Tobacco retail availability and smoking-A systematic review and meta-analysis

Area of Science:

• Public Health
• Epidemiology
• Tobacco Control Policy

Background:

• Global health policies often focus on consumer-level interventions to reduce tobacco harm.
• Limiting the supply of tobacco products by decreasing retail availability is a potential strategy to reduce cigarette smoking.

Purpose of the Study:

• To conduct a systematic literature review and meta-analysis to assess the association between tobacco retail availability and smoking behaviors.
• To inform policymakers on the effectiveness of reducing tobacco retail density as a tobacco control measure.

Main Methods:

• Systematic searches of five databases were conducted up to January 2023.
• Included studies examined tobacco retail density, proximity, or mixed measures as exposures and smoking behaviors as outcomes.
• Meta-analyses were performed on studies with similar populations, exposures, and outcomes, including at least three studies.

Main Results:

• Sixty-two studies were included, showing positive associations between tobacco outlet density and smoking in pregnant women, youth, and adults.
• Meta-analyses indicated higher tobacco retail density was associated with ever smoking (OR 1.20), current youth smoking (OR 1.23), and adult smoking (OR 1.11).
• Restrictive tobacco retail laws near schools or homes showed limited impact on smoking, except for heavy-smoking men.

Conclusions:

• Higher tobacco retail density is consistently associated with increased cigarette smoking across various populations.
• Strategies aimed at reducing tobacco retailer density should be integrated into comprehensive tobacco control efforts.
• Current evidence suggests that proximity-based tobacco retail laws may have limited effectiveness in reducing overall smoking rates.