Category Archives: Tobacco

Tobacco

Could a tobacco license scheme in Scotland disincentivise tobacco sales?

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The Scottish Government has committed to achieving a smoke-free generation by 2034. This ambitious goal has sparked debate about which measures will drastically reduce tobacco use and sales of tobacco products. One option is the introduction of a tobacco license scheme. A new study in Scotland from the SPECTRUM team shows that the introduction of a tobacco license scheme has the potential to disincentivise tobacco sales and reduce the availability of tobacco products.

In 2010, the Scottish Government introduced a registration system that was mandatory for businesses selling tobacco. However, there is no cost associated with registering to sell tobacco products. One option for helping to meet the smoke-free generation target is the introduction of a tobacco licensing scheme in Scotland.  

A tobacco retail license is a regulatory mechanism that requires retailers to purchase a special license to legally sell tobacco products. Tobacco license schemes are crucial for monitoring sales of tobacco products, reducing illicit sales, and enforcing regulations such as sales prohibition to minors. By charging fees to obtain a license can increase the cost of selling tobacco, making the product more expensive for consumers and less profitable for retailers. Consequently, this can lead to reduced tobacco product availability as retailers may choose to diversify their business models away from tobacco. A tobacco retailer reduction has been widely associated with lower smoking prevalence and fewer tobacco-attributable diseases.

However, the implementation of license fees has faced challenges from retailers and the tobacco industry, who raise concerns about their impact on business profitability. Retailers also provide essential local services and if the introduction of a tobacco license fee undermines the viability of the business, then this could negatively impact local communities. Therefore, the public health benefits of fee-based license systems that reduces tobacco availability have to be considered against the potential financial impacts on retailers.

Although many countries worldwide have considered different forms of license schemes, little is known about the effectiveness of these different schemes in disincentivising tobacco sales and their financial impacts on retailers.

Simulating the implementation of a tobacco license fee in Scotland: a case of study

As part of the SPECTRUM Consortium we addressed this question by analysing data from over one million commercial transactions across 179 smaller retailers (convenience stores) in Scotland between 2019 and 2022. We found that stores generate an annual median of £15,859 revenue from tobacco sales. Retailers in the most deprived areas of Scotland received 1.6 times more revenue than those in low-deprivation neighbourhoods. Moreover, urban retailers obtained 2.3 times higher revenues than rural stores (see table 1 below).

All RetailersHigh deprived areasMedium deprived areasLow deprived areasUrban areasRural areas
Median Gross Revenues£15,859£18,403£17,694£11,609£18,247£7,638
Table 1. Baseline annual median revenues from tobacco sales among retailers by area types within 2019 and 2022.

We found that the magnitude of the financial impacts of schemes on Scottish retailers varied in relation to the level at which the fee was set. For instance, adopting a low license fee similar to the one operating in New Brunswick, Canada, (a universal fee of CA$50/year, approximately £29/year), would result in a median tobacco revenue reduction of 0.18% among retailers in Scotland. However, if following Finland’s example of requiring a universal fee of €500/year (approximately £428/year) smaller retailers in Scotland would see their revenues reduced by 2.70% (see table 2 below). In both cases, the impacts of these licenses’ fees may not deter tobacco sales. In order to achieve a significant revenues reduction, such as a 30% reduction, would require a universal fee to be set at £4,758/year, which is substantially higher than those currently active in other countries.

Additionally, our results showed that each scheme type impacted differently on retailers located in different types of areas of the country. Universal and urban/rural flat fees would result in higher revenues reductions for retailers in low deprivation areas. Using a high-level universal fee (similar to Finland), results in a revenue reduction of 3.61% in low deprivation areas. This decline is more significant than the 2.70% reduction observed in high deprivation neighbourhoods. In contrast, volumetric schemes would lead to similar percent revenue reductions across all retailers.

