Reducing exposure to tobacco retailers with residential zoning policy: insights from a geospatial analysis of Wilmington, Delaware

ABSTRACT

Cigarette use remains the leading preventable cause of premature mortality in the US, with declines in smoking rates slowing in recent years. One promising target for improved tobacco control is the expanded regulation of tobacco retailers. Evaluations of such policy attempts have largely produced mixed results to date. The objective of this study was to the assess the potential of using a novel, residentially-focused zoning approach to produce a more targeted and equitable reduction in tobacco retailers in high-risk urban settings. We focused on Wilmington, Delaware, a city characterized by high poverty rates, a majority Black population, a disparate number of tobacco retailers, and an elevated smoking prevalence. Through the use of geospatial analyses, we observed disproportionately higher counts of convenience store tobacco retailers in medium- and high-density residential zones in Wilmington relative to the surrounding county. By linking electronic health record (EHR) data from a local health care system and US Census Bureau data, we further found that approximately 80% of Wilmington smokers and 60% of Wilmington youth lived in these residential zones. These findings highlight the potential to more equitably reduce tobacco retailer exposure through a residentially-focused zoning approach. Tobacco control policy and research implications are considered.

KEYWORDS:

• Tobacco retailers
• zoning
• built environment
• smoking
• geospatial

This article is related to:

Research for city practice

Disclosure statement

No potential conflict of interest was reported by the author(s).

Supplementary material

Supplemental data for this article can be accessed here.

Additional information

Funding

This work was supported by the National Institute of General Medical Sciences [P20 GM103446].

Notes on contributors

Scott D. Siegel

Scott D. Siegel is a behavioral scientist and psychologist who develops, implements, and evaluates interventions designed to address the social and behavioral determinants of health.

Madeline Brooks

Madeline Brooks is a health services researcher with expertise in mixed methods and spatial analytics.

Jason Bourke

Jason Bourke conducts public policy analysis research, largely situated in the Wilmington, Delaware context.

Frank C. Curriero

Frank Curriero conducts research on the development and application of spatial and spatial-temporal methods in the public health sciences.