Assessing Temporal Changes in Spatially-Varying Disparities in Tobacco Retailer Density across Ohio.

Background: Place-based disparities in tobacco retailer density (TRD) are related to place-based disparities in tobacco use. This project aimed to assess the equity of changes in TRD disparities for various communities over the last 5 years. In addition, we sought to explore how changes varied as a function of local tobacco retailer licensing policies. Methods: In 2017 and 2022, we geocoded all tobacco retailers (including hookah cafés and vape shops) in Ohio and used census-derived information to categorize 3149 census tracts based on their demographic characteristics. With these data, we calculated cross-sectional TRD disparities, then estimated changes in TRD from 2017-2022. We also assessed tracts that had (vs had not) implemented tobacco retailer licensing. Analyses used negative binomial models adapted to account for spatial association across tracts and temporal dependence over years. Results: There was hardly any change in overall TRD over the 5-year period (1.77% decline). However, disparities were slightly attenuated for tracts with a high prevalence of Hispanic individuals, children, poverty, and African American individuals. The TRD did not decline for rural (vs suburban) areas; furthermore, rurality was one of the strongest predictors of TRD. In suburban and urban areas (where tobacco retailer licensing was most common), TRD declined more in high-poverty tracts that did (vs did not) have tobacco retailer licensing. Conclusion: Declines in TRD were greater for some communities than others. In particular, there was no indication that TRD is declining in rural areas of the state. Findings indicate the need for support and expansion of state and local-level tobacco control policies.