Fee scheme and levelAll retailersHigh DeprivedMedium deprivedLow deprived
Universal low: £29/yr-0.18%-0.16%-0.17%-0.25%
Universal medium:£139/yr-0.88%-0.76%-0.79%-1.20%
Universal high: £428/yr-2.70%-2.32%-2.42%-3.67%
Volumetric low: £0.06/1000 sticks-0.18%-0.18%-0.18%-0.18%
Volumetric medium: £0.29/1000 sticks-0.86%-0.87%-0.89%-0.87%
Volumetric high: £0.91/1000 sticks-2.70%-2.72%-2.78%-2.73%
Urban/Rural low: U=£33/yr R=£14/yr-0.18%-0.17%-0.18%-0.22%
Urban/Rural medium: U=£161/yr R=£67/yr-0.88%-0.83%-0.86%-1.07%
Urban/Rural high: U=£493 R=£206/yr-2.70%-2.53%-2.65%-3.27%
Table 2. Median percentage reduction in tobacco revenues across retailers after the implementation of different license fees by area types.

Implications for Tobacco Control policies

These findings have implications for how we develop our approach to reducing tobacco harms in Scotland. Our study showed the potential of license fee schemes to disincentivise tobacco sales as they effectively increase the cost of selling tobacco. However, to significantly impact tobacco revenues and encourage retailers to diversify their business models away from tobacco sales, this policy would necessitate the implementation of relatively high-level fees.

The study described unequal financial impacts from each license scheme among retailers. The effectiveness of universal and urban/rural flat fees to reduce tobacco outlet availability could be questioned, as they would have a lower impact on retailers in high deprivation areas. These areas are typically targeted in tobacco control efforts since they present the highest densities of tobacco retailers and the worst smoking outcomes.

In contrast, volumetric fees could ensure an equal reduction of tobacco revenues across all retailers. Nevertheless, retailers with greater sales volume, more diversified business models (large retailers and supermarkets) or located in more profitable neighbourhoods (ie, urban areas) might have greater financial resources to cope with a given loss of 10% of their profits compared with other retailers.

Policymakers should carefully design and implement policies that maximise a reduction in tobacco outlet availability in all areas to mitigate smoking-related harms without threatening retail viability. One possible strategy in Scotland might include a modest flat fee, considering a lower fee in rural areas where retailers might be more vulnerable to potential shutdowns (ie, urban/rural scheme), along with an additional moderate volumetric fee.

Find out more about this study

The full study methods, findings and discussion of this study are published in Tobacco Control: “Geographical differences in the financial impacts of different forms of tobacco licence fees on small retailers in Scotland”.

About the author:

Roberto Valiente is postdoctoral researcher in Health and Environment at the Centre for Research on Environment, Society and Health (CRESH) and the SPECTRUM Consortium in the University of Edinburgh. His work is focused on the use of Geographic Information Systems to explore how the physical and social environment may shape population behaviours and health. His current research is focused on the study of commercial determinants of health from a spatial perspective, particularly those related with tobacco and alcohol issues.

Tobacco

The declining importance of tobacco sales to convenience stores in Britain

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Tobacco products are becoming less important to the business models of convenience stores across Britain. This is the finding of our new study of the products sold in convenience stores over a 3 year period across England, Scotland and Wales prior to the start of the Covid pandemic. 

Looking at the sales of tobacco and other products sold alongside tobacco is important because it tells us about how much profit is made from tobacco by smaller retailers but also about the role of tobacco in generating greater ‘footfall’ for these smaller retailers. It is argued that footfall products, such as milk or bread, bring customers into the store and lead to wider expenditure on other (non-footfall) items.  The tobacco industry has long argued that tobacco is vital for increasing customer footfall and therefore tobacco products help drive the sales of other (potentially more profitable) items that retailers stock. Our new results recently published in the journal Tobacco Control suggest the footfall argument made by the tobacco industry does not hold-up to scrutiny.

How did we go about our research? We looked at this issue by examining the electronic till receipts of all items purchased in almost 1300 retailers across the country during 4 corresponding weeks in 2016 and 2019. We found that the number of shopping baskets containing tobacco fell by nearly half (47%) over these 3 years. When we compared tobacco to other commonly purchased products (such as milk, bread, newspapers and alcohol) we found that the decline in sales was much higher for tobacco.

