Understanding the Relation Between Tobacco Outlet Density and Tobacco Use in African American Young Adults

Researchers assessed the relation between tobacco outlet density (TOD) and sociodemographic factors (e.g., urbanicity, % people living in poverty, % minorities in a census tract). Results revealed TOD disparities, with the greatest density in areas where ethnic minorities and the poor live. Researchers found relations between TOD and smoking behavior, although results are mixed, with some finding no relations at all. This suggests that the TOD/tobacco use relation is heterogeneous. We proposed to assess the relation between TOD and tobacco use (i.e., combustible cigarettes and chew tobacco) behavior in a sample of 694 African American young adults (aged 18-22) participating in the Panel Study of Income Dynamics (PSID) Transition to Adulthood (TA) 2015 supplement. Using binary logistic regression and controlling for urbanicity (urban versus rural neighborhood), education, risky behaviors, and sex, we assessed main effects, and all two and three-way interactions involving TOD and urbanicity. There were two significant two-way interactions. There was a positive TOD/tobacco use relation for males but a negative relation for females (p=0.031). There was a significant education by TOD interaction (p=0.036) with TOD positively related to tobacco use for participants with ≤ high school but a negative relation for participants with > high school education. There was also a significant TOD by urbanicity by risky behavior three-way interaction (p=0.037). For participants living in a rural neighborhood, the relation between TOD and tobacco use was positive for those engaging in risky behavior but negative for those not engaging in risky behavior. In urban settings, the relation was almost reverse, with those engaging in risky behavior having a negative relation between TOD and tobacco use. This suggests the relation between TOD and tobacco use is complex. Researchers should assess how TOD impacts use in different populations, using methods permitting greater assessment of heterogeneity of effects.