Association between school-based tobacco retailer exposures and young adolescent cigarette, cigar and e-cigarette use

Abstract

BackgroundAssociations between retail tobacco availability and tobacco use have been mixed. This study examined associations between school-based retail environment exposures and current use of cigarettes, cigar products and e-cigarettes among middle school youth in Cleveland, OH.MethodsRetailers selling tobacco products were identified using the 2015 Cleveland Food Retail Database (n=639 stores). Youth survey data were drawn from the 2016 Cleveland Youth Risk Behavior Survey, administered to all 7th/8th graders across the Cleveland Metropolitan School District (n=3778, response rate=83.0%). Past 30-day cigarette, cigar product and e-cigarette use were assessed. Student demographics, number of days walking to/from school each week and number of times youth stopped at a retailer to/from school each week were included. For each school (n=63), tobacco retail density (TRD) and proximity (TRP) to nearest retailer were calculated for each product. Multiple regression analysis assessed associations between retail exposures and youth tobacco use.ResultsAcross all schools, 3.9%, 10.2% and 8.6% of students currently use cigarettes, cigar products and e-cigarettes, respectively, and 15.2% currently use at least one tobacco product. TRD and TRP were not associated with current use; frequency of walking to school and stopping at retailers were strongly associated with current use.ConclusionsAlthough TRD and TRP were not significantly associated with tobacco product use, youth who reported regularly walking to/from school or who reported stopping at a retail store before/after school were significantly more likely to be a current tobacco product user. This may be due to increased exposure to exterior and point-of-sale marketing.

Effect of Additional Motivational Interviewing on Smoking Abstinence for 1-Year among Korean Adolescents: Results from A Comparative Retrospective Study in Quitline

“…However, this might not have interfered with the current findings because we did not see different results in the subgroup analysis by self-efficacy level and the number reasons to quit. Finally, school and family environments are among the most critical factors that strongly influence adolescents [8,[44][45][46][47]. However, our study did not include these factors, including parental smokers, parental disapproval of smoking, and number of peer smokers.…”

Tobacco retail availability and cigarette and e-cigarette use among youth and adults: a scoping review

“…52 Retailer proximity to schools and adolescents' smoking outcomes Current smoking Three cross-sectional US studies examined current adolescent smoking, defined as past 30-day smoking 42 49 or past 30-day smoking and more than 100 lifetime cigarettes 50 and retailer proximity to schools, measured as a straight-line distance in feet 50 or in miles 49 and street network distance. 42 None found significant associations.…”

“…31 In a US study, the number of e-cigarette retailers per square mile within schools' ZIP codes was not related to current use among students. 42 Proximity, defined as a presence of at least one e-cigarette specialty store within a 0.25-mile buffers from schools, was only associated with lifetime use in middle school students (vs high school students) (OR=1.70; 95% CI: 1.02 to 2.83) and not associated with current use. 40 In a Canadian study, the presence of at least one e-cigarette retailer within 0.5, 1.0 and 1.5 km circular buffers around schools was not associated with lifetime or current use.…”

“…39 Smoking was not associated with higher retailer density in egocentric buffers around schools in three US, one Canadian (Ontario) and one Australian (Victoria) studies, 30 37 47 49 50 and inversely associated with higher density within 500 m road network buffers in one New Zealand study (OR=0.75; 95% CI: 0.65 to 0.87; p<0.05). 33 An administrative measure of density per square mile around schools in the USA showed no association, 42 while density per square kilometre within school ZIP codes in a Scottish study (OR=0.75; 95% CI: 0.59 to 0.95; p<0.05) 39 showed an inverse relationship.…”

“…31 In a US study, walking distance from school to the closest e-cigarette retailer was not associated with students' current e-cigarette use. 42 While no studies examined the initiation of e-cigarettes (exclusively), two considered initiation of alternative/noncombustible tobacco products (including e-cigarettes) among youth and young adults. A longitudinal study in the USA showed that living in census tracts with higher tobacco retailer density per square mile was positively associated with adolescents' initiation of alternative tobacco products (OR=1.22, 95% CI: 1.07 to 2.12), but no association was found for retailer proximity from home measured in roadway miles.…”