# Project 1: Tobacco Retailer Density, Smoking and Tobacco-Related Disease

> **NIH NIH P01** · UNIV OF NORTH CAROLINA CHAPEL HILL · 2020 · $354,916

## Abstract

Abstract
The concentration of tobacco retail stores in a specific area (i.e., tobacco retailer density) may produce or
sustain higher smoking levels through increased exposure to tobacco marketing, access to cheaper tobacco
products, and establishing tobacco use as a norm. Disparities in tobacco retailer density have been
documented with African American, Latino, and low-income communities having higher tobacco retailer density
than their counterparts. Some communities are exploring ways to reduce retailer density, but there is little
empirical evidence about the potential impacts of such interventions. We propose to provide evidence
regarding the impacts of retailer density on a) smoking behaviors; and b) subsequent health outcomes.
In Aim 1 of this study we build a geocoded, longitudinal database of the approximately 275,000 tobacco
retailers throughout the U.S. between 2000-2018. Using adaptive kernel density estimation, we will develop
annual measures of census tract- and county- level tobacco retailer density and examine associations with
area demographic characteristics. In Aim 2, we link the density data with county smoking data derived from the
Behavioral Risk Factor Surveillance System. We then analyze cross-lag models to determine whether greater
retailer density drives county smoking prevalence or whether retailers locate in areas with high demand for
tobacco. Aim 3 integrates cancer, cardiovascular and pulmonary disease, and birth outcomes incidence data
from the North American Association of Central Cancer Registries (NACCR), the Healthcare Cost and Utility
Project (HCUP), and the National Vital Statistics System (NVSS) to estimate potential population level health
effects of capping tobacco retailer density.
Evidence regarding the effect of retail density on smoking is emerging, but questions remain about temporality
and ultimate impact on health. The proposed work is the first to longitudinally examine these associations,
substantially strengthening causal inference, and is also the first to examine associations between tobacco
retailer density and subsequent tobacco-related health effects, including cancer.

## Key facts

- **NIH application ID:** 10005222
- **Project number:** 5P01CA225597-03
- **Recipient organization:** UNIV OF NORTH CAROLINA CHAPEL HILL
- **Principal Investigator:** KURT M. RIBISL
- **Activity code:** P01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $354,916
- **Award type:** 5
- **Project period:** 2018-09-01 → 2024-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10005222

## Citation

> US National Institutes of Health, RePORTER application 10005222, Project 1: Tobacco Retailer Density, Smoking and Tobacco-Related Disease (5P01CA225597-03). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10005222. Licensed CC0.

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