A Systematic Review of Neighborhood Disparities in Point-of-Sale Tobacco Marketing

Abstract

We systematically reviewed evidence of disparities in tobacco marketing at tobacco retailers by sociodemographic neighborhood characteristics. We identified 43 relevant articles from 893 results of a systematic search in 10 databases updated May 28, 2014. We found 148 associations of marketing (price, placement, promotion, or product availability) with a neighborhood demographic of interest (socioeconomic disadvantage, race, ethnicity, and urbanicity). Neighborhoods with lower income have more tobacco marketing. There is more menthol marketing targeting urban neighborhoods and neighborhoods with more Black residents. Smokeless tobacco products are targeted more toward rural neighborhoods and neighborhoods with more White residents. Differences in store type partially explain these disparities. There are more inducements to start and continue smoking in lower-income neighborhoods and in neighborhoods with more Black residents. Retailer marketing may contribute to disparities in tobacco use. Clinicians should be aware of the pervasiveness of these environmental cues.

FIGURE 1—

PRISMA flow diagram of inclusion of studies and results. Note. PRISMA = Preferred Reporting Items for Systematic Reviews and Meta-Analyses.

FIGURE 2—

Count of results for general tobacco marketing by direction of association and neighborhood characteristics of (a) socioeconomic disadvantage, (b) Asian American race, (c) Black race, (d) Hispanic/Latino ethnicity, (e) minority status, and (f) urbanicity: May 28, 2014.

FIGURE 3—

Count of results for menthol-specific marketing by direction of association and neighborhood characteristics of (a) socioeconomic disadvantage, (b) Asian American race, (c) Black race, (d) Hispanic/Latino ethnicity, (e) minority status, and (f) urbanicity: May 28, 2014.

FIGURE 4—

Count of results for smokeless tobacco–specific marketing by direction of association and neighborhood characteristics of (a) socioeconomic disadvantage, (b) Asian American race, (c) Black race, (d) Hispanic/Latino ethnicity, (e) minority status, and (f) urbanicity: May 28, 2014.

FIGURE 5—

Count of results for cigar-specific marketing by direction of association and neighborhood characteristics of (a) socioeconomic disadvantage, (b) Asian American race, (c) Black race, (d) Hispanic/Latino ethnicity, (e) minority status, and (f) urbanicity: May 28, 2014.

FIGURE 6—

Slide from Philip Morris USA Integrated Retail Demographic Database presentation.