Where are licensed tobacco retailers most densely concentrated and what influence does this have on youth and adult smoking?

Background: Previous studies suggest that licensed tobacco retailers (LTRs) are clustered in disadvantaged neighborhoods. We investigated whether LTRs in New York State (NYS) are more densely concentrated in low-SES and racial-ethnic communities, and whether this distribution is associated with self-reported exposure to retail tobacco advertising and smoking-related attitudes and behaviors among youth and adults.

Methods: A list of all LTRs was obtained for 2000-2008. Retailers were geocoded to a census tract. The density of LTRs was operationalized as the number of tobacco retailers per 1,000 residents. Census tracts were characterized as low-SES and high racial/ethnic minority population using census data and previously established methods. The density of LTRs at the census tract level was modeled using spatial regression methods. Smoking outcomes were measured using the New York Adult Tobacco Survey and New York Youth Tobacco Survey and modeled using regression analysis.

Results: LTRs in NYS are more densely concentrated in low SES and racial/ethnic minority neighborhoods. The density of LTRs was not associated with adult smoking or cessation behaviors. Youth who lived in areas with high density of LTRs were more likely to report seeing cigarette advertising in stores and to be open to smoking, but were not more likely to experiment with smoking or to be established smokers.

Conclusions: In New York state, licensed tobacco retailers are more likely to be located in areas with low SES and higher concentration of minority populations. High LTR density is not associated with adult smoking, but may increase youth susceptibility to smoking.