title: Concentration of tobacco advertisements at SNAP and WIC stores, Philadelphia, Pennsylvania, 2012.
abstract: BACKGROUND
  Tobacco advertising is widespread in urban areas with racial/ethnic minority and low-income households that participate in nutrition assistance programs. Tobacco sales and advertising are linked to smoking behavior, which may complicate matters for low-income families struggling with disparate health risks relating to nutrition and chronic disease. We investigated the relationship between the amount and type of tobacco advertisements on tobacco outlets and the outlet type and location.
  
  
  METHODS
  By using field visits and online images, we inspected all licensed tobacco retail outlets in Philadelphia (N = 4,639). Point pattern analyses were used to identify significant clustering of tobacco outlets and outlets with exterior tobacco advertisements. Logistic regression was used to analyze the relationship between the outlet's acceptance of Supplemental Nutrition Assistance Program (SNAP) and Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) and the presence of tobacco advertisements.
  
  
  RESULTS
  Tobacco outlets with exterior tobacco advertisements were significantly clustered in several high-poverty areas. Controlling for racial/ethnic and income composition and land use, SNAP and WIC vendors were significantly more likely to have exterior (SNAP odds ratio [OR], 2.11; WIC OR, 1.59) and interior (SNAP OR, 3.43; WIC OR, 1.69) tobacco advertisements than other types of tobacco outlets.
  
  
  CONCLUSIONS
  Tobacco advertising is widespread at retail outlets, particularly in low-income and racial/ethnic minority neighborhoods. Policy makers may be able to mitigate the effects of this disparate exposure through tobacco retail licensing, local sign control rules, and SNAP and WIC authorization.
authors: University of Pennsylvania School of Design, 127 Meyerson Hall, 210 S 34th St, Philadelphia, PA 19104. Email: ahillier@design.upenn.edu.
authors: Amy
authors: A
authors: Hillier
authors: Drexel University School of Public Health, Philadelphia, Pennsylvania.
authors: Mariana
authors: M
authors: Chilton
authors: University of Pennsylvania School of Social Policy and Practice, Philadelphia, Pennsylvania.
authors: Qian-Wei
authors: QW
authors: Zhao
authors: Philadelphia Department of Public Health, Philadelphia, Pennsylvania.
authors: Dorota
authors: D
authors: Szymkowiak
authors: Philadelphia Department of Public Health, Philadelphia, Pennsylvania.
authors: Ryan
authors: R
authors: Coffman
authors: Philadelphia Department of Public Health, Philadelphia, Pennsylvania.
authors: Giridhar
authors: G
authors: Mallya
mesh_terms: D000329:Advertising / Q000706:statistics & numerical data*; D003132:Commerce / Q000706:statistics & numerical data*; D063105:Food Assistance / Q000458:organization & administration*; D006801:Humans; D015143:Philadelphia / Q000453:epidemiology; D011203:Poverty; D015995:Prevalence; D011632:Public Assistance / Q000458:organization & administration; D012189:Retrospective Studies; D012907:Smoking / Q000453:epidemiology*; D062789:Tobacco Products / Q000600:supply & distribution*; D014505:Urban Population
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