RELATIONSHIP BETWEEN SEXUAL MINORITY COUPLES AND TOBACCO RETAILER DENSITY AND MARKETING Public Deposited

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  • March 19, 2019
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  • Lee, Joseph
    • Affiliation: Gillings School of Global Public Health, Department of Health Behavior
Abstract
  • Introduction. Tobacco use is markedly higher among lesbian, gay, and bisexual (LGB) populations than heterosexuals. Higher density of tobacco retailers and more tobacco marketing is found in neighborhoods with more low-income residents and more racial/ethnic diversity. Same-sex couples tend to live in similar neighborhoods, but the association of this demographic with tobacco retailer density or marketing have not been examined. Methods. Data come from a study of 97 US counties, with tobacco retailers geocoded to census tracts and direct observation of marketing in 2,234 retailers in 2012. In the first study, I used spatial regression to test the relationship between the rate of same-sex couple households and the number of tobacco retailers per 1,000 people in 17,667 census tracts. In the second study, I used multi-level models to test the relationship between the same-sex couple household rate in census tracts and retailers’ marketing characteristics. In both studies, I examined the association of the outcome variables in sex-stratified models, including neighborhood demographics and other environmental characteristics to examine confounding. Results. Results from spatial regression show that higher rates of both female and male same-sex couples were associated with a higher density of tobacco retailers. For female couples, the association was not significant after controlling for area-level characteristics, such as percent African American, percent Hispanic, median household income, the presence of interstate highways, and urbanicity, which are neighborhood correlates of higher tobacco retailer density. For male couples, the association persisted after control for these characteristics. Contrary to our hypotheses, we found no evidence of tobacco industry marketing at tobacco retailers differing by rates of same-sex couples in census tracts with the exception of three findings in the opposite direction of our hypotheses. Conclusion. Same-sex couples reside in areas with higher tobacco retailer density, but tobacco retailer marketing characteristics may not differ substantially. While LGB disparities in tobacco use may be influenced by neighborhood environment, the magnitude of the association suggests other explanations of these disparities remain important areas of research. Tobacco retailers’ tobacco marketing characteristics do not differ substantially by the rate of same-sex couples in their neighborhood.
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  • In Copyright
Advisor
  • Ribisl, Kurt
  • Goldstein, Adam
  • Bowling, J. Michael
  • Pan, William
  • Reyes, H. Luz McNaughton
Degree
  • Doctor of Philosophy
Degree granting institution
  • University of North Carolina at Chapel Hill Graduate School
Graduation year
  • 2015
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  • Chapel Hill, NC
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