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A Neighborhood Analysis of Underage Tobacco Sales within the Serving Area of a Canadian Public Health Unit

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Document pages: 16 pages

Abstract: Despite the fact that the sale of tobacco to minorsis illegal in Ontario, youth are still able to purchase tobacco. This studyaims to determine the geographic variations of underage tobacco sales at theneighborhood level within the Windsor-Essex County Health Unit. Data werecollected on all inspections of tobacco retail stores from 2007 to 2011 in theWindsor-Essex County Health Unit. Data were split into season 1(September-February) and season 2 (March-August) to assess a possible seasonaleffect. Relative risks were calculated for each dissemination area (DA) bymodeling the risks in a hierarchical Bayesian fashion, incorporatingappropriate random effects terms for both spatially correlated and uncorrelatedrandom errors with adjustments for neighborhood income. The association betweenviolation rate and proximity to a school was assessed through a bufferanalysis. Elliptical analysis detected a significant cluster of high risk DAsin season 1 in Windsor (p-value = 0.022) but no significant cluster in season 2. SomeDAs exhibited higher relative risks of tobacco sales to minors, however afteradjusting the model for neighborhood income no excess risk was observed. Theresults of the buffer analysis showed that in season 1 there was asignificantly higher probability (p-value = 0.045) of tobacco vendors located closer to schoolsto sell tobacco to minors. This analysis demonstrates the utility of asystematic approach to identifying neighborhoods with higher risks of tobaccosales to minors. The insights provided by this exploratory, ecologic study arevaluable for program planning and directing tobacco enforcement efforts to highrisk areas.

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