Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA.
Department of Family and Preventive Medicine, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA.
J Rural Health. 2023 Mar;39(2):338-346. doi: 10.1111/jrh.12687. Epub 2022 Jun 16.
Tobacco use prevalence is higher in rural compared to urban settings, possibly due to differences in tobacco availability, including the option to purchase food and other essential items in stores that do not sell tobacco (tobacco-free food retailers). The goal of this research is to determine whether tobacco-free food retailer availability varies by urbanicity/rurality.
Using the 2017 National Establishment Time-Series database, we identified food retailers across all census tracts containing food retailers in the United States (n = 66,053). We used multivariable logistic and linear regression models to test whether tobacco-free food retailer availability varied across 4-levels of census tract urbanicity/rurality (urban, suburban, large town, and small town/rural) for 2 outcomes: (1) the presence of at least 1 tobacco-free food retailer and (2) the percent of all food retailers that were tobacco-free.
Compared to urban core census tracts, suburban census tracts had a lower odds (aOR = 0.77, 95% CI = 0.73, 0.81) of having at least 1 tobacco-free food retailer, while small town/rural census tracts had greater odds (aOR = 1.23, 95% CI = 1.15, 1.32). Suburban census tracts (B = -2.29, P < .001) and large town census tracts (B = -1.90, P < .001) also had a lower percentage of tobacco-free food retailers compared to urban census tracts.
Compared to urban cores, tobacco-free food retailers were less prevalent in suburban and large town areas, though similarly or slightly more available in rural areas. Future research should assess whether these differences depend on varying store types.
与城市相比，农村的烟草使用率更高，这可能是由于烟草供应的差异，包括在不卖烟草的商店购买食品和其他必需品的选择（无烟草食品零售商）。这项研究的目的是确定无烟草食品零售商的供应是否因城市/农村的不同而有所不同。
我们使用 2017 年全国机构时间序列数据库，确定了美国所有包含食品零售商的普查区的食品零售商（n = 66053）。我们使用多变量逻辑和线性回归模型来测试无烟草食品零售商的供应是否因普查区城市/农村的 4 个级别（城市、郊区、大城镇和小镇/农村）而有所不同，有两个结果：（1）至少有 1 家无烟草食品零售商；（2）无烟草食品零售商占所有食品零售商的比例。
与城市核心普查区相比，郊区普查区拥有至少 1 家无烟草食品零售商的可能性较低（aOR = 0.77，95%CI = 0.73，0.81），而小镇/农村普查区的可能性较高（aOR = 1.23，95%CI = 1.15，1.32）。郊区普查区（B = -2.29，P <.001）和大城镇普查区（B = -1.90，P <.001）的无烟草食品零售商比例也低于城市普查区。
与城市核心区相比，无烟草食品零售商在郊区和大城镇地区的普及程度较低，而在农村地区则类似或略高。未来的研究应该评估这些差异是否取决于不同的商店类型。
