Evaluating how licensing-law strategies will change neighborhood disparities in tobacco retailer density

项目摘要/摘要 增加或修改烟草许可法正在成为越来越受欢迎的烟草控制方法，但 这对健康差距的影响尚不清楚。目前，有充分的证据表明，烟草的密度 零售商在低收入、非裔美国人和西班牙裔社区更多。在这些零售商的市场营销 销售点会影响社会环境，并可对促进入门和 抑制戒烟。有了许可法战略，社区不仅可以要求商店获得许可证 销售烟草，但可以制定发放这些许可证的规定(例如，限制 或禁止零售商进入学校1000英尺以内)。研究表明，这种公共政策方法是 减少烟草零售商及其相应销售点数量的有效手段 市场营销。然而，这些战略中的一些对富裕的低少数民族地区可能比对 低收入、高种族/少数民族地区--提案所指的“高风险”地区。这 潜在的结果尤其令人不安，因为低收入、非裔美国人和西班牙裔人口 此外，与烟草有关的发病率和死亡率也是最高的。因此，这样做的目的是 R21提案是在俄亥俄州评估四大许可法战略的平等影响，这些战略具有 被提议限制烟草零售商。目标1将测试是否减少 烟草零售商将减少烟草零售商在分销方面的不平等。Aim 2将测试 限制烟草零售商靠近学校将减少目前烟草分销中的不平等 烟草零售商。目标3将测试禁止在药店销售烟草是否会加剧 烟草零售商的分销。分析将使用空间建模技术进行，该技术具有 在烟草控制研究中很少使用。以及一份已经获得的10,722份烟草清单 在俄亥俄州的零售商，分析将首先建立烟草零售商密度的当前政策之前的状态，在 人口普查区域级别。然后，每个目标都将模拟许可法限制的影响，并估计后 保单零售商密度。最后，每项政策都将根据其平等影响(是否会 为弱势群体提供更少、平等或更多的好处)。将使用三个基准：减少百分比 对于低风险的人口普查地区，零售商的密度并不大；烟草零售商之间的关系强度 烟草零售商的密度和社会人口结构已经减少；政策出台后，烟草零售商的密度并没有更大 在低风险的人口普查地区。这一新项目将提供有关相对平等影响的急需信息。 主要的许可法战略。调查结果将指导州和社区远离许可法的努力 将无意中扩大全国癌症差距的战略，并朝着有利于 将产生积极的平等影响。作为第一个将许可法研究与差异相结合的项目 研究表明，该项目可以显著改变控烟研究和政策的方向。

PROJECT SUMMARY/ABSTRACT Adding or modifying tobacco licensing laws is becoming an increasingly popular tobacco control approach, but the implications for health disparities is unknown. Currently, it is well-documented that the density of tobacco retailers is greater in low-income, African American, and Hispanic neighborhoods. Marketing at these retailers' points of sale impacts the social environment and can have powerful effects on promoting initiation and inhibiting cessation. With licensing-law strategies, communities can not only require stores to obtain a license to sell tobacco, but can set stipulations to granting these licenses (e.g., capping the number of retailers in an area, or banning retailers from within 1000 feet of a school). Research suggests this public policy approach is an effective means for reducing the number of tobacco retailers and their corresponding point-of-sale marketing. However, some of these strategies could be more beneficial for affluent, low-minority areas than for low-income, high-racial/ethnic minority areas—what the proposal is referring to as “high risk” areas. This potential outcome is particularly troubling given that low-income, African American, and Hispanic populations also exhibit some of the highest rates of tobacco-related morbidity and mortality. Therefore, the purpose of this R21 proposal is to evaluate in Ohio the equality-impact of the four major licensing-law strategies that have been proposed to restrict tobacco retailers. Aim 1 will test whether reducing the number and/or density of tobacco retailers will reduce inequalities in the distribution of tobacco retailers. Aim 2 will test whether restricting tobacco retailers from being close to schools will reduce current inequalities in the distribution of tobacco retailers. Aim 3 will test whether banning tobacco sales in pharmacies will exacerbate inequalities in the distribution of tobacco retailers. Analyses will be conducted using spatial modeling techniques, which have rarely been used in tobacco control research. With a list that has already been acquired of all 10,722 tobacco retailers in Ohio, analyses will begin by establishing the current, pre-policy state of tobacco retailer density, at the census-tract level. Each aim will then model the effects of a licensing-law restriction and estimate the post- policy retailer density. Finally, each policy will be evaluated in terms of its equality-impact (whether it will provide less, equal, or greater benefit to vulnerable groups). Three benchmarks will be used: the % reduction in retailer density is not greater for low-risk census tracts; the strength of the relation between tobacco retailer density and sociodemographics has diminished; and the post-policy density of tobacco retailers is not greater in low-risk census tracts. This novel project will provide much-need information on the relative equality-impact of the major licensing-law strategies. Findings will guide state and community efforts away from licensing-law strategies that will inadvertently widen the nation's cancer disparities and toward licensing-law strategies that will have a positive equality-impact. As the first project to integrate licensing-law research with disparities research, this project could significantly change the direction of tobacco control research and policy.