We also discovered that the price of tobacco products rose significantly over this time period yet at the same time the proportion of total store turnover accounted for by shoppers who included a tobacco product in their basket fell. In 2016, 11 per cent of transactions involved only tobacco, but this fell to 6 per cent in 2019. The proportion of sales containing a mix of tobacco products and other items also declined, falling from 14 per cent to 9 per cent.  It was also evident that as the frequency of tobacco transactions declined so the financial value of non-tobacco items bought alongside tobacco also reduced.

When we examined geographical differences in the sales data, we found that retailers’ declining reliance on tobacco sales was seen across the country. Tobacco product sales, and their contribution towards weekly turnover, were higher in shops in urban, more economically deprived areas compared with rural stores and those in affluent areas. However, these stores saw the greatest reductions over time, narrowing the differences between areas.

Why does all this matter? The governments in England, Scotland and Wales all have ambitious targets to eliminate smoking over the next decade. For example, in Scotland the Scottish Government is committed to reducing the proportion of the population who smoke to 5% by 2034. Similar targets are in place in England and Wales. Yet meeting these goals will require a wide range of policies including reducing the availability of tobacco products. In Scotland, for example, tobacco remains highly available with around 10,000 retailers selling tobacco which means it can be purchased on most street corners. A key obstacle to reducing the number of places where tobacco can be purchased has been concerns about how this will affect smaller businesses that may be particularly dependent on selling tobacco, and also that selling tobacco helps to drive the sales of other (more profitable) products. Our findings counter this claim and show that tobacco is becoming less important to smaller retailers.

We, therefore, encourage policymakers in the UK to follow the lead of the New Zealand government who have an ambitious plan to greatly reduce the number of tobacco retailers, as well as the recommendations of The Khan review: making smoking obsolete report commissioned by the UK Government to develop new policies in England that will lessen the availability of tobacco in our local communities. Policy approaches should include help for businesses to diversify away from tobacco, including support for smaller stores to focus on more health enabling and more profitable products. This would be a crucial step towards reducing the number of people who smoke, and eliminating a product that is responsible for the deaths of 78,000 people in the UK each year.

Tunstall H, Shortt N, Kong A, Pearce J, 2022. Is tobacco a driver of footfall amongst small retailers? A geographical analysis of tobacco purchasing using electronic point-of-sale data. Tobacco Control. In Press.

Alcohol, Inequalities, Job, Tobacco

New job at CRESH: Postdoctoral Researcher, Environment and Health

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This is a full time (35 hours per week), fixed term post available for 3 years.

The salary for this role is £33,797 – £40,322 per annum.

We are seeking to appoint a Postdoctoral Researcher in the field of ‘Environment and Health  for a period of 3 years to contribute a UK Prevention Research Partnership (UKPRP) Consortium – SPECTRUM (Shaping Public hEalth poliCies To Reduce ineqUalities and harm) www.ed.ac.uk/spectrum. SPECTRUM has an ambitious programme of research, knowledge exchange and public engagement focusing on the commercial determinants of health relating to tobacco, alcohol and food. In this role you will work under the supervision and mentorship of Professor Jamie Pearce and Professor Niamh Shortt.

The successful candidate will play a lead role in a programme of work aiming to identify how the local environment can be shaped to change behaviour, prevent harm and reduce inequalities. The aim is to examine the intended and unintended impacts of (and interventions in) the local commercial environment on the consumption of unhealthy commodities. The focus of this role will be to conduct spatial and quantitative analyses, contribute to final publications and help to accelerate the impact of the research.

Informal enquiries to Prof Jamie Pearce (jamie.pearce@ed.ac.uk), Prof Niamh Shortt (niamh.shortt@ed.ac.uk)

For more details and how to apply click here.

Data, Inequalities, Tobacco, Uncategorized, wellbeing

What next for tobacco control in Scotland?

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New research from the CRESH team using data from 124,566 shopping baskets purchased in convenience stores across Scotland has found that the purchase price of tobacco is lower in more disadvantaged neighbourhoods, largely because of the higher sales of the cheapest brands in these areas.

