New York State Department of Health Announces Study Linking Density of Tobacco Retailers to Minority and Low-Income Areas

DOH Continues Aggressive Public Awareness Campaign to Reduce Tobacco Use

ALBANY, N.Y. (April 22, 2013) -- State Health Commissioner Nirav R. Shah, M.D., M.P.H, today announced the results of a study showing that tobacco retailer density is greater in neighborhoods where higher proportions of minority and low-income New Yorkers live. The study, "Density of Tobacco Retailers and its Association with Sociodemographic Characteristics of Communities across New York," published March 21 in the journal, Public Health, was authored by scientists from the State Department of Health's (DOH) Bureau of Tobacco Control in collaboration with RTI, International, the Bureau of Tobacco Control's independent evaluator.

"All of New York's children have a right to live and play in neighborhoods free of dangerous tobacco marketing," Commissioner Shah said. "This new study suggests that minority and low-income New Yorkers are more likely to be exposed to tobacco marketing within their own community."

This new study examined the relationship between demographic factors including community income, race/ethnicity, and median age and their association with tobacco retailer density across seven areas within the state. The results indicate that census tracts with higher proportions of African Americans and Hispanics and lower incomes generally had higher tobacco retailer density.

"The fact that tobacco marketing is more likely to take place in areas where minority and low-income New Yorkers live is especially concerning as these groups may be particularly vulnerable to industry practices that recruit new smokers, as demonstrated by their higher tobacco use rates," Yvonne Graham, director of DOH's Office of Minority Health and Health Disparities Prevention, said.

Tobacco marketing has caught the attention of public health scientists. In another recent study by RTI, International, "Influence of Tobacco Displays and Ads on Youth: A Virtual Store Experiment," published in Pediatrics in January 2013, the authors presented the results of an experiment in which 1,200 young people took "virtual" online shopping trips through computerized convenience stores. It found that youth were more likely to make purchase attempts of cigarettes in shops where tobacco products were in plain sight compared to when they were hidden in cabinets. Together, these studies point to future tobacco control interventions that could reduce the negative health and economic burden of tobacco on minority and low-income groups in New York.

The evidence shows that the tobacco industry's extensive marketing in retail stores contributes significantly to youth tobacco use. The 2012 Surgeon General's report, Preventing Tobacco Use Among Youth and Young Adults, concludes that the evidence for tobacco marketing's influence on adolescent smoking is "strong and consistent" and involves selection of brands, smoking initiation, and overall consumption.

DOH supports actions to address the problems associated with tobacco marketing, such as New York City's "Sensible Tobacco Enforcement Proposal" to prohibit the use of coupons to lower the price of tobacco products, implement a minimum price of $10.50 for packs of cigarettes and little cigars, raise penalties on retailers that evade tobacco taxes and establish a minimum pack size for small cigars and cigarillos.

The proposal is directly in line with evidence showing that increasing the price of tobacco products is the most effective way to reduce tobacco use, particularly among children and teens. In a 2012 report, the U.S. Surgeon General described tobacco use as a "pediatric epidemic." Despite advances in helping New Yorkers to quit smoking, 11.9 percent of high school students still smoke in New York State. Moreover, among adults who become daily smokers, 88 percent begin smoking by the age of 18, before they can legally buy their first pack. Unless further reductions in the rate of tobacco use are achieved, approximately 389,000 of New York's children currently under the age of 18 will ultimately die of a smoking-related illness, including many types of cancer, heart disease, stroke, chronic obstructive pulmonary disease (COPD) and other lung diseases. It is estimated that those tobacco-related illnesses cost New York upwards of $8 billion annually in health care costs alone. It is vital that New York take as many steps as possible to stem the tide of disease and death caused by cigarettes.

The New York State Department of Health Tobacco Control Program (NYTCP) implements evidence-based and promising strategies to prevent and reduce tobacco use. The program began in January 2000, and is built on a foundation of community partners using evidence-based strategies from the Guide to Community Preventive Services to decrease tobacco use. Over time, the program has effectively implemented a strong clean indoor air law, maintained support for high tobacco taxes to keep the price of tobacco high, and worked to increase access to effective cessation services and motivate smokers to try to quit. As a result of programmatic efforts, youth and adult smoking rates are at their lowest levels on record. For more information on efforts by the NYTCP, visit:

Part of New York's efforts to reduce the negative consequences associated with tobacco use are outlined in the Department of Health's 2013-17 Prevention Agenda: New York State's Health Improvement Plan. This plan serves as a roadmap for local community action to improve health and address health disparities. Key focus areas include reducing death, disability and illness related to tobacco use and secondhand smoke exposure.

Prevention Agenda goals for the year 2017 include:

  • Promote tobacco use cessation, especially among low socio-economic status (SES) populations and those with poor mental health.
  • Decrease the prevalence of cigarette smoking by adults by 18% from 18.4% in 2011 to 15.0%.
  • Decrease the prevalence of any tobacco use (cigarettes, cigars smokeless tobacco) by high school age students by 30% from 21.2% in 2010 to 15%.
  • Reduce Disparity: decrease the prevalence of cigarette smoking among adults with incomes less than $25,000 by 30 percent, from 28.5 percent (2011) to 20 percent.
  • Increase the utilization of smoking cessation benefits among smokers who are enrolled in Medicaid Managed Care by 141% from 17% (2011) to 41%.

For additional information about New York's efforts to reduce tobacco use can be found at: