Spatial distribution of e-cigarette vending machines: a case study from Germany.

Area of Science:

• Public Health
• Spatial Epidemiology
• Tobacco Control

Background:

• Germany has the highest global density of cigarette vending machines.
• Proliferation of e-cigarette vending machines raises public health concerns, especially youth exposure.
• Limited data exist on the spatial distribution and placement of e-cigarette vending machines.

Purpose of the Study:

• To conduct the first spatial analysis of e-cigarette vending machines in Germany.
• To examine the spatial distribution and co-location patterns of e-cigarette vending machines.
• To use the Berlin-based company 'Vape4Me' as a case study for this analysis.

Main Methods:

• Geo-referenced data from the 'Vape4Me' website were extracted and validated.
• Spatial analyses included density mapping, proximity assessments, and co-location analysis using ArcGIS Pro, R, and OpenRouteService.
• Regression analysis examined associations with population size; on-site inspections validated selected sites.

Main Results:

• 316 'Vape4Me' e-cigarette vending machines were identified, with the highest concentration in Berlin.
• Machine density correlated significantly with population size (3.24% increase per 1000 residents).
• In Berlin, machines were co-located with commercial/hospitality venues, rarely near public utility areas; disposable e-cigarettes were offered with basic age verification.

Conclusions:

• E-cigarette vending machines normalize use through 24/7 access and integration into daily environments, challenging tobacco control.
• Urgent need for stronger regulations, including potential bans on vending machine sales of e-cigarettes.
• Protecting youth from early nicotine exposure requires addressing vending machine accessibility.