Cigarette smoking is one of the leading causes of preventable ill-health, hospitalisations and deaths in Scotland. Approximately 19% of adults in Scotland smoke, this rises to 32% in our most deprived fifth of neighbourhoods and falls to 9% in the most affluent neighbourhoods. As Scotland moves towards a ‘Tobacco Endgame’ the Scottish Government have a target to reduce smoking prevalence to less than 5% by 2034. A recent review of smoking projections by CRUK however suggests that Scotland may miss this target by 16 years in the poorest neighbourhoods. It is important that we continue to explore all potential determinants of smoking, particularly those that drive smoking in our most deprived communities.

We know that tobacco price is one of the most important determinants of smoking behaviour and that many smokers are price sensitive. Whilst it may appear that all tobacco products are becoming increasingly expensive, research suggests that the average tobacco price in the UK has remained relatively unchanged in real terms over the past 20 years in spite of numerous tax increases. A practice, known as ‘undershifting’, has seen tobacco companies limit price increases on the cheapest brands and instead increase the price of the most expensive brands by larger margins, thus absorbing the tax increases on the cheapest cigarettes allowing them to remain cheap (Hiscock et al. 2018).  As a result, the price of the lowest priced cigarette brands has remained relatively steady and the tobacco market as a whole has become increasingly stratified by price between the cheapest ‘sub value’ , ’value’, ‘mid price’ and high priced ‘premium’ brands. We wanted to understand these differentials in price a little better, so we carried out some research that was published recently in Tobacco Control. We explored whether the price paid for tobacco (both cigarettes and roll your own tobacco) was different in different types of neighbourhoods. We compared areas by deprivation, by the density of tobacco outlets and by rurality.

We analysed tobacco purchase data provided to us by The Retail Data Partnership. We looked at more than 124,000 purchases in 274 stores across Scotland in April 2018. For cigarettes the average price paid for a pack of 20 was £8.49, ranging from £7.20 to £13.25. For roll your own tobacco (RYO) 30g the average price paid was £12.14, with prices ranging from £9.80 to £15.99. We found that the price paid for tobacco did vary by neighbourhood type. In neighbourhoods with the lowest average household income the average purchase was 50p less for a pack of 20 cigarettes, and 34p less for roll your own tobacco compared with the most affluent neighbourhoods.

We then asked whether this was driven by individual brands being cheaper in more deprived areas, or whether cheaper, sub-value, brands were just more popular in such places. We found little evidence that individual brands were priced differently. Although the cheaper brands are the most popular in all neighbourhoods and across Scotland, accounting for 52% of sales, there’s a big difference in popularity between more and less deprived areas, In the most deprived areas these brands account for 58%  of sales, but in most affluent areas it was just 39% (See Figure 1 below). So, it is the dominance of cheaper brands in more deprived areas that drives the 50p difference in average price paid per pack between deprived and affluent areas. Remember this matters because the tobacco companies work to subdue tax-based price rises on the cheapest brands.

We also explored whether the density of tobacco retailers and/or rurality had an impact on tobacco price. We found little evidence of a density effect, but we did find that the individual brands analysed were significantly cheaper in rural areas.

So what does this mean and what can we take from this research? It is clear from the CRUK review that we need to work harder in order to reach the 2034 target of less than 5% of the population smoking. Price is a lever that we can pull, but to date this has been largely done through tax increases. This research shows us that the cheapest brands are the most popular in all neighbourhood types, but much more so in our most deprived neighbourhoods where smoking rates are highest. We found that the price paid for tobacco is lower in more deprived areas compared to more affluent areas. Our results confirm that the dominance of cheaper, so called ‘sub-value’ brands in more deprived areas, is a driving force behind the difference in price paid for tobacco between neighbourhoods. This highlights the importance of cheaper tobacco products to the consumer and the market.  Cheap tobacco may help tobacco companies to retain price sensitive consumers who live in the most deprived areas, which, in turn, contributes to health inequalities. In addition to increases to the duty rates on tobacco, more radical policy responses are likely to be required. These include a combination of minimum unit pricing (MUP) and a price cap at the upper end. The MUP would raise the cost of cheaper cigarettes and the price cap at the upper end would prevent the more expensive brands being used to ‘protect’ the cheaper ones from tax rises.

