Influence of tobacco retail stores on adolescent smoking: A systematic literature review

Background: Most adult smokers initiate smoking during adolescence. Tobacco companies focus on marketing efforts inside tobacco retail stores. Exposure to tobacco product marketing occurs whenever adolescents visit these stores. This study aims to expand knowledge about the influence of tobacco retailers on adolescent smoking by addressing a specific question: Does the density (or the number) and the proximity of tobacco retail stores influence adolescent smoking?

Methods: This study is a systematic review using literature published in the past decade. The distribution or number of tobacco retailers and adolescent smoking behaviors were the variables of interest.

Results: Nine cross-sectional studies met the inclusion criteria. Two studies found a significant effect of store density on adolescent “ever” smoking. Two studies found a significant association between store density and adolescent “past” smoking. Two of six studies that examined the influence of store density on adolescent “current” smoking yielded a significant result. One of two studies that explored the relation between store density and adolescent “future” smoking found a significant result. One of two studies that analyzed the influence of store proximity on youth “ever” and “current” smoking reported statistical significance. Two studies measured proximity of tobacco retailers: one near schools and one near homes.

Implication: Administrators in charge of education, finance, and health should pay attention to zoning and licensing restrictions for tobacco stores and marketing. Intensified school-based smoking prevention programs provided by public health professionals including school nurses are important for the students who attend schools with higher density of tobacco stores.