Study: Reduce ‘tobacco swamps’ to improve health

A new study co-written by an ECU researcher says public health could be improved by reducing “tobacco swamps” – densely located stores that sell tobacco products. 

Charlotte has 1,032 tobacco retailers, and 43.1% of public schools are within 1,000 feet of a tobacco retailer.

Similar to “food swamps,” a term used to describe areas with a high density of restaurants or stores selling unhealthy food, the research says living near more tobacco retailers is linked with people being more likely to use tobacco and less likely to quit. 

The analysis, published in September in the international journal Tobacco Control, examined the results of 27 studies of tobacco retail density, adult tobacco use and health outcomes from eight countries: Australia, Canada, Denmark, England, Finland, New Zealand, Scotland and the United States. 

In the U.S., there are 27 brick-and-mortar tobacco retailers for every one McDonald’s restaurant, equaling 375,000 tobacco retail locations. Retailers are not equally distributed and tend to be clustered in lower-income and minority communities, according to the study. 

The researchers, including lead author Joseph G.L. Lee, associate professor of health education and promotion in the College of Health and Human Performance at ECU, found lower tobacco retailer density was associated with a 2.6% reduction in the risk of tobacco use behaviors. The study also explored differences in results by sex, income level and intensity of tobacco use. 

“Broadly speaking, implementing policies that reduce the number and concentration of stores selling tobacco could decrease smoking by between 2% and 3% among adults,” Lee said. 

Lee and faculty members from UNC-Chapel Hill, Washington University in St. Louis and Stanford University School of Medicine are members of the ASPiRE Center, a research collaborative funded by the National Institutes of Health. The center is working to build a scientific evidence base for effective policies in the retail environment to help reduce tobacco use, tobacco-related disparities and the public health burden of tobacco, including cancer. 

Tobacco use is the leading preventable cause of death in the U.S., with 480,000 deaths and more than $300 billion in health care spending and productivity losses caused by cigarette smoking each year, according to ASPiRE Center data. 

(Laura Brossart of the Brown School Center for Public Health Systems Science at Washington University contributed to this story).