With growing international interest in the ‘Tobacco Endgame’, policymakers should identify measures that counter industry tactics that enable the continued sales of cheap tobacco. We published this paper in the first week of the COVID-19 pandemic in the UK. These are clearly strange times and we should rightly focus on the public health impacts of the global pandemic, and in particular the vast health inequalities that are arising. We must not however forget that the public health challenges we were faced with before this pandemic remain. Tobacco, and other unhealthy commodities, require our attention and the inequalities that arise from them remain a matter of social justice.

You can find the paper here:

Shortt, N., Tunstall, H., Mitchell, R., Coombes, E., Jones, A., Reid, G. & Pearce, J. Using point-of-sale data to examine tobacco pricing across neighbourhoods in Scotland. Tobacco Control, Published Online First: 19 March 2020. doi: 10.1136/tobaccocontro

References

Hiscock R, Branston JR, McNeill A, et al. Tobacco industry strategies undermine government tax policy: evidence from commercial data. Tob Control 2018;27:488 LP – 497. doi:10.1136/tobaccocontrol-2017-053891

Alcohol, Built Environment, Data, Inequalities, Tobacco, Uncategorized, wellbeing

New ESRC funded study on Tobacco and Alcohol

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We are delighted to announce that we have been awarded funding from the ESRC for a project exploring tobacco and alcohol environments in Scotland. The project ‘Change in alcohol and tobacco availability, population health and the lived experience’ will be funded for 3 years, beginning December 2019 for a total of £761, 470. The project will be led by Professor Niamh Shortt with co-investigators from the University of Edinburgh (Professor Jamie Pearceand Dr Tom Clemens), Glasgow Caledonian University (Professor Carol Emslie) and the MRC/CSO Social and Public Health Sciences Unit, University of Glasgow (Professor Richard Mitchell).

This research will measure change in the availability of alcohol and tobacco in Scottish neighbourhoods over time and explore how this change relates to health outcomes and how residents experience the availability of alcohol and tobacco in their neighbourhoods. The findings will be important because smoking and alcohol consumption are leading causes of illness and death. In Scotland smoking causes one in every 5 deaths and one in 20 deaths is related to alcohol. This harm is not equally shared; those on the lowest incomes suffer the greatest harm. These illnesses and deaths are preventable. The World Health Organisation recommends that nations prioritise interventions that reduce the supply of alcohol and tobacco.

Why might neighbourhood supply of alcohol and tobacco matter? Research suggests that when there are a lot of outlets in a neighbourhood this impacts upon consumption in three ways. 1. The outlets may be more competitive and drive prices down to attract customers. 2. Oversupply may normalise the products when they are sold alongside everyday commodities, such as bread and milk. 3. Tobacco and alcohol may simply be easier to buy in areas where there are more outlets.

In order to explore the relationship between supply, behaviour and harm we need data on the location of every outlet in Scotland selling tobacco and/or alcohol. Ideally, to be able to say something about whether the relationship may be causal, we need this data over time. We have already collected data on the specific location of every outlet selling tobacco and licensed to sell alcohol over multiple time periods (2012 and 2016 (nationwide alcohol and tobacco – see paper here) and 2008 (alcohol in four cities – see paper here)). As part of this project we will collect updated data for 2019/20. This will allow us to measure this change over time. Using an approach called trajectory modelling we will group neighbourhoods that have had a similar degree of change; some neighbourhoods may have lost, or gained, local shops or pubs, whereas some may not have changed at all. We will then identify features of these neighbourhoods that may be driving this change, for example the age profile of the population or poverty levels. This will help policy makers understand the drivers of change in our neighbourhoods.

