ABSTRACT
Background: This study investigates whether residential exposure to tobacco outlets (i.e., convenience stores and other stores selling tobacco) is associated with attitudes towards smoking among a sample of urban, primarily African American, adolescent smokers. Methods: Cross-sectional survey data for 197 adolescents were integrated with spatial data on tobacco outlets via subject home addresses. Ordinal regression was employed to test hypotheses that closer proximity to, and higher concentrations of, tobacco outlets are associated with higher measures of intention to continue to smoke in the future, weaker self-efficacy related to stopping smoking, and more accepting social norms related to smoking, while controlling for characteristics of age, gender, family and peer smoking contexts, and level of nicotine dependence. Moderation by age and gender was also investigated. Results: Higher residential tobacco outlet density is significantly associated with a greater intention to smoke in the next 3 months, a lower readiness to stop smoking, and a greater likelihood of accepting a cigarette from a friend. Residential proximity to a tobacco outlet is significantly associated with a greater intention to smoke 5 years on. Evidence of a relationship between exposure to tobacco outlets and social norms related to smoking was not found, nor was there evidence for moderation of these relationships by age or gender. Conclusions: These results suggest that among urban adolescents who currently smoke, higher residential exposure to tobacco outlets is associated with greater predisposition towards future smoking and lower self-evaluation of the ability to stop smoking.
Acknowledgments
We gratefully acknowledge the helpful comments of the editors of the journal.
The authors declare that they have no conflicts of interest.
Author contributions
J.M. contributed to the research design, data analysis, interpretation of results, and writing and revision of the manuscript. M.M. contributed to the research design, data collection, interpretation of results, and writing and editing of the manuscript.
Funding
This research was supported by the Virginia Foundation for Healthy Youth, grant 8520894. The findings and conclusions are those of the authors and do not necessarily represent the views of the Virginia Foundation for Healthy Youth. The Virginia Foundation for Healthy Youth had no further role in the design and conduct of the study; in the collection, management, analysis, and interpretation of data; in the preparation, review, or approval of the manuscript; or in the decision to submit the manuscript for publication.