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

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.

Correspondence: lisawood@uwa.edu.au


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.

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