To measure the relationship between changing supply and harm we will link these trajectories, and our measures of availability at each time point, to alcohol and tobacco health outcomes (behaviour, illness and death). We will use statistical models to see whether areas experiencing an increase or decrease in outlets have seen a corresponding increase or decrease in these outcomes. This will allow us to get a better understanding of whether an over supply of alcohol and tobacco is related to smoking and alcohol consumption and harm. These findings will provide important evidence related to the provision of such commodities in our neighbourhoods.

Although these statistics are important to report we also need to understand why an oversupply of alcohol and tobacco may influence behaviour and harm. Whilst the literature suggests the pathways listed above, we know little about the experiences of individuals living in neighbourhoods with contrasting availability. We don’t understand the individual experience of any of these pathways. Professor Carol Emslie will lead a qualitative work package and researchrs will meet with groups of individuals, in neighbourhoods of contrasting trajectories, to talk to them about the supply of alcohol and tobacco. We will explore their experiences of neighbourhood and assess how their perceived notions of their neighbourhood availability contrast with our statistical measures. Finally, we will meet with residents, retailers and policy stake-holders to explore potential interventions related to supply. Policies at this level require public, retailer and political support. We will discuss the priorities held by various groups, present our quantitative results and gauge attitudes towards potential interventions.

Throughout the project will be committed to knowledge exchange, public events and speaking with non academic partners. If you wish to know more about this research, or would like one of the researchers to come to your organisation to provide you initial findings (once the project is under way) then contact the Principal Investigator here: niamh.shortt@ed.ac.uk

Built Environment, Inequalities, Tobacco

Children in deprived areas encounter shops selling tobacco six times more frequently than those in well-off areas

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By Dr Fiona Caryl.

Our new study  looking at exposure of children to tobacco retailing, recently published in the journal Tobacco Control, shows that an average 10-to-11-year-old child in Scotland comes within 10m of a shop selling tobacco 43 times a week. This rises to 149 times a week for children living in the poorest areas—six times more than the 23 encounters a week experienced by children living in affluent areas. This demonstrates an unexpectedly large inequality in the amount of times children are exposed to tobacco sales. Unexpected because in the same study we showed that tobacco outlets are 2.6 times more common around the homes of children living in the most deprived areas than the least. Yet we found a six-fold difference in exposure because we used GPS trackers (fully consented and ethics-approved, of course) to follow exactly where children moved through their environments. We found that most exposure came from convenience stores (41%) and newsagents (15%) on school days, with peaks before and after school hours. At weekends, we found most exposure came from supermarkets (14%), with a peak around midday.

Why does this matter? This may not sound like a lot of exposure, and we might ask if a child is really exposed to tobacco just by being in or near a shop selling tobacco, especially after the ban on point-of-sale (POS) tobacco displays. But then we don’t actually know how many micro-exposures it takes to make a child think that smoking is a normal, acceptable and widespread behaviour rather than a major cause of premature death. Research into advertising suggests that the mere-exposure to indirect and incidental stimuli can influence attitudesnon-consciously when they’re repeatedly presented. The ban on POS tobacco displays has reduced children’s susceptibility to smoking, but children still notice tobacco on sale. In fact, recent research shows that the conspicuousness and prominence of tobacco in shops varies considerably between areas of high and low deprivation. And the difference in prominence has been increasing since the POS ban.

The difference in the number of times children in poor areas are in or near to places selling tobacco is most concerning when you consider the pathways leading people to start smoking. Most adult smokers start when they are teenagers, and the availability of tobacco products is a key factor in in why people start to smoke and why they find it hard to give-up. Our findings raise important questions about when and where tobacco products are sold and the messaging this is sending to children.

Inequalities, News, Social and Physical Environment, Tobacco

New evidence linking availability of tobacco & smoking

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The connection between the local availability of tobacco products and smoking behaviour has been underlined in new research from the CRESH team this week. Published in the journal Tobacco Control, we show how moving into an area of Scotland where tobacco products are more readily available can significantly increase the risk of smoking while pregnant. We estimate that a pregnant woman living in an area with the highest tobacco availability is 70% more likely to smoke than when she was living in an area with the lowest availability of tobacco products.

