A cross-sectional analysis of socio-spatial patterning of tobacco retail in Shanghai, China

Nicotine Tob Res. 2022 Jul 2;ntac155. doi: 10.1093/ntr/ntac155. Online ahead of print.

Abstract

Introduction: International evidence from high-income countries demonstrates that the availability of tobacco tends to be greater in more urban and more deprived neighbourhoods. However, little is known about the socio-spatial disparities in other settings, including megacities in China. This study investigated the patterning of tobacco retailers across Shanghai by types of tobacco retailers, including the relationship with levels of urbanity and neighbourhood deprivation.

Methods: Tobacco retailer data (n = 19,413) was extracted from a web-scraped Points-of-Interest database. For all communities (n = 5,432) across Shanghai, neighbourhood tobacco retail availability was calculated using population-weighted kernel density estimation and grouped by quintiles of neighbourhood deprivation and a 3-level urban classification. Associations were analysed using the Kruskal-Wallis test and epsilon-squared.

Results: Across Shanghai, tobacco retail availability decreased from more urbanised areas to less urbanised areas. There was a statistical difference (p < 0.001) in the availability of tobacco retail across quintiles of deprivation, with the highest availability in the less deprived neighbourhoods and the lowest availability in the most deprived neighbourhoods. However, this trend was reversed in the urban centre, where retail availability was greatest in the most deprived areas. Convenience stores were the most common type of tobacco retailer across the city, while tobacco-only outlets were most strongly associated with levels of neighbourhood deprivation.

Conclusion: The results show an association between tobacco retail availability and neighbourhood deprivation, which varied with levels of urbanity and types of tobacco retailers. These findings provide supportive evidence for further interventions that target reducing inequalities in exposure to tobacco retail.

Implications: This is the first study to examine the relationship between tobacco retail availability and neighbourhood deprivation in the context of Chinese megacities. Using data from Shanghai, China, we found a significant non-linear association between tobacco retail availability and neighbourhood deprivation across the city. It is plausible that the socio-spatial disparities in tobacco retail availability at the neighbourhood level may be a key factor explaining differences in smoking behaviours between sociodemographic groups. The findings emphasise the need for greater efforts in regulating neighbourhood-level tobacco retailing in China.