Tobacco retailer density and smoking behavior in a rural Australian jurisdiction without a tobacco retailer licensing system

INTRODUCTION An emerging body of research has developed around tobacco retailer density and its contribution to smoking behavior. This cross-sectional study aimed to determine the association between tobacco retailer density and smoking behavior in a rural Australian jurisdiction without a tobacco retailer licensing system in place. METHODS A local government database (updated 2018) of listed tobacco retailers (n=93) was accessed and potential unlisted tobacco retailers (n=230) were added using online searches. All retailers (n=323) were visited in 2019 and GPS coordinates of retailers that sold tobacco (n=125) were assigned to suburbs in ArcMap. A community survey conducted in the Local Government Area provided smoking and sociodemographic data amongst adult respondents (n=8981). Associations between tobacco retailer density (calculated as the number of retailers per km2 based on respondents' suburb of residence) and daily, occasional and experimental smoking were assessed using multilevel logistic regression analysis. Separate models with and without covariates were undertaken. RESULTS Without adjusting for possible confounders, living in suburbs with greater retailer density did not increase the odds of daily smoking (OR=1.01; 95% CI: 0.92-1.12), occasional smoking (OR=1.05; 95% CI: 0.94-1.18), or experimental smoking (OR=0.98; 95% 0.92- 1.05). However, after adjustment, living in suburbs with greater retailer density increased the odds of occasional smoking behavior (AOR=1.37; 95% CI: 1.10-1.71) but not daily or experimental smoking. CONCLUSIONS This study found a significant positive association between tobacco retailer density and the likelihood of occasional smoking in a rural Australian jurisdiction without a tobacco retailer licensing system in place. The findings strengthen calls for the introduction of a comprehensive, positive tobacco retailer licensing system to provide a framework for improving compliance with legislation and to reduce the overall availability of tobacco products in the community.