# Associations of Tobacco Retailer Density with Neighborhood Sociodemographics, Individual Smoking Behaviors, & COPD Hospital Admission Rates: A Spatial Health Approach

> **NIH NIH F31** · UNIV OF NORTH CAROLINA CHAPEL HILL · 2020 · $29,106

## Abstract

Abstract. Tobacco use remains the leading cause of preventable death in the United States, causing more
than 480,000 deaths annually. Due to higher smoking prevalence, tobacco-related health problems
disproportionately afflict lower income and some racial and ethnic minority groups. The presence of tobacco
retailers may influence smoking behaviors through greater availability of tobacco products, lower costs of
obtaining products, cheaper prices, and greater exposure to tobacco product marketing. Tobacco retailer
density (TRD) is a measure of the concentration of tobacco retailers in an area, and retailer density is
associated with cigarette smoking intentions, initiation, use, and cessation. The overall training objectives of
this project are for the applicant to develop a theoretical understanding of how the built environment may
impact health while developing multilevel and geospatial modeling and analysis skills. These skills will be used
to achieve the overall project objective of examining associations of TRD with area demographics, smoking
behaviors, and COPD-related hospital admission rates across the nation. While there is increasing evidence
that exposure to tobacco retailers is not equitable across neighborhood demographics and that TRD may
impact smoking behaviors, significant gaps in the literature remain, including: 1) a failure to consider whether
neighborhood TRD depends, in part, on the demographics of surrounding area; 2) a limited number of national
studies examining multilevel associations of TRD with smoking and cessation behaviors, and little attention to
whether relationships may differ by neighborhood demographics; and 3) few studies that examine associations
of TRD with smoking-related disease. Using secondary data, the applicant will address these gaps in the
literature with three Specific Aims: 1) Using spatial econometrics, identify whether neighborhood
sociodemographic compositions of census tracts surrounding a focal tract are associated with TRD; 2)
Examine associations of county-level TRD with individual-level smoking and cessation behaviors; 2a) Test a
moderation model to determine whether these associations vary by county-level sociodemographic
compositions; and 3) Examine associations of county-level TRD with county-level COPD-related hospital
admission rates. To investigate the proposed Aims, the applicant will integrate several publicly available data
sources, including the 2010-2014 American Community Survey (neighborhood sociodemographics), the 2014-
2015 Tobacco Use Supplement (individual-level smoking and cessation behaviors), and the 2014 Healthcare
Cost and Utilization Project State Inpatient Database (county-level COPD-related hospital admission rates).
The proposed research fits within NCI’s vision, “To eliminate smoking, and the cancers and other harms it
causes, to improve public health.” My study will extend knowledge of whether TRD is associated with smoking
and disease in diverse neighborhoods. Th...

## Key facts

- **NIH application ID:** 9910864
- **Project number:** 1F31CA239331-01A1
- **Recipient organization:** UNIV OF NORTH CAROLINA CHAPEL HILL
- **Principal Investigator:** Amanda Kong
- **Activity code:** F31 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $29,106
- **Award type:** 1
- **Project period:** 2019-12-01 → 2020-07-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9910864

## Citation

> US National Institutes of Health, RePORTER application 9910864, Associations of Tobacco Retailer Density with Neighborhood Sociodemographics, Individual Smoking Behaviors, & COPD Hospital Admission Rates: A Spatial Health Approach (1F31CA239331-01A1). Retrieved via AI Analytics 2026-06-11 from https://api.ai-analytics.org/grant/nih/9910864. Licensed CC0.

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