Farther distance to tobacco store associated with quitting smoking

An increase in distance to a tobacco store from home was associated with increased odds of smoking cessation, according to research published in JAMA Internal Medicine.

Minimizing stores that sell tobacco in residential areas may result in lower tobacco consumption, Anna Pulakka, PhD, from the department of public health at the University of Turku, Finland, and colleagues wrote.

"Smoking continues to be a leading health risk globally, emphasizing the need for identifying measures to curb the tobacco epidemic," they wrote.

Pulakka and colleagues noted that previous studies provided insufficient evidence to confirm an association between smoking behaviors and retail environment.

"Importantly, none of the existing prospective studies have been informative about the effect of a change in access to tobacco on changes in smoking behaviors — a key issue for policy," they stated.

The researchers used data from two prospective cohort studies: The Health and Social Support (HeSSup) study and the Finnish Public Sector (FPS) study. Their data included 20,729 men and women aged between 18 and 75 years who were either smokers or ex-smokers at baseline.

Pulakka and colleagues reported that 28% and 39% of the participants quit smoking and 7% and 6% of the participants relapsed in the FPS and HeSSup studies, respectively.

They found that a 500-meter increase in the distance to a tobacco store from home was associated with a 16% increase in smoking cessation odds in between-individual analysis (pooled OR = 1.16; 95% CI, 1.05-1.28) and 57% increase in within-individual analysis (pooled OR = 1.57; 95% CI, 1.32-1.86) after adjusting for various factors.

Distance increase was not associated with smoking relapse.

"To the best of our knowledge, this is the first study to examine the impact of change in access to tobacco on smoking behaviors in two large independent data sets using between-individual and within-individual comparisons," Pulakka and colleagues concluded. "We found robust evidence suggesting that among Finnish adults who smoked, increase in the distance from home to a tobacco outlet increased the odds of quitting smoking. Among ex-smokers, however, change in distance to the nearest tobacco outlet was not associated with smoking behaviors."

In a related editorial, Cheryl Bettigole, MD, MPH, and Thomas A. Farley, MD, MPH, from the Philadelphia Department of Public Health, wrote that "it is time to recognize the risks that tobacco retail outlets pose to communities."

"We can now conclude that tobacco outlets and the heavy dose of tobacco marketing they dump into their communities cause smoking — more precisely, they inhibit quitting among smokers," they said.

Bettigole and Farley said that policy makers need to protect Americans from "relentless marketing."

"It is now painfully clear that Big Tobacco, by redirecting its massive marketing budget to retail stores, has hit upon a strategy that works," they concluded. "The Marlboro Man no longer rides on television and radio, but point-of-sale substitutes — price discounts, coupons, advertisements, and a barrage of other retailer promotions — can be nearly as effective. Those of us who care about the health of the nation must redesign our antismoking strategy to confront this danger." – by Chelsea Frajerman Pardes

Disclosures: The researchers report no relevant financial disclosures.