Why is this important? Firstly, smoking during pregnancy is a vital Public Health issue and is recognised as a key priority area for UK health policy. It is harmful for both the mother and the developing fetus and the effects for social and health outcomes can persist into childhood and adulthood. Since smoking is so strongly associated with poverty and deprivation, it also has an important role to play in the persistence of health inequalities across generations.

But there are other reasons why the research is important. Much of what we know, including previous research from CRESH, is based on information from a single point in time. While these studies are crucial in establishing the strength of associations, they are less useful for determining mechanisms. A key question that remains is whether high availability is the cause of smoking behaviour or whether retailers preferentially locate in areas of high demand. Both pathways are plausible but both carry very different conclusions and policy recommendations. Our latest research is able to address this question using information on smoking during pregnancy which is collected routinely as part of Scotland’s hospital maternity records. By looking at multiple pregnancies to the same individual, we were able to relate changes in smoking behaviour between pregnancies to changes in exposure to tobacco retailers from residential moves. This approach provides strong evidence that availability is causally linked to behaviour.

The policy implications are clear. As more and more countries move towards a “Tobacco Endgame” policy this, and other research, highlights how a focus on tackling the local availability of tobacco products will be crucial. In a week where the UK government has suggested that preventing poor health lies with “people choosing to look after themselves better, staying active and stopping smoking” our findings are a timely reminder of the importance of considering the wider set of structural factors that shape our health of which our residential environment is one important component.

Physical Environment, Tobacco

TOBACCO OUTLET DENSITY AND PATHWAYS TO SMOKING AMONG TEENAGERS

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Why are adolescents that live in areas with high concentrations of tobacco shops more likely to smoke?

New findings suggest Scottish teenagers living in areas with a high density of shops selling tobacco have greater knowledge about cigarette brands.

Earlier work in Scotland found that adults and adolescents living in areas with high densities of shops selling tobacco were more likely to smoke. Public health researchers have suggested that restrictions on tobacco retail outlet density are a potential ‘new frontier’ in the long-running campaign to achieve a tobacco ‘endgame’. However, the reasons why exposure to greater numbers of tobacco outlets is associated with smoking are unclear and the types of restrictions on retail density that might best support this public health goal are not known.

SALSUS _Q_cover_2A new study by CRESH has explored possible pathways linking tobacco outlet density to smoking among adolescents. Our work used responses from 22,049 13 and 15 year olds to the 2010 Scottish School Adolescent Lifestyle and Substance Use Survey. Data from the Scottish Tobacco Retailers Register were used to calculate a measure of the density of tobacco outlets around the survey respondents’ homes.

We were interested to know whether adolescents in areas with more tobacco outlets had better knowledge of tobacco products, and so assessed how many cigarette brands they could name. We also looked at whether adolescents in high outlet density areas had more positive attitudes about smoking as it has been suggested that exposure to outlets and the tobacco marketing and purchasing found within them may ‘normalise’ smoking. We examined whether in areas where there are more tobacco outlets it may be easier for adolescents to make underage cigarette purchases. Finally, we considered tobacco price, assessing whether in areas with more tobacco shops, and more retail competition, cigarettes were cheaper. Continue reading TOBACCO OUTLET DENSITY AND PATHWAYS TO SMOKING AMONG TEENAGERS →

Inequalities, Tobacco

Seeing e-cigarettes in shops may influence their use by teenagers

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By Jamie Pearce

Adolescents who recall seeing e-cigarettes in shops are more likely to have tried them in the past and are more likely to intend to try them in the future, according to a study published in the open access journal BMC Public Health.

16004247125_95069f5207_z

Source: http://www.ecigclick.co.uk. Creative Commons License

Continue reading Seeing e-cigarettes in shops may influence their use by teenagers →

Alcohol, Tobacco

Scotland’s poorest neighbourhoods have the most shops selling alcohol and tobacco

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By Niamh K Shortt

New research published this week in BMC Public Health by the CRESH team, and colleagues in Global Public Health, has found that Scotland’s most deprived neighbourhoods have the highest availability of both tobacco and alcohol outlets.  The average density of tobacco outlets rises from 50 per 10,000 population in the least income deprived areas to 100 per 10,000 in the most deprived areas.  For alcohol outlets licensed to sell alcohol for consumption off the premises the figures were 25 per 10,000 in the least income deprived areas rising to 53 per 10,000 in the most income deprived areas.

