Tobacco retail availability and smoking behaviours among patients seeking treatment at a nicotine dependence treatment clinic
Jürgen Rehm 1,2,3
More details
Hide details
Social and Epidemiological Research (SER) Department, Centre for Addiction and Mental Health (CAMH), Toronto, Canada
Dalla Lana School of Public Health, Toronto, Canada
Institute of Medical Sciences, University of Toronto (UofT), Toronto, Canada
Dept. of Psychiatry, Faculty of Medicine, UofT, Canada
Addictions Program, Centre for Addiction and Mental Health (CAMH), Toronto, Canada
Submission date: 2014-05-26
Acceptance date: 2014-08-28
Publication date: 2014-12-02
Corresponding author
Michael Chaiton   

Social and Epidemiological Research (SER) Department, Centre for Addiction and Mental Health (CAMH), Toronto, Canada
Tobacco Induced Diseases 2014;12(December):19
Availability of tobacco may be associated with increased smoking. Little is known about how proximity to a retail outlet is associated with smoking behaviours among smokers seeking treatment.

A cross sectional study was conducted using chart data was extracted for 734 new clients of a nicotine dependence clinic in Toronto, Canada who visited during the period April 2008 to June 2010. Using a tobacco retail licensing list, clients were coded as to whether there were 0, 1, or more than 1 retail outlet located 250 m from their postal code address. Conditional fixed effects regression analyses were used to assess the association between proximity and quit status, number of previous quit attempts, number of cigarettes per day, and time to first cigarette, controlling for demographic characteristics and neighbourhood.

72% of patients lived within 250 m of a retail outlet. Those who had more than one outlet with 250 m of their address were less likely to be abstinent at the initial assessment (OR = 0.45; 95% CI: 0.23, 0.87; p = 0.014) and less likely to have a longer time to first cigarette (OR = 0.60; 95% CI: 0.45, 0.79), both before and after adjustment for covariates. Smokers who had at least one outlet within 250 m of their address smoked 3.4 cigarettes more per day than smokers without an outlet after controlling for neighbourhood and covariates. There was no significant association between proximity and lifetime number of quit attempts.

Proximity to a tobacco retail outlet was associated with smoking behaviours among a heavily addicted, treatment seeking population. Environmental factors may have a substantial impact on the ability of smokers to quit smoking.

