Associations of Alcohol and Tobacco Retail Outlet Rates with Neighborhood Disadvantage

David C. Wheeler, Joseph Boyle, D. Jeremy Barsell, Trevin Glasgow, F. Joseph McClernon, Jason A. Oliver and Bernard F. Fuemmeler
Additional contact information
David C. Wheeler: Department of Biostatistics, Virginia Commonwealth University, Richmond, VA 23298, USA
Joseph Boyle: Department of Biostatistics, Virginia Commonwealth University, Richmond, VA 23298, USA
D. Jeremy Barsell: Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, VA 23298, USA
Trevin Glasgow: Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, VA 23298, USA
F. Joseph McClernon: Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC 27705, USA
Jason A. Oliver: Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC 27705, USA
Bernard F. Fuemmeler: Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, VA 23298, USA

IJERPH, 2022, vol. 19, issue 3, 1-13

Abstract: Tobacco causes 29% of cancer-related deaths while alcohol causes 5.5% of cancer-related deaths. Reducing the consumption of these cancer-causing products is a special priority area for the National Cancer Institute. While many factors are linked to tobacco and alcohol use, the placement and density of retail outlets within neighborhoods may be one community-level risk factor contributing to greater use of these products. To elucidate associations between tobacco, alcohol, and tobacco and alcohol retail outlets (TRO, ARO, and TARO) and neighborhood disadvantage over a large geographic area, we employed a novel Bayesian index modeling approach to estimate a neighborhood disadvantage index (NDI) and its associations with rates of the three types of retailers across block groups in the state of North Carolina. We used a novel extension of the Bayesian index model to include a shared component for the spatial pattern common to all three types of outlets and NDI effects that varied by outlet type. The shared component identifies areas that are elevated in risk for all outlets. The results showed significant positive associations between neighborhood disadvantage and TROs (relative risk (RR) = 1.12, 95% credible interval (CI = 1.09, 1.14)) and AROs (RR = 1.15, 95% CI = 1.11, 1.17), but the association was greatest for TAROs (RR = 1.21, 95% CI = 1.18, 1.24). The most important variables in the NDI were percent renters (i.e., low home ownership), percent of homes built before 1940 (i.e., old housing stock), and percent without a high school diploma (i.e., low education).

Keywords: alcohol; tobacco; retail outlets; neighborhood disadvantage; neighborhood deprivation (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (3)

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