ASPO Abstracts
Geographic Disparity of Tobacco Use in Missouri
Category: Behavioral Science & Health Communication, Cancer Health Disparities
Conference Year: 2018
Abstract Body:
Purpose: To examine the prevalence and geographic disparity of tobacco use and relevant area characteristics in Missouri. Methods: Data from 2011 Missouri County-level Study (CLS) were analyzed to identify the product types of tobacco use, including cigarette, other tobacco products (cigar, bidi, pipe, kretek or clove cigarette), and smokeless tobacco products (chewing tobacco, snuff or snus). Using U.S. Census data, a Zip code-level socioeconomic deprivation (SED) index was developed to evaluate small-area neighborhood SED context. Rural/urban locations were defined according to the USDA urban-rural codes. Tobacco outlet locations and tobacco taxation rates were obtained from the Missouri Department of Mental Health and Department of Revenue. Zip codes were used for linking neighborhood measures to the CLS with extensive individual characteristics, including health behaviors and self-reported tobacco policies. Results: The overall prevalence of tobacco use in Missouri was 28.5% (cigarette: 23.1%, other products: 5.1%, smokeless products: 4.4%). Significant geographic hotspots (higher-than-expected) of cigarette smoking were found across the state (prevalence varied from 26.7% to 31.0%). The prevalence rate was higher in neighborhoods with greater SED (highest quartile vs. lowest quartile: 33.9% vs. 24.6%), higher density of tobacco retailers (highest quartile vs. lowest quartile: 33.7% vs. 23.2%), and in rural areas (rural vs. urban: 32.9% vs. 28.3%). The proportion of tobacco users was lower in neighborhoods with local tobacco tax (27.0% vs. 31.5%) and among those with self-reported private (home/car) tobacco bans (10.5% vs. 53.7%), workplace bans (22.5% vs. 36.9%), and those who supported the clean air policies (14.4% vs. 47.0%). Conclusion: The prevalence of tobacco use in Missouri is significantly higher than the targets of the Healthy People 2020 and there is significant geographic heterogeneity in tobacco use behaviors. Future studies should focus on developing effective multilevel strategies for tobacco control interventions to substantially decrease the prevalence and eliminate geographic disparity of tobacco use.
Keywords: Tobacco Use, Disparity, Neighborhood, Multilevel, Tobacco Control.