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Density and Proximity of Tobacco Outlets to Homes and Schools: Relations with Youth Cigarette Smoking


This study investigated the associations of youth cigarette smoking with tobacco outlet densities and proximity of tobacco outlets to youth homes and schools across different buffers in 45 midsized California communities. The sample comprised 832 youths who were surveyed about their smoking behaviors. Inclusion criteria included both home and school addresses within city boundaries. Observations in the 45 cities were conducted to document addresses of tobacco outlets. City- and buffer-level demographics were obtained and negative binomial regression analyses with cluster robust standard errors were conducted. All models were adjusted for youth gender, age, and race. Greater densities of tobacco outlets within both a 0.75 and 1-mile buffer of youth homes were associated with higher smoking frequency. Neither tobacco outlet densities around schools nor distance to the nearest tobacco outlet from home or school were associated with youths past-30-day smoking frequency. Lower population density and percent of African Americans in areas around homes and lower percent of unemployed in areas around schools were associated with greater smoking frequency. Results of this study suggest that restricting outlet density within at least 1-mile surrounding residential areas will help to reduce youth smoking.

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The authors declare that there are no conflict of interests.


This publication was made possible by grant CA138956 from the National Cancer Institute (NCI) and grant 19CA-016 from the Tobacco-Related Disease Research Program (TRDRP; The content is solely the responsibility of the authors and does not necessarily represent the official view of NCI and TRDRP.

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Correspondence to Sharon Lipperman-Kreda.

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Lipperman-Kreda, S., Mair, C., Grube, J.W. et al. Density and Proximity of Tobacco Outlets to Homes and Schools: Relations with Youth Cigarette Smoking. Prev Sci 15, 738–744 (2014).

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  • Youth cigarette smoking
  • Tobacco outlets
  • Density
  • Proximity
  • Tobacco control