Concentration of Tobacco Advertisements at SNAP and WIC Stores, Philadelphia, Pennsylvania, 2012

Abstract

IntroductionTobacco advertising is widespread in urban areas with racial/ethnic minority and low-income households that participate in nutrition assistance programs. Tobacco sales and advertising are linked to smoking behavior, which may complicate matters for low-income families struggling with disparate health risks relating to nutrition and chronic disease. We investigated the relationship between the amount and type of tobacco advertisements on tobacco outlets and the outlet type and location.MethodsBy using field visits and online images, we inspected all licensed tobacco retail outlets in Philadelphia (N = 4,639). Point pattern analyses were used to identify significant clustering of tobacco outlets and outlets with exterior tobacco advertisements. Logistic regression was used to analyze the relationship between the outlet’s acceptance of Supplemental Nutrition Assistance Program (SNAP) and Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) and the presence of tobacco advertisements.ResultsTobacco outlets with exterior tobacco advertisements were significantly clustered in several high-poverty areas. Controlling for racial/ethnic and income composition and land use, SNAP and WIC vendors were significantly more likely to have exterior (SNAP odds ratio [OR], 2.11; WIC OR, 1.59) and interior (SNAP OR, 3.43; WIC OR, 1.69) tobacco advertisements than other types of tobacco outlets.ConclusionTobacco advertising is widespread at retail outlets, particularly in low-income and racial/ethnic minority neighborhoods. Policy makers may be able to mitigate the effects of this disparate exposure through tobacco retail licensing, local sign control rules, and SNAP and WIC authorization.

Risky Substance Use Environments and Addiction: A New Frontier for Environmental Justice Research

“…Research suggests that racial and socioeconomic inequities persist in the residential proximity to, and density of, stores selling tobacco and alcohol. Many U.S.-based studies at the state, metropolitan area, and county levels have found that stores selling tobacco are disproportionately located in neighborhoods with higher percentages of minorities, particularly African Americans and Hispanics [ 52 , 53 , 54 ], and lower income [ 55 , 56 , 57 ]. Similar patterns of racial and economic inequity have been found for alcohol outlets [ 58 , 59 , 60 ].…”

Ethical imperatives against item restriction in the Supplemental Nutrition Assistance Program

“…Among SNAP recipients, agency-influencing contexts may include living with unemployment or poverty wages, amenity-poor neighborhoods, low mobility, and high exposure to unhealthy food and beverage advertising (Gray et al, 2016; Hillier, 2012). Indeed, some researchers suggest that poverty is the most influential contextual factor on food choices, and that healthy food affordability poses a significant and critical barrier (Drewnowski & Eichelsdoerfer, 2010).…”

Smoking among patients in substance use disorders treatment: associations with tobacco advertising, anti-tobacco messages, and perceived health risks

“…Moreover, tobacco companies have specifically marketed to marginalized groups with higher smoking rates (7, 8). Currently, most tobacco advertising occurs at point-of-sale locations such as convenience stores (8), and is concentrated in poor neighborhoods (13, 16). It is likely that individuals with SUDs are among those who frequent locations with a high concentration of tobacco ads and promotional item marketing.…”