Finding it hard to quit smoking? Blame proximity

Living near a tobacco retailer could make it harder to quit smoking, suggests a University of Houston study.

Associate professor of health Lorraine Reitzel used smartphones and GPS to track how tobacco sellers’ accessibility affects smokers, and found that proximity to tobacco retailers was a key factor in the ease of quitting.

Professor Reitzel had previously worked on a study published in 2011 in the American Journal of Public Health “on the effects of tobacco outlet density and proximity on smoking cessation,” she told The Daily Cougar, the University of Houston student newspaper. “In that study, we looked at where people lived and whether the density of outlets around them and their residential proximity to the closest outlet was related to their ability to quit smoking.”

In this recent study, funded by UT Health Science Center School of Public Health, the American Cancer Society, the MD Anderson Cancer Center, and others, Reitzel directed her focus to local shops and their impact on smokers’ habits. Study participants used a smartphone and GPS to document and collect data about their real-time experience, and data was logged and analyzed starting from before they quit until a week after they quit. Study participants answered real-time questions about their urges to smoke, supplying the study with detailed information not only about their cravings, but about their geographic location at the time those cravings struck.

The research suggests that the number of stores available to buy tobacco did not increase the urge to smoke — rather, it was the stores’ proximity to the smoker’s home. When study participants responded to questions from their homes, those who live closer to a tobacco retailer documented greater urges to light up when compared to their counterparts living further away.

Despite the fact that the study monitored participants’ exposure to tobacco retailers outside of the neighborhood, it found that the link between the shops and the cravings was only notable when participants were at home. The study’s findings suggest that “close residential proximity” to a tobacco retailer was linked with stronger urges as well as stronger cravings during attempts at quitting. In other words, the closer you live to a tobacco retailer, the more difficult it may be to quit smoking.

The use of GPS enabled the study to paint a “picture of what smokers are exposed to throughout the context of their everyday lives,” Reitzel explained. ”While increasing our understanding about how the neighborhood environments affect smoking and other health outcomes is important, we have to also recognize that people do not spend their entire day in their neighborhood.”

The implications are especially relevant for healthcare policy. The study also suggests that “systematically” inhibiting tobacco sales, such as by banning tobacco product sales in residential areas, may impact smoking by making it hard to buy tobacco when cravings hit.  As Reitzel points out, by potentially banning the sale of tobacco products in residential areas, accessibility to tobacco would drop — as, the study suggests, would smoking.