Density of tobacco retailers near schools: effects on tobacco use among students

Am J Public Health. 2009 Nov;99(11):2006-13. doi: 10.2105/AJPH.2008.145128.


Objectives: We examined the relationship between students' tobacco use and the density and proximity of tobacco retailers near their schools.

Methods: We used data from the 2003-2004 California Student Tobacco Survey and California retail licensing data. Measures included students' self-reported tobacco use and geocoded state-reported locations of tobacco retailers. We used random-intercept generalized linear mixed modeling to jointly evaluate individual-level and school-level predictors.

Results: Density of retailers was associated with experimental smoking (odds ratio [OR] = 1.11; 95% confidence interval [CI] = 1.02, 1.21) but not established smoking (OR = 1.06; 95% CI = 0.94, 1.20). The effects on experimental smoking were confined to high school students (OR = 1.17; 95% CI = 1.06, 1.29) in urban areas (OR = 1.11; 95% CI = 1.01, 1.21); no effects were observed among middle school students or in rural schools. High school students were more likely to obtain cigarettes from a retailer; middle school students relied more heavily on social sources.

Conclusions: Our results support the plausibility of reducing rates of students' experimental smoking, but not established smoking, by restricting their access to commercial sources of tobacco in urban areas.

MeSH terms

  • Adolescent
  • Adolescent Behavior
  • California / epidemiology
  • Cluster Analysis
  • Commerce*
  • Female
  • Geographic Information Systems
  • Humans
  • Male
  • Nicotiana*
  • Odds Ratio
  • Prevalence
  • Schools*
  • Smoking / epidemiology*