Assessing the impact, equity, and mechanisms of a novel policy intervention to reduce tobacco retailer density in communities

评估降低社区烟草零售商密度的新颖政策干预的影响、公平性和机制

• 批准号: 10586496
• 负责人: Daniel Philip Giovenco
• 金额: $ 58.39万
• 依托单位: COLUMBIA UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-02-01 至 2028-01-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10586496
• 关键词: Adult; Attention; Behavior; Behavioral; Behavioral Mechanisms; Case Study; Characteristics; Charge; Cities; Communities; Community Health; Contracts; Data; Disparity; Economically Deprived Population; Empirical Research; Ensure; Environment; Environmental Impact; Equity; Ethnic Origin; Evaluation Research; Excision; Goals; Grant; Health; Health Surveys; Income; Individual; Intervention; Interview; Licensing; Link; Low income; Marketing; Measures; Methods; Modeling; Municipalities; Neighborhoods; New York City; Pattern; Perception; Pharmacy facility; Philadelphia; Policies; Policy Developments; Population; Public Health; Public Policy; Race; Research; Respondent; Sales; Sampling; San Francisco; Scientist; Site; Smoking; Smoking Behavior; Structure; Subgroup; Testing; Time; Time trend; Tobacco; Tobacco use; United States National Institutes of Health; Variant; behavior change; career; cigarette smoking; community engaged research; comparative; demographics; density; falls; frontier; health disparity; health equity; health equity promotion; improved; inequitable distribution; interest; intervention effect; marginalization; marginalized population; novel; novel strategies; population survey; preventable death; public policy on tobacco; social disparities; sociodemographics; socioeconomic disparity; spatial epidemiology; substance use; tobacco control; tobacco products; trend

PROJECT SUMMARY/ABSTRACT Tobacco retailer density is disproportionately high in low-income communities and certain racial/ethnic enclaves, contributing to severe socioeconomic and social disparities in smoking and its resultant health harms. Local, environmental-level interventions that aim to reduce the number of tobacco retailers are a new policy frontier in tobacco control that may be particularly effective in promoting health equity, but the impact of these initiatives is critically understudied in real-world settings. Three major US cities – San Francisco, Philadelphia, and New York City (NYC) – recently enacted novel measures that establish caps on the number of tobacco retail licenses permitted in city districts. Density reduction under this intervention occurs not through license revocation, but gradually through retailer attrition. The effects of these “capping” policies on retailer density reduction and the resultant tobacco product marketplace largely depend on temporal, spatial, and store-level patterns in license forfeiture, which are not well-understood. Moreover, to comprehensively assess public health impact, it is critical to conduct stakeholder analyses after implementation, describe the policy’s impact on and mechanisms of behavior change, and identify potential unintended effects. The proposed mixed-methods, comparative case study will use archival tobacco retail licensing data, annual audits of tobacco retailers, semi-structured interviews with key community stakeholders, and geocoded health survey data to evaluate this intervention and examine differential policy impact across neighborhoods and population subgroups. Specifically, the project will: 1) Measure tobacco retailer density reduction and its association with community demographics across study sites; 2) Longitudinally characterize changes in the tobacco marketplace during policy implementation; 3) Qualitatively assess key stakeholder perceptions of the policy, its mechanisms of action, and its behavioral impact; and 4) Identify associations between tobacco retailer density reduction and smoking trends in NYC neighborhoods using a unique, annual population survey with geocoded respondent data. Given the lack of empirical support for this nascent, environmental-level tobacco control intervention, study results will provide timely, essential, and experiential evidence to inform equitable policy formation and improve implementation in order to maximize impact and reduce persistent health disparities.

项目总结/摘要 烟草零售商密度在低收入社区和某些种族/族裔社区中高得不成比例。 飞地，造成吸烟及其导致的健康方面的严重社会经济和社会差距 伤害旨在减少烟草零售商数量的地方环境层面的干预措施是一种新的 烟草控制的政策前沿，可能对促进健康公平特别有效，但 这些举措在现实世界中的研究严重不足。美国三大城市--弗朗西斯科， 费城和纽约市--最近颁布了新的措施，对这一数字设定了上限 烟草零售许可证在城市地区。在这种干预下的密度降低不是通过 许可证撤销，但逐渐通过零售商的自然减员。这些“封顶”政策对零售商的影响 密度的降低和由此产生的烟草产品市场在很大程度上取决于时间、空间和 许可证没收的商店级模式，目前还不太清楚。此外，为了全面评估 公共卫生影响，关键是在实施后进行利益相关者分析，描述政策的 行为变化的影响和机制，并确定潜在的意外影响。拟议 混合方法，比较案例研究将使用档案烟草零售许可证数据，年度审计 烟草零售商，与关键社区利益相关者的半结构化访谈，以及地理编码健康调查 数据来评估这种干预措施，并检查不同社区和人口的政策影响 分组。具体而言，该项目将：1）测量烟草零售商密度的降低及其与 研究地点的社区人口统计学; 2）纵向描述烟草的变化 3）质量管理评估主要利益相关者对政策的看法， 作用机制及其行为影响;以及4）确定烟草零售商密度之间的关联 减少和吸烟趋势在纽约市社区使用一个独特的，年度人口调查与地理编码 应答数据。由于缺乏对这种新生的、环境层面的烟草控制的经验支持， 干预，研究结果将提供及时，必要和经验证据，为公平政策提供信息 制定和改进执行工作，以最大限度地扩大影响，减少长期存在的健康差距。