Tobacco retailer proximity and density and nicotine dependence among smokers with serious mental illness

Am J Public Health. 2014 Aug;104(8):1454-63. doi: 10.2105/AJPH.2014.301917. Epub 2014 Jun 12.

Abstract

Objectives: We examined the density and proximity of tobacco retailers and associations with smoking behavior and mental health in a diverse sample of 1061 smokers with serious mental illness (SMI) residing in the San Francisco Bay Area of California.

Methods: Participants' addresses were geocoded and linked with retailer licensing data to determine the distance between participants' residence and the nearest retailer (proximity) and the number of retailers within 500-meter and 1-kilometer service areas (density).

Results: More than half of the sample lived within 250 meters of a tobacco retailer. A median of 3 retailers were within 500 meters of participants' residences, and a median of 12 were within 1 kilometer. Among smokers with SMI, tobacco retailer densities were 2-fold greater than for the general population and were associated with poorer mental health, greater nicotine dependence, and lower self-efficacy for quitting.

Conclusions: Our findings provide further evidence of the tobacco retail environment as a potential vector contributing to tobacco-related disparities among individuals with SMI and suggest that this group may benefit from progressive environmental protections that restrict tobacco retail licenses and reduce aggressive point-of-sale marketing.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Age Factors
  • Female
  • Humans
  • Male
  • Mental Disorders / epidemiology*
  • Mental Disorders / psychology
  • Residence Characteristics / statistics & numerical data
  • San Francisco / epidemiology
  • Sex
  • Smoking / epidemiology*
  • Smoking / psychology
  • Socioeconomic Factors
  • Tobacco Products / supply & distribution*
  • Tobacco Use Disorder / epidemiology*
  • Tobacco Use Disorder / psychology