Simulating the density reduction and equity impact of potential tobacco retail control policies.
Simulating the density reduction and equity impact of potential tobacco retail control policies.
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DOI：
10.1136/tobaccocontrol-2020-056002
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发表时间：
2021-12
期刊：
影响因子：
5.2
通讯作者：
Shortt NK
中科院分区：
文献类型：
--
作者：
Caryl FM;Pearce J;Reid G;Mitchell R;Shortt NK
减少烟草供应对于减少吸烟不平等和吸烟相关危害非常重要。为了实现这一目标，人们提出了各种政策，但它们的影响——尤其是对公平的影响——往往是未知的。在这里，我们使用国家级数据模拟旨在降低烟草销售密度（TOD）的潜在政策的影响。烟草零售商地点 (n=9030) 根据苏格兰国家登记册进行地理编码，形成基线。制定了三类十二项政策： 1. 规范销售烟草的零售商类型； 2. 规范烟草销售地点； 3. 基于区域的 TOD 上限。密度降低的衡量标准是各数据区 TOD 的平均减少百分比和全国零售商数量。公平影响是使用基于回归的收入剥夺五分位的相对不平等指数（RII）来衡量的。限制烟草销售仅限于单一销售点类型（“超市”、“酒类商店”、“药房”）的政策导致全国 TOD 减少 80% 以上，烟草销售点数量减少 90% 以上。然而，RIIs 指出，其中两项政策（“酒类商店”、“药房”）加剧了 TOD 中的社会经济不平等。促进公平的政策包括“最小间距”和“儿童空间”周围的禁区。消除统计上显着的 TOD 不平等的唯一政策是有意这样做的政策（“减少集群”）。通过空间模拟，我们表明所有选定的政策都不同程度地减少了烟草零售的供应。然而，这样做最“成功”的国家也加剧了不平等。因此，政策制定者应考虑如何降低烟草零售密度的方法以及衡量成功的方法如何与政策目标保持一致。
Reducing the provision of tobacco is important for decreasing inequalities in smoking and smoking-related harm. Various policies have been proposed to achieve this, but their impacts—particularly on equity—are often unknown. Here, using national-level data, we simulate the impacts of potential policies designed to reduce tobacco outlet density (TOD). Tobacco retailer locations (n=9030) were geocoded from Scotland’s national register, forming a baseline. Twelve policies were developed in three types: 1. Regulating type of retailer selling tobacco; 2. Regulating location of tobacco sales; 3. Area-based TOD caps. Density reduction was measured as mean percentage reduction in TOD across data zones and number of retailers nationally. Equity-impact was measured using regression-based Relative Index of Inequality (RII) across income deprivation quintiles. Policies restricting tobacco sales to a single outlet type (“Supermarket”; “Liquor store”; “Pharmacy”) caused >80% TOD reduction and >90% reduction in the number of tobacco outlets nationally. However, RIIs indicated that two of these policies (“Liquor store”, “Pharmacy”) increased socioeconomic inequalities in TOD. Equity-promoting policies included “Minimum spacing” and exclusion zones around “Child spaces”. The only policy to remove statistically significant TOD inequalities was the one deliberately targeted to do so (“Reduce clusters”). Using spatial simulations, we show that all selected policies reduced provision of tobacco retailing to varying degrees. However, the most ‘successful’ at doing so also increased inequalities. Consequently, policymakers should consider how the methods by which tobacco retail density is reduced, and success measured, align with policy aims.
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