Prospective association of tobacco retailer density and neighbourhood walkability with youth vaping initiation in California, USA

Alyssa F Harlow; Laura K Thompson; Sandrah P Eckel; Adam M Leventhal; Danielle F Haley; Megan E Roberts; Myles G Cockburn; Jessica L Barrington-Trimis

doi:10.1136/tc-2024-058974

Prospective association of tobacco retailer density and neighbourhood walkability with youth vaping initiation in California, USA

Tob Control. 2025 Jan 8:tc-2024-058974. doi: 10.1136/tc-2024-058974. Online ahead of print.

Authors

Alyssa F Harlow^{1

2

3}, Laura K Thompson^{4

3}, Sandrah P Eckel^{4

2

3}, Adam M Leventhal^{4

2

3}, Danielle F Haley⁵, Megan E Roberts⁶, Myles G Cockburn^{4

3}, Jessica L Barrington-Trimis^{4

2

3}

Affiliations

¹ Department of Population and Public Health Sciences, University of Southern California, Los Angeles, California, USA afharlow@usc.edu.
² Institute for Addiction Science, University of Southern California, Los Angeles, CA, USA.
³ Norris Comprehensive Cancer Center, Los Angeles, CA, USA.
⁴ Department of Population and Public Health Sciences, University of Southern California, Los Angeles, California, USA.
⁵ Department of Community Health Sciences, Boston University School of Public Health, Boston, Massachusetts, USA.
⁶ Division of Health Behavior and Health Promotion, The Ohio State University College of Public Health, Columbus, Ohio, USA.

PMID: 39779327
DOI: 10.1136/tc-2024-058974

Abstract

Background: Tobacco retailer density might influence youth e-cigarette use due to increased access and exposure to point-of-sale marketing. There is a need for longitudinal investigations on the association of tobacco retailer density with youth e-cigarette use, with consideration of contextual factors such as neighbourhood walkability that could enhance retailer exposure.

Methods: Five semi-annual waves (Fall 2021-Fall 2023) of a Southern California school-based cohort of youth who never vaped at baseline (n=3401; mean baseline age=15 years [range=12-17]) were merged with spatial data on tobacco retailers corresponding to each school year. Time-varying measures of retailer exposures included count of retailers within circular home buffers (800 m/1600 m buffers) and retailer density/km² within home census tracts. Discrete-time survival analyses estimated associations of time-lagged and time-varying retailer exposures with vaping initiation at each 6-month follow-up, adjusting for race/ethnicity, parental education, neighbourhood walkability and an Area Deprivation Index. Secondary analyses examined moderation by neighbourhood walkability based on a National Walkability Index.

Results: The incident rate of vaping initiation was 3.8% per 6-month follow-up. After covariate adjustment, only associations with census tract retail density were statistically significant (risk ratio (RR) highest vs lowest quartile=1.36, 95% CI=1.01 to 1.84). In moderation analyses, count of retailers within 800 m home buffers was positively associated with vaping initiation for youth who lived in the most walkable neighbourhoods (RR=1.08, 95% CI: 1.01 to 1.16), with no association for youth in less walkable neighbourhoods (RR=1.00, 95% CI:0.95 to 1.05; interaction p-value=0.0238).

Conclusion: Findings highlight the potential role of restricting retailer density in preventing youth vaping, particularly in areas characterised by both greater walkability and tobacco retailer density.

Keywords: Electronic nicotine delivery devices; Environment; Nicotine; Non-cigarette tobacco products.

Abstract

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