The neighbourhood effects of geographical access to tobacco retailers on individual smoking behaviour

Abstract

Objective: To investigate whether neighbourhood measures of geographical accessibility to outlets selling tobacco (supermarkets, convenience stores and petrol stations) are associated with individual smoking behaviour in New Zealand.Methods: Using Geographical Information Systems, travel times from the population-weighted centroid of each neighbourhood to the closest outlet selling tobacco were calculated for all 38,350 neighbourhoods across New Zealand. These measures were appended to the 2002/03 New Zealand Health Survey; a national survey of 12,529 adults. Two-level logistic regression models were fitted to examine the effects of neighbourhood locational access upon individual smoking behaviour after controlling for potential individual- and neighbourhood-level confounding factors, including deprivation and urban/rural status.Results: After controlling for individual-level demographic and socioeconomic variables, individuals living in the quartiles of neighbourhoods with the best access to supermarkets (OR1.23, 95% CI 1.06-1.42) and convenience stores (OR 1.19, 95% CI 1.03-1.38) had a higher odds of smoking compared to individuals in the worst access quartiles. However, theassociation between neighbourhood accessibility to supermarkets and convenience stores was not apparent once other neighbourhood-level variables (deprivation and rurality) were included.Conclusions: At the national level, there is little evidence to suggest that after adjustment for neighbourhood deprivation better locational access to tobacco retail provision in New Zealand is associated with individual-level smoking behaviour