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Association Between Distance From Home to Tobacco Outlet and Smoking Cessation and Relapse

Pulakka, A; Halonen, JI; Kawachi, I; Pentti, J; Stenholm, S; Jokela, M; Kaate, I; ... Kivimaki, M; + view all (2016) Association Between Distance From Home to Tobacco Outlet and Smoking Cessation and Relapse. JAMA Internal Medicine , 176 (10) pp. 1512-1519. 10.1001/jamainternmed.2016.4535. Green open access

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Abstract

IMPORTANCE: Reduced availability of tobacco outlets is hypothesized to reduce smoking, but longitudinal evidence on this issue is scarce. OBJECTIVE: To examine whether changes in distance from home to tobacco outlet are associated with changes in smoking behaviors. DESIGN, SETTING, AND PARTICIPANTS: The data from 2 prospective cohort studies included geocoded residential addresses, addresses of tobacco outlets, and responses to smoking surveys in 2008 and 2012 (the Finnish Public Sector [FPS] study, n = 53 755) or 2003 and 2012 (the Health and Social Support [HeSSup] study, n = 11 924). All participants were smokers or ex-smokers at baseline. We used logistic regression in between-individual analyses and conditional logistic regression in case-crossover design analyses to examine change in walking distance from home to the nearest tobacco outlet as a predictor of quitting smoking in smokers and smoking relapse in ex-smokers. Study-specific estimates were pooled using fixed-effect meta-analysis. EXPOSURES: Walking distance from home to the nearest tobacco outlet. MAIN OUTCOMES AND MEASURES: Quitting smoking and smoking relapse as indicated by self-reported current and previous smoking at baseline and follow-up. RESULTS: Overall, 20 729 men and women (age range 18-75 years) were recruited. Of the 6259 and 2090 baseline current smokers, 1744 (28%) and 818 (39%) quit, and of the 8959 and 3421 baseline ex-smokers, 617 (7%) and 205 (6%) relapsed in the FPS and HeSSup studies, respectively. Among the baseline smokers, a 500-m increase in distance from home to the nearest tobacco outlet was associated with a 16% increase in odds of quitting smoking in the between-individual analysis (pooled odds ratio, 1.16; 95% CI, 1.05-1.28) and 57% increase in within-individual analysis (pooled odds ratio, 1.57; 95% CI, 1.32-1.86), after adjusting for changes in self-reported marital and working status, substantial worsening of financial situation, illness in the family, and own health status. Increase in distance to the nearest tobacco outlet was not associated with smoking relapse among the ex-smokers. CONCLUSIONS AND RELEVANCE: These data suggest that increase in distance from home to the nearest tobacco outlet may increase quitting among smokers. No effect of change in distance on relapse in ex-smokers was observed.

Type: Article
Title: Association Between Distance From Home to Tobacco Outlet and Smoking Cessation and Relapse
Open access status: An open access version is available from UCL Discovery
DOI: 10.1001/jamainternmed.2016.4535
Publisher version: http://doi.org/10.1001/jamainternmed.2016.4535
Language: English
Additional information: Copyright 2016 American Medical Association. All rights reserved. This version is the version of record. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Science & Technology, Life Sciences & Biomedicine, Medicine, General & Internal, General & Internal Medicine, NEIGHBORHOOD SOCIOECONOMIC-STATUS, INDIVIDUAL-LEVEL SMOKING, QUIT SMOKING, DENSITY, PROXIMITY, COHORT, ADULTS, REDUCTION, POLICY, INTERVENTIONS
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health > Epidemiology and Public Health
URI: https://discovery.ucl.ac.uk/id/eprint/1508743
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