Cohen JE, Anglin L: Outlet density: a new frontier for tobacco control. Addiction. 2009, 104 (1): 2-3. doi:10.1111/j.1360-0443.2008.02389.x.
Tilson M: Reducing the Availability of Tobacco Products at Retail: Policy Analysis. 2011, Retrieved from
Bird M: Radical institutional change at a crown corporation: the Liquor Control Board of Ontario, 1985–2010. Cana Pol Sci Rev. 2010, 4 (2–3): 1-17. Retrieved from
Chapman S, Freeman B: Regulating the tobacco retail environment: beyond reducing sales to minors. Tob Control. 2009, 18: 496-501. 10.1136/tc.2009.031724. doi:10.1136/tc.2009.031724.
Halonen JI, Kivimäki M, Kouvonen A, Pentti J, Kawachi I, Subramanian SV, Vahtera J: Proximity to a tobacco store and smoking cessation: a cohort study. Tob Control. 2014, 23 (2): 146-151. 10.1136/tobaccocontrol-2012-050726. doi:10.1136/tobaccocontrol-2012-050726.
Reitzel LR, Cromley EK, Li Y, Cao Y, Dela Mater R, Mazas CA, Wetter DW: The effect of tobacco outlet density and proximity on smoking cessation. Am J Public Health. 2011, 101 (2): 315-320. 10.2105/AJPH.2010.191676. doi:10.2105/AJPH.2010.191676.
Han T, Alexander M, Niggebrugge A, Hollands GJ, Marteau TM: Impact of tobacco outlet density and proximity on smoking cessation: a longitudinal observational study in two English cities. Health and Place. 2014, 27C: 45-50. doi:10.1016/j.healthplace.2014.01.008.
Pearce J, Hiscock R, Moon G, Barnett R: The neighbourhood effects of geographical access to tobacco retailers on individual smoking behavior. J Epidemiol Community Health. 2009, 63 (1): 69-77. 10.1136/jech.2007.070656. doi:10.2105/AJPH.2010.191676.
Samokhvalov AV, Selby P, Bondy SJ, Chaiton M, Ialomiteanu A, Mann R, Rehm J: Smokers who seek help in specialized cessation clinics: How special are they compared to smokers in general population?. J Smok Cessat. 2013, 1-9.
Wilkins R, Peters P: Census of Canada. Postal Code Conversion File, PCCF + Version 5K May 2011 Postal Codes. 2006, Ottawa: Statistics Canada, Health Analysis Division,
Bow C, Jennifer D, Waters N, Faris P, Seidel J, Galbraith D: Accuracy of city postal code coordinates as a proxy for location of residence. Int J Health Geogr. 2004, 3: 5-10.1186/1476-072X-3-5. doi:10.1186/1476-072X-3-5.
Healy M, Gilliland J: Quantifying the magnitude of environmental exposure misclassification when using imprecise address proxies in public health research. Spatial Spatio-Temporal Epidem. 2012, 3 (1): 55-67. 10.1016/j.sste.2012.02.006. doi:10.1016/j.sste.2012.02.00.
Kirchner TR, Cantrell J, Anesetti-Rothermel A, Ganz O, Vallone DM, Abrams DB: Geospatial exposure to point-of-sale tobacco: real-time craving and smoking-cessation outcomes. Am J Prev Med. 2013, 45 (4): 379-385. 10.1016/j.amepre.2013.05.016. doi:10.1016/j.amepre.2013.05.016.
Babor T, Caetano R, Casswell S, Edwards G, Giesbrecht N, Graham K, Rossow I: Alcohol: No Ordinary Commodity. Research and Public Policy. 2010, Oxford: Oxford University Press, 2.
Laws MB, Whitman J, Bowser DM, Krech L: Tobacco availability and point of sale marketing in demographically contrasting districts of Massachusetts. Tob Control. 2002, 11: ii71-ii73. doi:10.1136/tc.11.suppl_2.ii71.
Hyland A, Travers MJ, Cummings KM, Bauer J, Alford T, Wieczorek WF: Tobacco outlet density and demographics in Erie County, New York. Am J Public Health. 2003, 93 (7): 1075-1076. 10.2105/AJPH.93.7.1075. doi:10.2105/AJPH.93.7.1075.
Siahpush M, Jones PR, Singh GK, Timsina LR, Martin J: Association of availability of tobacco products with socioeconomic and racial/ethnic characteristics of neighbourhoods. Public Health. 2010, 124 (9): 525-529. 10.1016/j.puhe.2010.04.010. doi:10.1016/j.puhe.2010.04.010.
Novak SP, Reardon SF, Raudenbush SW, Buka SL: Retail tobacco outlet density and youth cigarette smoking: a propensity-modeling approach. Am J Public Health. 2006, 96 (4): 670-676. 10.2105/AJPH.2004.061622. doi:10.1136/jech.2004.029041.
Ogneva-Himmelberger Y, Ross L, Burdick W, Simpson SA: Using geographic information systems to compare the density of stores selling tobacco and alcohol: youth making an argument for increased regulation of the tobacco permitting process in Worcester, Massachusetts, USA. Tob Control. 2010, 19 (6): 475-480. 10.1136/tc.2008.029173. doi:10.1136/tc.2008.029173.
Callaghan RC, Veldhuizen S, Ip D: Contraband cigarette consumption among adolescent daily smokers in Ontario, Canada. Tob Control. 2011, 20: 173-174. 10.1136/tc.2010.037507. doi:10.1136/tc.2010.037507.
Mecredy GC, Diemert LM, Callaghan RC, Cohen JE: Association between use of contraband tobacco and smoking cessation outcomes: a population-based cohort study. Can Med Assoc J. 2013, 185 (7): E287-E294. 10.1503/cmaj.111861. doi:10.1503/cmaj.111861.
Beyond Smoking Prevalence: Exploring the Variability of Associations between Neighborhood Exposures across Two Nested Spatial Units and Two-Year Smoking Trajectory among Young Adults
Adrian Ghenadenik, Katherine Frohlich, Lise Gauvin
International Journal of Environmental Research and Public Health
The added value of accounting for activity space when examining the association between tobacco retailer availability and smoking among young adults
Martine Shareck, Yan Kestens, Julie Vallée, Geetanjali Datta, Katherine L Frohlich
Tobacco Control
Spatio-temporal determinants of mental health and well-being: advances in geographically-explicit ecological momentary assessment (GEMA)
Thomas R. Kirchner, Saul Shiffman
Social Psychiatry and Psychiatric Epidemiology
Tobacco retail availability and risk of relapse among smokers who make a quit attempt: a population-based cohort study
Michael O Chaiton, Graham Mecredy, Joanna Cohen
Tobacco Control
Residential environments and smoking behaviour patterns among young adults: A prospective study using data from the Interdisciplinary Study of Inequalities in Smoking cohort
Adrian Ghenadenik, Lise Gauvin, Katherine Frohlich
Preventive Medicine
Awareness of the Harms of Continued Smoking Among Cancer Survivors
Lawson Eng, Devon Alton, Yuyao Song, Jie Su, Qihuang Zhang, Jiahua Che, Delaram Farzanfar, Rahul Mohan, Olivia Krys, Katie Mattina, Christopher Harper, Sophia Liu, Tom Yoannidis, Robin Milne, Nazek Abdelmutti, M. Brown, Ashlee Vennettilli, Andrew Hope, Doris Howell, Jennifer Jones, Peter Selby, William Evans, Wei Xu, David Goldstein, Meredith Giuliani, Geoffrey Liu
Supportive Care in Cancer
Retailer density reduction approaches to tobacco control: A review
Allison Glasser, Megan Roberts
Health & Place
Associations of tobacco retailer availability with chronic obstructive pulmonary disease related hospital outcomes, United States, 2014
Amanda Kong, Christopher Baggett, Nisha Gottfredson, Kurt Ribisl, Paul Delamater, Shelley Golden
Health & Place
Associations of tobacco retailer density and proximity with adult tobacco use behaviours and health outcomes: a meta-analysis
Joseph Lee, Amanda Kong, Kerry Sewell, Shelley Golden, Todd Combs, Kurt Ribisl, Lisa Henriksen
Tobacco Control
Effect of tobacco outlet density on quit attempts in Korea: a multi-level analysis of the 2015 Korean Community Health Survey
Jaehyung Kong, Sung-il Cho
Epidemiology and Health
Journals System - logo
Scroll to top