CIgarettes and Alcohol. By CharlesFred, Flickr. Creative Commons Licence.
Source: CharlesFred, Flickr. Creative Commons Licence.

Continue reading Scotland’s poorest neighbourhoods have the most shops selling alcohol and tobacco →

Built Environment, Inequalities, Tobacco

Neighbourhood availability of tobacco is likely to be a factor in explaining adult smoking in Scotland

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In our new paper published in Nicotine & Tobacco Research we find that adults in Scotland living in environments with a greater availability of tobacco outlets are more likely to smoke, and less likely to quit. This follows on from our earlier work, in which we found that teenagers in Scotland are more likely to smoke if they live in areas with the highest number of tobacco retailers.cigarette-counter-725x544 Continue reading Neighbourhood availability of tobacco is likely to be a factor in explaining adult smoking in Scotland →

Alcohol, Built Environment, Data, Tobacco

Empowering communities: An interactive tobacco and alcohol outlet density webmap for Scotland

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Today we are launching an interactive webmap that allows users to map tobacco and alcohol outlet density, and related health outcomes, for neighbourhoods (‘datazones‘) across Scotland.  The underlying data we have collected and assembled can also be freely downloaded for use.  Our research from Scotland shows that outlet density matters for health:

  • areas with the highest alcohol outlet density have double the death rate of those with the lowest densities (see our blog post, report and infographic)
  • adolescents living in areas with the highest tobacco outlet density are almost 50% more likely to smoke than those with the lowest (see our blog post, paper and infographic).

ALCOHOL OUTLET DATA UPDATED 25 JUNE 2015:  Previous to this date the alcohol outlet density data had used an alternate measure of density than outlets per km2, resulting in values that were typically 30-40% lower than the actual value.  Whilst the figures have changed the general picture has not: an area of high density remains an area of high density.  The rest of the data are unaffected.

webmap

Continue reading Empowering communities: An interactive tobacco and alcohol outlet density webmap for Scotland →

Built Environment, Data, News, Tobacco

Smoking and Health in Scotland: key stats

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smoking_infographic2Today we’re launching our hot-off-the-press infographic about Smoking and Health in Scotland.  In collaboration with Action on Smoking and Health (ASH) Scotland we’ve created this summary of some of the key statistics on smoking and health in Scotland, featuring some headline results from our own research.  Please use and circulate widely! Continue reading Smoking and Health in Scotland: key stats →

Built Environment, Inequalities, Tobacco

‘An environment where young people choose not to smoke’ is not one where tobacco products are sold on every street corner

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By Niamh Shortt

Teenagers are more likely to smoke if they live in areas with the highest number of tobacco retailers. Our paper led by Niamh Shortt, published today in Tobacco Control, examined the relationship between tobacco outlet density and smoking habits of 13 and 15 year olds in Scotland.   Continue reading ‘An environment where young people choose not to smoke’ is not one where tobacco products are sold on every street corner →

Built Environment, Tobacco

Will the new point of sale legislation in Scotland influence young people’s knowledge and attitudes of tobacco products?

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By Jamie Pearce & Catherine Tisch

Smoking remains one of the most significant public health challenges in Scotland and is implicated in one in every five Scottish deaths.  Each year, around 15,000 young Scottish people start smoking and many go on to become regular smokers.  Since the introduction of the Tobacco Advertising and Promotion Act in 2005, most forms of tobacco advertising and sponsorship in the UK have been banned. One of the few ways the tobacco industry can legitimately promote their products (often by elaborate and prominent means) is via point of sale (POS) tobacco displays.  A recent systematic review showed that POS displays increased children’s susceptibility to smoking, experimentation and initiation into smoking. Continue reading Will the new point of sale legislation in Scotland influence young people’s knowledge and attitudes of tobacco products? →