourhoods and the lowest availability in the most deprived neighbourhoods. However, this trend was reversed in the urban centre, where retail availability was greatest in the most deprived areas. Convenience stores were the most common type of tobacco retailer across the city, while tobacco-only outlets were most strongly associated with levels of neighbourhood deprivation. Conclusion The results show an association between tobacco retail availability and neighbourhood deprivation, which varied with levels of urbanity and types of tobacco retailers. These findings provide supportive evidence for further interventions that target reducing inequalities in exposure to tobacco retail. Implications This is the first study to examine the relationship between tobacco retail availability and neighbourhood deprivation in the context of Chinese megacities. Using data from Shanghai, China, we found a significant non-linear association between tobacco retail availability and neighbourhood deprivation across the city. It is plausible that the socio-spatial disparities in tobacco retail availability at the neighbourhood level may be a key factor explaining differences in smoking behaviours between sociodemographic groups. The findings emphasise the need for greater efforts in regulating neighbourhood-level tobacco retailing in China.

Introduction A cross-sectional survey GENERATE (GEospatial aNalysis of ExtRacorporeal membrane oxygenATion in Europe) initiated on behalf of the European chapter of the Extracorporeal Life Support Organization (EuroELSO), aims to provide a systematic, detailed description of contemporary Extracorporeal Life Support (ECLS) provision in Europe, map the spatial distribution of ECLS centers, and the accessibility of ECLS. Methods Structured data collection forms were used to create a narrative description of ECLS provision in EuroELSO affiliated countries. This consisted of both center-specific data and relevant national infrastructure. Data was provided by a network of local and national representatives. Spatial accessibility analysis was conducted where appropriate geographical data were available. Results 281 centers from 37 countries affiliated to EuroELSO were included in the geospatial analysis and demonstrate heterogeneous patterns of ECLS provision. Accessibility of ECLS services within 1 hour of drive-time is available for 50% of the adult population in 8 of 37 countries (21.6%). This proportion is reached within 2 hours in 21 of 37 countries (56.8%) and within 3 hours in 24 of 37 countries (64.9%). For pediatric centers, accessibility is similar with 9 of 37 countries (24.3%) reached the covering of 50% of the population aged 0–14 within 1 hour and 23 of 37 countries (62.2%) within 2 hours and 3 hours. Conclusions ECLS services are accessible in most of the European countries, but their provision differs across the continent. There is still no solid evidence given regarding the optimal ECLS provision model. The spatial disparity in ECLS provision demonstrated in our analysis requires governments, healthcare professionals and policy makers to consider how to develop existing provision to accommodate the anticipated increase in need for time critical access to this advanced support modality.

ObjectivesRegulating 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.MethodsTwelve 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.ResultsAll 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.ConclusionSpatial 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.

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