Department of Public Health, Amsterdam Public Health research institute, Amsterdam UMC, University of Amsterdam, Postbus, Amsterdam, 22660, 1100 DD, the Netherlands.
Department of Geography and Planning, University of Amsterdam, Amsterdam, Postbus, Amsterdam, 15629, 1001 NC, The Netherlands.
BMC Public Health. 2023 Aug 9;23(1):1515. doi: 10.1186/s12889-023-16347-7.
Previous studies found that tobacco outlets were unevenly distributed by area socioeconomic status (SES). However, evidence from continental Europe is limited. This study aims to assess differences in tobacco outlet presence, density and proximity by area SES in the Netherlands.
All tobacco outlets in four Dutch cities (Amsterdam, and medium-sized cities Eindhoven, Haarlem, and Zwolle) were mapped between September 2019 and June 2020. We estimated associations between average property value of neighbourhoods (as an indicator of SES, grouped into quintiles) and (1) tobacco outlet presence in the neighbourhood (yes/no), (2) density (per km), and (3) proximity to the closest outlet (in meters), using logistic and linear regression models.
46% of neighbourhoods contained at least one tobacco outlet. Tobacco outlets were mostly situated in city centres, but the distribution of tobacco outlets varied per city due to differences in urban structures and functions. In the medium-sized cities, each quintile higher neighbourhood-SES was associated with lower tobacco outlet presence (OR:0.71, 95%CI:0.59;0.85), lower density (B:-1.20 outlets/km, 95%CI:-2.20;-0.20) and less proximity (B:40.2 m, 95%CI 36.58;43.83). Associations were the other way around for Amsterdam (OR:1.22, 95%CI:1.05;1.40, B:3.50, 95%CI:0.81;6.20, and B:-18.45, 95%CI:-20.41;-16.49, respectively). Results were similar for most types of tobacco outlets.
In medium-sized cities in the Netherlands, tobacco outlets were more often located in low-SES neighbourhoods than high-SES. Amsterdam presented a reverse pattern, possibly due to its unique urban structure. We discuss how licensing might contribute to reducing tobacco outlets in low-SES neighbourhoods.
先前的研究发现，烟草销售点在地区社会经济地位（SES）方面分布不均。然而，来自欧洲大陆的证据有限。本研究旨在评估荷兰四个城市（阿姆斯特丹和中等城市埃因霍温、哈勒姆和兹沃勒）烟草销售点的存在、密度和邻近程度与地区 SES 的差异。
2019 年 9 月至 2020 年 6 月期间，我们对四个荷兰城市（阿姆斯特丹和中等城市埃因霍温、哈勒姆和兹沃勒）的所有烟草销售点进行了映射。我们使用逻辑回归和线性回归模型，估计了社区平均房地产价值（作为 SES 的指标，分为五分位数）与（1）社区内是否存在烟草销售点（是/否）、（2）密度（每公里）和（3）与最近销售点的距离（米）之间的关联。
46%的社区至少有一个烟草销售点。烟草销售点主要位于市中心，但由于城市结构和功能的不同，烟草销售点的分布因城市而异。在中等城市中，每个 SES 较高的社区都与烟草销售点的存在率较低（OR：0.71，95%CI：0.59；0.85）、密度较低（B：-1.20 个销售点/公里，95%CI：-2.20；-0.20）和距离较近（B：40.2 米，95%CI：36.58；43.83）有关。而阿姆斯特丹的情况则相反（OR：1.22，95%CI：1.05；1.40，B：3.50，95%CI：0.81；6.20，B：-18.45，95%CI：-20.41；-16.49）。结果对于大多数类型的烟草销售点都是相似的。
在荷兰的中等城市中，烟草销售点更多地位于 SES 较低的社区，而不是 SES 较高的社区。阿姆斯特丹则呈现出相反的模式，这可能是由于其独特的城市结构造成的。我们讨论了许可制度如何有助于减少 SES 较低社区的烟草销售点。
