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Principal Investigator: Daniel Philip Giovenco
Organization: COLUMBIA UNIVERSITY HEALTH SCIENCES
Fiscal Year: 2024
Award: $564,965
Funding agency: National Cancer Institute
PROJECT SUMMARY/ABSTRACT
Tobacco retailer density is disproportionately high in low-income communities and certain racial/ethnic
enclaves, contributing to severe socioeconomic and social disparities in smoking and its resultant health
harms. Local, environmental-level interventions that aim to reduce the number of tobacco retailers are a new
policy frontier in tobacco control that may be particularly effective in promoting health equity, but the impact of
these initiatives is critically understudied in real-world settings. Three major US cities – San Francisco,
Philadelphia, and New York City (NYC) – recently enacted novel measures that establish caps on the number
of tobacco retail licenses permitted in city districts. Density reduction under this intervention occurs not through
license revocation, but gradually through retailer attrition. The effects of these “capping” policies on retailer
density reduction and the resultant tobacco product marketplace largely depend on temporal, spatial, and
store-level patterns in license forfeiture, which are not well-understood. Moreover, to comprehensively assess
public health impact, it is critical to conduct stakeholder analyses after implementation, describe the policy’s
impact on and mechanisms of behavior change, and identify potential unintended effects. The proposed
mixed-methods, comparative case study will use archival tobacco retail licensing data, annual audits of
tobacco retailers, semi-structured interviews with key community stakeholders, and geocoded health survey
data to evaluate this intervention and examine differential policy impact across neighborhoods and population
subgroups. Specifically, the project will: 1) Measure tobacco retailer density reduction and its association with
community demographics across study sites; 2) Longitudinally characterize changes in the tobacco
marketplace during policy implementation; 3) Qualitatively assess key stakeholder perceptions of the policy, its
mechanisms of action, and its behavioral impact; and 4) Identify associations between tobacco retailer density
reduction and smoking trends in NYC neighborhoods using a unique, annual population survey with geocoded
respondent data. Given the lack of empirical support for this nascent, environmental-level tobacco control
intervention, study results will provide timely, essential, and experiential evidence to inform equitable policy
formation and improve implementation in order to maximize impact and reduce persistent health disparities.
Terms: <21+ years old><Abscission><Adult><Adult Human><Attention><Behavior><Behavioral><Behavioral Mechanisms><Case Study><Characteristics><Charge><Cities><Communities><Community Health><Contracting Opportunities><Contracts><Data><Disparities><Disparity><Ecological impact><Economic Income><Economical Income><Economically Deprived Population><Empirical Research><Ensure><Environment><Environmental Impact><Equity><Ethnic Origin><Ethnicity><Evaluation Research><Excision><Extirpation><Goals><Grant><Health><Health Surveys><Income><Individual><Intervention><Intervention Strategies><Interview><Licensing><Link><Low income><Marketing><Measures><Mechanisms of Behavior and Behavior Change><Methods><Modeling><Municipalities><NIH><National Institutes of Health><Neighborhoods><New York City><Pattern><Perception><Pharmacies><Pharmacy facility><Philadelphia><Policies><Policy Developments><Population><Public Health><Public Policy><Race><Races><Removal><Research><Respondent><SES disparity><Sales><Sampling><San Francisco><Scientist><Site><Smoking><Smoking Behavior><Structure><Subgroup><Surgical Removal><Temporal trend><Testing><Time><Time trend><Tobacco><Tobacco Consumption><Tobacco use><Trends over time><United States National Institutes of Health><Variant><Variation><adulthood><behavior change><behavior mechanism><career><case report><cigarette smoking><cigarette use><community engaged participatory research><community engaged research><community partnered research><community-based health><community-engaged study><community-partnered study><comparative><demographics><density><disparity in health><economically deprived group><economically deprived people><economically disadvantaged group><economically disadvantaged individual><economically disadvantaged people><economically disadvantaged population><falls><frontier><health disparity><health equity><health equity promotion><improved><incomes><inequitable distribution><interest><intervention effect><interventional strategy><marginalization><marginalized group><marginalized individual><marginalized people><marginalized population><new approaches><novel><novel approaches><novel strategies><novel strategy><population survey><preventable death><preventable mortality><promote health equity><public policy on tobacco><racial><racial background><racial origin><resection><social disadvantage><social disparities><social inequality><socio-demographics><socio-economic disparity><socio-economic inequality><socio-economic inequity><sociodemographics><socioeconomic disparity><socioeconomic inequality><socioeconomic inequity><spatial epidemiology><substance use><substance using><tobacco control><tobacco control policy><tobacco policy><tobacco product use><tobacco products><trend><underclass>