Proximity to a tobacco store and smoking cessation: a cohort study

Background It is not clear whether the availability of tobacco affects the likelihood of smoking cessation. We examined whether the proximity to a tobacco store and the number of stores were associated with smoking cessation, and compared results for proximity variables based on walking and straight-line (as the crow flies) distance. Methods The study population consisted of 8751 baseline smokers from the Finnish Public Sector study in 1997-2005. Smoking intensity (cigarettes/day) was determined at baseline and smoking cessation was determined from a follow-up survey in 2008-2009. Proximity was measured using straight-line and walking distance from home to the nearest tobacco store, and another exposure variable was the number of stores within 0.50km from home. We calculated associations with log-binomial regression models, adjusting for individual-level and area-level confounders. Results Of the participants, 3482 (39.8%) quit smoking during the follow-up (mean follow-up 5.5years, SD 2.3 years). Among men who were moderate/heavy smokers at baseline and lived <0.50km walking distance from the nearest tobacco store, the likelihood of smoking cessation was 27% (95% CI 12% to 40%) lower compared with those living 0.50km from a store. Having even one store within 0.50km walking distance from home decreased cessation in men who were moderate/heavy smokers by 37% (95% CI 19% to 51%). No decrease was found for men who were light smokers at baseline or for women. Conclusions Living within walking distance of a tobacco store reduced the likelihood of smoking cessation among men who were moderate/heavy smokers.