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Retail Environment Features that Affect Smoking Behavior in Changsha, China

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2015, Doctor of Philosophy, Ohio State University, Public Health.
Background: Tobacco use causes more than one million deaths each year in China, and this number is expected to reach 3.5 million by 2030 if the current trends continue. Retail environment features are connected with health behaviors such as cigarette smoking. A high density of tobacco retail stores and a high prevalence of marketing practices at the point-of-sale have a profound impact on tobacco smoking especially among youth. In contrast, the availability of smoking cessation medications and services in pharmacies is related to their utilization among smokers and therefore, possibly also related to quit rates. However, little is known about these features of the retail environment in China. Objectives: The objectives of this study were to (1) measure retailers’ compliance with the zoning regulation of banning tobacco retail sales near schools and to examine the density and characteristics of tobacco retail outlets around schools and in neighborhoods, (2) estimate the prevalence and characteristics of tobacco marketing at the point-of-sale, and, (3) examine the availability and characteristics of smoking cessation medications and the sales of tobacco products in pharmacies in China. Methods: We audited tobacco retail stores within 200 meters of 36 schools and in 36 residential neighborhoods in the city of Changsha, China. The audit form included items about store location, demographics, availability and characteristics of tobacco products, tobacco advertising, promotion, and tobacco product displays as well as tobacco control signs. We also performed in-pharmacy visits with a standard checklist, which include items on the availability of cessation medication and advertisements for medication, cessation treatment services, tobacco control signs, and tobacco products in pharmacies. Results: There were many strong pro-tobacco features in the retail environment, and they included: (1) a high density of tobacco retail stores near schools and in neighborhoods, indicating low compliance with the regulation of prohibiting tobacco retail sales within 100 meters of schools; (2) new tobacco products are emerging, especially those targeting youth and females, such as menthol cigarettes, female-targeted cigarettes, and e-cigarettes; (3) low compliance with the regulation that requires tobacco retail stores to place a visible `no sales to minors’ sign; (4) a high prevalence of tobacco marketing practices, especially those targeting youth, such as displaying tobacco products within 3 feet of the floor and within 12 inches of toys, candy, and ice cream; and, (5) emerging tobacco sales in pharmacies. Whereas, the anti-tobacco features we assessed were weak, and they included: (1) low availability of smoking cessation medications in pharmacies; (2) few pharmacies had cessation medication advertisements; (3) no pharmacy provided any smoking cessation services or self-help materials; and, (4) the cost of smoking cessation medication is high and it has not been covered by health insurance. Conclusions: The retail environment in the city of Changsha has strong pro-tobacco and weak anti-tobacco features. To better curb the tobacco epidemic in China, efforts are needed to improve the compliance with the regulations that protect youth, to counteract pro-tobacco marketing, and to promote the availability of smoking cessation medications and services in pharmacies.
Amy Ferketich (Advisor)
Randi Foraker (Committee Member)
Bo Lu (Committee Member)
153 p.

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Citations

  • Wang, L. (2015). Retail Environment Features that Affect Smoking Behavior in Changsha, China [Doctoral dissertation, Ohio State University]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=osu1437651533

    APA Style (7th edition)

  • Wang, Ling. Retail Environment Features that Affect Smoking Behavior in Changsha, China. 2015. Ohio State University, Doctoral dissertation. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=osu1437651533.

    MLA Style (8th edition)

  • Wang, Ling. "Retail Environment Features that Affect Smoking Behavior in Changsha, China." Doctoral dissertation, Ohio State University, 2015. http://rave.ohiolink.edu/etdc/view?acc_num=osu1437651533

    Chicago Manual of Style (17th edition)