Socioeconomic area disparities in tobacco retail outlet density: a Western Australian analysis

Lisa J Wood, Gavin Pereira, Nick Middleton and Sarah Foster
Med J Aust 2013; 198 (9): 489-491. || doi: 10.5694/mja12.11539


Objective: To examine the association between tobacco outlet density and area socioeconomic status (SES) in Western Australia.

Design and setting: Ecological cross-sectional study investigating the relationship between the area SES of, and the density of tobacco retail outlets in, WA suburbs and towns for the Perth metropolitan area, and at the regional and state level. SES was determined using the 2006 Australian Bureau of Statistics Index of Relative Socioeconomic Advantage and Disadvantage (IRSAD) and classified into quartiles (very low, low, high and very high); tobacco outlet data were sourced from the WA Department of Health register of retailers licensed to sell tobacco at May 2011.

Main outcome measure: Tobacco outlet density rate (per 10 000 residents).

Results: In WA overall, suburbs and towns with a very low IRSAD had more than four times the number of tobacco outlets compared with those with a very high IRSAD (P < 0.001). This trend was similar when analyses were restricted to the Perth metropolitan area and to regional areas. Suburbs and towns in regional WA with a very low IRSAD had more than five times the number of tobacco outlets than those with a very high IRSAD (P < 0.001).

Conclusions: This study provides the first Australian evidence of a strong relationship between area SES and tobacco outlet density. Findings are consistent with a number of United States studies that report higher tobacco outlet densities in lower SES or minority neighbourhoods. The results underscore the importance of policy approaches to limit the number of tobacco retail licences granted, and to reduce the geographic density of outlets in more disadvantaged suburbs and towns.

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  • Lisa J Wood1
  • Gavin Pereira1,2
  • Nick Middleton3
  • Sarah Foster1

  • 1 Centre for the Built Environment and Health, School of Population Health, University of Western Australia, Perth, WA.
  • 2 Yale Center for Perinatal, Pediatric, and Environmental Epidemiology, Department of Epidemiology and Public Health, School of Medicine, Yale University, New Haven, Conn, USA.
  • 3 NJM Spatial, Perth, WA.



We acknowledge funding from the Cancer Council of WA for this research, and the Department of Health (WA) for providing access to the tobacco retailer data. We also acknowledge research assistance from Jacqueline Sansom, Esther Dawkins and Catherine Coletsis. Lisa Wood and Sarah Foster are supported by Healthway Health Promotion Research Fellowships (20693 and 21363, respectively).

Competing interests:

No relevant disclosures.

  • 1. Daube MM, Chapman S. Tobacco plain packaging. Med J Aust 2012; 197: 272. <MJA full text>
  • 2. Gartner CE, Chapman SF, Hall WD, Wakefield MA. Why we need tobacco sales data for good tobacco control. Med J Aust 2010; 192: 3-4. <MJA full text>
  • 3. Novak SP, Reardon SF, Raudenbush SW, Buka SL. Retail tobacco outlet density and youth cigarette smoking: a propensity-modeling approach. Am J Public Health 2006; 96: 670-676.
  • 4. Chuang YC, Cubbin C, Ahn D, Winkleby MA. Effects of neighbourhood socioeconomic status and convenience store concentration on individual level smoking. J Epidemiol Community Health 2005; 59: 568-573.
  • 5. Ogneva-Himmelberger Y, Ross L, Burdick W, Simpson SA. Using geographic information systems to compare the density of stores selling tobacco and alcohol: youth making an argument for increased regulation of the tobacco permitting process in Worcester, Massachusetts, USA. Tob Control 2010; 19: 475-480.
  • 6. Yu D, Peterson NA, Sheffer MA, et al. Tobacco outlet density and demographics: analysing the relationships with a spatial regression approach. Public Health 2010; 124: 412-416.
  • 7. Hyland A, Travers MJ, Cummings KM, et al. Tobacco outlet density and demographics in Erie County, New York. Am J Public Health 2003; 93: 1075-1076.
  • 8. Peterson NA, Yu D, Morton CM, et al. Tobacco outlet density and demographics at the tract level of analysis in New Jersey: a statewide analysis. Drugs: Education, Prevention and Policy 2011; 18: 47-52. doi: 10.3109/09687630903514891.
  • 9. Paul CL, Mee KJ, Judd TM, et al. Anywhere, anytime: retail access to tobacco in New South Wales and its potential impact on consumption and quitting. Soc Sci Med 2010; 71: 799-806.
  • 10. Chapman S, Freeman B. Regulating the tobacco retail environment: beyond reducing sales to minors. Tob Control 2009; 18: 496-501.
  • 11. Australian Bureau of Statistics. Census of population and housing: census geographic areas digital boundaries, Australia, 2006. (ABS Cat. No. 2923.0.30.001.) (accessed Oct 2012).
  • 12. Australian Bureau of Statistics. Information paper: an introduction to Socio-Economic Indexes for Areas (SEIFA), 2006 (Preliminary). (ABS Cat. No. 2039.0.) (accessed Oct 2012).
  • 13. Turrell G, Hewitt BA, Miller SA. The influence of neighbourhood disadvantage on smoking cessation and its contribution to inequalities in smoking status. Drug Alcohol Rev 2012; 31: 645-652.
  • 14. Pearce J, Hiscock R, Moon G, Barnett R. The neighbourhood effects of geographical access to tobacco retailers on individual smoking behaviour. J Epidemiol Community Health 2009; 63: 69-77.
  • 15. Rodriguez D, Carlos HA, Adachi-Mejia AM, et al. Predictors of tobacco outlet density nationwide: a geographic analysis. Tob Control 2012; Apr 4. [Epub ahead of print.]
  • 16. Australian Institute of Health and Welfare. Australia's health 2012. Canberra: AIHW, 2012. (AIHW Cat. No. AUS 156; Australia's Health No. 13.) (accessed Feb 2013).
  • 17. Livingston M. Alcohol outlet density and assault: a spatial analysis. Addiction 2008; 103: 619-628.
  • 18. Scollo M. Price sensitivity among various population groups. In: Scollo MM, Winstanley MH, editors. Tobacco in Australia: facts and issues. 4th ed. Melbourne: Cancer Council Victoria, 2012: Section 13.1.4. (accessed Oct 2012).
  • 19. Begg S, Vos T, Barker B, et al. The burden of disease and injury in Australia 2003. Canberra: Australian Institute of Health and Welfare, 2007. (AIHW Cat No. PHE 82.) (accessed Oct 2012).
  • 20. Government of Western Australia Department of Racing, Gaming and Liquor. A note from the Director General explaining the making of decisions in the public interest [pamphlet]. (accessed Oct 2012).
  • 21. Public Health Law and Policy Technical Assistance Legal Center. Municipal authority to regulate the location and operation of tobacco retailers [memorandum]. 2002. California Department of Public Health. (accessed Oct 2012).


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