Lee Joseph G L, Landrine Hope, Torres Essie, Gregory Kyle R
Department of Health Education and Promotion, College of Health and Human Performance, East Carolina University, Greenville, North Carolina, USA.
Center for Health Disparities, Brody School of Medicine, East Carolina University, Greenville, North Carolina, USA.
Tob Control. 2016 Dec;25(e2):e142-e145. doi: 10.1136/tobaccocontrol-2016-053188. Epub 2016 Sep 8.
Tobacco retailers are an important source of tobacco products for minors. Previous research shows racial discrimination in sales to minors, but no national study has examined neighbourhood correlates of retailer under-age sales.
We accessed publicly available results of 2015 US Food and Drug Administration (FDA) inspections of tobacco retailers (n=108 614). In this cross-sectional study, we used multilevel logistic regression to predict the likelihood of retailer sale to a minor based on tract characteristics. We assessed the proportion of residents identifying as American Indian, Asian, Black, Latino and White; Isolation Index scores for each racial/ethnic group; the proportion of people less than age 65 living in poverty; and the proportion of residents age 10-17 in relation to retailer inspection results.
The proportion of American Indian residents, Black residents, Latino residents and residents less than age 65 under the poverty line in a neighbourhood are independently, positively associated with the likelihood that a retailer in that neighbourhood will fail an under-age buy inspection. The proportion of White residents and residents age 10-17 are independently, negatively associated with the likelihood of sale of tobacco products to a minor. Isolation Index scores show a similar pattern. In multivariable models holding neighbourhood characteristics constant, higher proportions of Black (+), Latino (+) and age 10-17 (-) residents remained significant predictors of the likelihood of under-age sale.
Regulatory agencies should consider oversampling retailers in areas with higher likelihood of sales to minors for inspection. Interventions with tobacco retailers to reduce inequities in youth access should be implemented.
烟草零售商是未成年人获取烟草产品的重要来源。先前的研究表明在向未成年人销售烟草方面存在种族歧视，但尚无全国性研究考察零售商向未成年人销售烟草与社区因素之间的关联。
我们获取了美国食品药品监督管理局（FDA）2015年对烟草零售商检查（n = 108614）的公开结果。在这项横断面研究中，我们使用多水平逻辑回归，根据社区特征预测零售商向未成年人销售烟草的可能性。我们评估了自认为是美洲印第安人、亚洲人、黑人、拉丁裔和白人的居民比例；每个种族/族裔群体的隔离指数得分；65岁以下生活在贫困中的人口比例；以及与零售商检查结果相关的10 - 17岁居民比例。
社区中美洲印第安居民、黑人居民、拉丁裔居民以及65岁以下处于贫困线以下居民的比例，与该社区零售商未能通过未成年人购买检查的可能性独立且呈正相关。白人居民以及10 - 17岁居民的比例，与向未成年人销售烟草产品的可能性独立且呈负相关。隔离指数得分呈现出类似模式。在保持社区特征不变的多变量模型中，较高比例的黑人（+）、拉丁裔（+）和10 - 17岁（-）居民仍然是未成年人销售可能性的显著预测因素。
监管机构应考虑对向未成年人销售烟草可能性较高地区的零售商进行过度抽样检查。应实施针对烟草零售商的干预措施以减少青少年获取烟草方面的不平等现象。
