Dissertations and Theses

Date of Degree

6-2-2022

Document Type

Dissertation

Degree Name

Doctor of Philosophy (Ph.D.)

Department

Health Policy and Management

Advisor(s)

Alexis Pozen

Committee Members

Andrew Maroko

Nevin Cohen

Subject Categories

Public Health

Keywords

Electronic cigarette retailer, vape shop, e-cigarette shop

Abstract

Background: The rampant expansion of the e-cigarette market over the last decade in the U.S. is a threat to the health of the public—due to the e-cigarette’s appeal to young people, addictiveness, and harms of consumption. It is vital to study the distribution of e-cigarette retailers of different types in major urban centers, such as New York City (NYC), to identify if certain neighborhoods are overburdened with retailers and if intervention is required. The current research on the e-cigarette retailer environment is limited in its scope and methods used.

Objective: To investigate neighborhood attributes associated with e-cigarette retailer density in NYC.

Methods: This dissertation employed cross-sectional observational research methods using the following data sources: NYC Department of Consumer and Worker Protection (2016–2018), NYC Department of City Planning (2016), and the U.S. Census Bureau’s American Community Survey (2016 5-year estimates). Presence (at least one retailer per Census Tract or CT), frequency, and density (retailers per 1,000 population, per square mile, average kernel density estimation or KDE) were the geographic access calculations produced per CT for vape-only, hybrid (licensed to sell tobacco and e-cigarette products), any e-cigarette (vape-only or hybrid), and tobacco-only retailers. Linear and logistic regressions were performed to assess the association between presence, frequency, or density per retailer type and neighborhood attributes (demographic and land use variables). Linear regressions were also run to assess the association among: 1) the distance between e-cigarette/vape-only retailers to the nearest tobacco-only retailer, 2) e-cigarette/vape-only retailer density and tobacco-only retailer density, 3) e-cigarette/vape-only density and percentage of inspections of tobacco-only retailers with a negative outcome.

Results: In NYC, tobacco-only retailers were the most common retailer type, followed by hybrid retailers and vape-only retailers. The presence, frequency, and density of vape-only retailers was found to have a consistent positive association with the percentage of the population between 18 to 24 years-of-age and percentage of tax lots classified as commercial or mixed land use across all geographic access calculations. Any e-cigarette retailer presence, frequency, or density is consistently positively associated with percentage of tax lots classified as commercial or mixed land use across all geographic access calculations. Any e-cigarette or vape-only retailers were found to be located within walking distance of tobacco-only retailers, especially in neighborhoods with a higher percentage of Latino and non-Latino Black population. Any e-cigarette or vape-only retailer density is positively associated with tobacco-only density (per square mile or average KDE). Any e-cigarette or vape-only retailer density (per square mile or average KDE) was not associated with the percentage of inspections of tobacco-only retailers with a negative outcome.

Conclusions: In NYC, retailer presence, frequency, and density vary by retailer type across CTs. Using clear retailer definitions and multiple geographic access calculations offers extra insights into the e-cigarette retailer environment in NYC. Given the association between retailer proximity and adult and youth product use, strategic regulation and effective surveillance of e-cigarette retailers (in general and by retailer type) is vital to prevent inequitable retailer exposure and subsequent e-cigarette use among younger or historically marginalized populations.

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Public Health Commons

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