Convenience stores as a risk factor for obesity among smokers

There has not been a study that examined the multidimensional representations of neighborhood environments with obesity, particularly among smokers. Obese smokers have higher mortality risks in the United States. In order to fill these important research gaps, we first conducted two separate robust principal component analyses to capture the variability of neighborhood built environments (i.e., unconnected streets, connected streets, and convenience stores) and neighborhood sociodemographic characteristics (i.e., neighborhood deprivation, suburbanity, and non-Hispanic homogeneity). Neighborhood built environment variables were obtained from geographic information system (ArcGIS 10), and neighborhood sociodemographic variables were obtained from the 2005-2009 American Community Survey. We then conducted a series of Bayesian multilevel logistic analysis on obesity among 1,879 smokers aged 25-44 years who lived within the St. Louis Metropolitan area between 2003 and 2007. After accounting for the gradients in suburbanity and non-Hispanic black homogeneity, the associations of neighborhood built and social environments with obesity and the racial difference in obesity among smokers were attenuated. The increase in convenience store density remained associated with higher odds of obesity [odds ratio (OR): 1.20; 95% credible interval (CI): 1.04, 1.40], and the odds of obesity among non-Hispanic black declined from 2.36 (95% CI: 1.73, 3.20) to 2.03 (95% CI: 1.39, 2.96). Bringing neighborhood deprivation, suburbanity and non-Hispanic black homogeneity into the equation provides a comprehensive examination of neighborhood environments and obesity among smokers. Because obese smokers are the high-risk populations, future efforts need to modify the concentration and in-store contents of convenience stores.