Associations of Alcohol and Tobacco Retail Outlet Rates with Neighborhood Disadvantage.
Abstract
Tobacco causes 29% of cancer-related deaths while alcohol causes 5.5% of cancer-related
deaths. Reducing the consumption of these cancer-causing products is a special priority
area for the National Cancer Institute. While many factors are linked to tobacco and
alcohol use, the placement and density of retail outlets within neighborhoods may
be one community-level risk factor contributing to greater use of these products.
To elucidate associations between tobacco, alcohol, and tobacco and alcohol retail
outlets (TRO, ARO, and TARO) and neighborhood disadvantage over a large geographic
area, we employed a novel Bayesian index modeling approach to estimate a neighborhood
disadvantage index (NDI) and its associations with rates of the three types of retailers
across block groups in the state of North Carolina. We used a novel extension of the
Bayesian index model to include a shared component for the spatial pattern common
to all three types of outlets and NDI effects that varied by outlet type. The shared
component identifies areas that are elevated in risk for all outlets. The results
showed significant positive associations between neighborhood disadvantage and TROs
(relative risk (RR) = 1.12, 95% credible interval (CI = 1.09, 1.14)) and AROs (RR
= 1.15, 95% CI = 1.11, 1.17), but the association was greatest for TAROs (RR = 1.21,
95% CI = 1.18, 1.24). The most important variables in the NDI were percent renters
(i.e., low home ownership), percent of homes built before 1940 (i.e., old housing
stock), and percent without a high school diploma (i.e., low education).
Type
Journal articleSubject
TobaccoBayes Theorem
Residence Characteristics
Commerce
Tobacco Products
Neighborhood Characteristics
Permalink
https://hdl.handle.net/10161/25553Published Version (Please cite this version)
10.3390/ijerph19031134Publication Info
Wheeler, David C; Boyle, Joseph; Barsell, D Jeremy; Glasgow, Trevin; McClernon, F
Joseph; Oliver, Jason A; & Fuemmeler, Bernard F (2022). Associations of Alcohol and Tobacco Retail Outlet Rates with Neighborhood Disadvantage.
International journal of environmental research and public health, 19(3). pp. 1134. 10.3390/ijerph19031134. Retrieved from https://hdl.handle.net/10161/25553.This is constructed from limited available data and may be imprecise. To cite this
article, please review & use the official citation provided by the journal.
Collections
More Info
Show full item recordScholars@Duke
F Joseph McClernon
Professor in Psychiatry and Behavioral Sciences
Joseph McClernon, Ph.D., is a professor in the Department of Psychiatry and Behavioral
Sciences and founder/director of the Center for Addiction Science and Technology (CfAST).
In his four years with the Duke Clinical and Translational Science Institute (CTSI)
he has served as director of the Evaluation and Strategic Planning core, interim co-director
of the Team Science core, and director of the Integration and Strategic Partnerships
pillar. During his tenure with CTSI, his leadership has be

Articles written by Duke faculty are made available through the campus open access policy. For more information see: Duke Open Access Policy
Rights for Collection: Scholarly Articles
Works are deposited here by their authors, and represent their research and opinions, not that of Duke University. Some materials and descriptions may include offensive content. More info