Purchase of Loose Cigarettes by Adult Smokers in Philadelphia: Individual-level Correlates and Neighborhood Characteristics

Background: A main source of cigarette use in low income communities is single (loose) cigarettes purchased illegally at tobacco retailers or from unregulated street vendors. The current study identifies the demographic and smoking-related factors associated with purchasing loose cigarettes among adult smokers in Philadelphia, and describes characteristics of neighborhoods related to prevalence of loose cigarette purchases.

Methods: This study used self-reported data from the Public Health Management Corporation’s 2010 Household Health Survey (HHS), a representative cross-sectional survey of health related factors among Philadelphia residents. Logistic regression was used to identify demographic and smoking-related predictors of ever-purchasing loose cigarettes among a sample of adult smokers. Aggregate 2010 HHS data was geocoded using ArcGIS 10.2, and compared with 2010 U.S. Census data and 2014 tobacco retailer density data by census tract.

Results: 11% of smokers indicated that they had ever purchased a loose cigarette. Logistic regression analysis identified that minorities, younger people, those with limited education, and part-time or unemployed workers, were more likely than comparison groups to have purchased loose cigarettes. Neighborhoods with greater prevalence of loose cigarette purchases had higher poverty rates and higher tobacco retail density.

Conclusions: Greater likelihood of purchasing loose cigarettes among minority smokers with low education level and less than full-time employment was expected given Philadelphia’s high volume of cigarette retailers in poor, primarily African American, neighborhoods. Results of this study could be used to inform community and city-wide actions to curb illegal sale of cigarettes as part of comprehensive tobacco control efforts.