New study shows race, neighborhood, income affect availability of single cigarettes

The Tobacco Prevention and Evaluation Program (TPEP) at UNC Family Medicine has found that where a person lives determines the likelihood of there being single cigarettes or improperly marketed and displayed tobacco products for sale in their neighborhood – potentially leading to easier and cheaper access to tobacco. This study is the first national evaluation of tobacco retailers who operate in violation of Federal Drug Administration (FDA) tobacco and sales regulations.

"This is a matter of fairness. Violations of federal tobacco regulations should not be related to the neighborhood in which you live," says Hannah M. Baker, UNC research associate and study author.

Published in the Center for Disease Control's Preventing Chronic Disease journal, the study by Joseph G.L. Lee, PhD, MPH; Hannah M Baker, MPH; Leah M. Ranney, PhD; and Adam O. Goldstein, MD, MPH presents the first national evidence that neighborhood characteristics are closely associated with illegal sales of single cigarettes, or "loosies."

Under the FDA's Family Smoking Prevention and Tobacco Control Act of 2009, there are several restrictions on how tobacco can be sold and displayed in stores, including regulations that prohibit the sale of single cigarettes or cigarettes in packs of fewer than 20. Additionally, stores are required to keep tobacco products behind the counter and refrain from placing cigarette vending machines in areas where youth can access them.

Studies in single cities and the state of California had previously found neighborhood composition differences in the availability of single cigarettes. However, smaller-scale studies conducted in Ohio and North Carolina counties could not find a correlation between class, race, and non-compliance with FDA regulations.

To investigate these conflicting trends more closely, Dr. Lee and colleagues gathered the results of all FDA retailer advertising and labeling inspections for a seven-month period. The team found that FDA tobacco violations, such as self-service displays and mislabeled products, were less likely to occur in minority neighborhoods. However, the likelihood of single-cigarette violations increased as the proportion of black, under-age, and low-income residents increased within a neighborhood.

As the study reports, "Single-cigarette sales facilitate tobacco initiation by young people, may allow retailers to avoid taxes, and do not have warning labels. Historically, single cigarettes are available from retailers even in areas with a ban on their sale, and our findings mirror earlier research showing high availability of single cigarette sales in neighborhoods with a high percentage of black residents."

The researchers speculate that market demand for more affordable tobacco products in low-income neighborhoods and the relative ease with which stores can sell singles clandestinely may be encouraging this trend.

"Our findings can assist the Food and Drug Administration in targeting federal tobacco retailer inspections to the places where they are most needed," says Lee, now an assistant professor in the Department of Health Education and Promotion at East Carolina University.