TITLE:
A Neighborhood Analysis of Underage Tobacco Sales within the Serving Area of a Canadian Public Health Unit
AUTHORS:
Saber Fallahpour, Tanya Navaneelan, Kristy McBeth, Prithwish De
KEYWORDS:
Tobacco, Dissemination Area, Bayesian Disease Mapping, Cluster, Buffer Analysis
JOURNAL NAME:
Open Journal of Statistics,
Vol.7 No.6,
December
1,
2017
ABSTRACT: Despite the fact that the sale of tobacco to minors
is illegal in Ontario, youth are still able to purchase tobacco. This study
aims to determine the geographic variations of underage tobacco sales at the
neighborhood level within the Windsor-Essex County Health Unit. Data were
collected on all inspections of tobacco retail stores from 2007 to 2011 in the
Windsor-Essex County Health Unit. Data were split into season 1
(September-February) and season 2 (March-August) to assess a possible seasonal
effect. Relative risks were calculated for each dissemination area (DA) by
modeling the risks in a hierarchical Bayesian fashion, incorporating
appropriate random effects terms for both spatially correlated and uncorrelated
random errors with adjustments for neighborhood income. The association between
violation rate and proximity to a school was assessed through a buffer
analysis. Elliptical analysis detected a significant cluster of high risk DAs
in season 1 in Windsor (p-value = 0.022) but no significant cluster in season 2. Some
DAs exhibited higher relative risks of tobacco sales to minors, however after
adjusting the model for neighborhood income no excess risk was observed. The
results of the buffer analysis showed that in season 1 there was a
significantly higher probability (p-value = 0.045) of tobacco vendors located closer to schools
to sell tobacco to minors. This analysis demonstrates the utility of a
systematic approach to identifying neighborhoods with higher risks of tobacco
sales to minors. The insights provided by this exploratory, ecologic study are
valuable for program planning and directing tobacco enforcement efforts to high
risk areas.