title: Is neighbourhood access to tobacco outlets related to smoking behaviour and tobacco-related health outcomes and hospital admissions?
abstract: Although the harms of tobacco use are widely accepted, few studies have examined the relationship between access to tobacco outlets and hospital admissions. This study aimed to examine the relationship between neighbourhood access to tobacco outlets, smoking and hospital admissions and self-reported morbidity.
  
  
  
  Responses as to smoking behaviour were obtained from 12,270 adult participants in Western Australia (2003-2009) and individually record-linked to hospital admissions and geographically linked to tobacco outlets.
  
  
  
  Neighbourhood access to tobacco outlets was marginally positively associated with being a current versus a past smoker. Tobacco outlet access was also positively associated with heart disease for smokers but not non-smokers. For smokers, each additional outlet within 1600m of home was associated with a 2% increase in the odds of heart disease.
  
  
  
  Smokers with greater access to tobacco outlets were more likely to be diagnosed with or admitted to hospital for heart disease. Regulating the density of tobacco outlets in the community has immense potential to improve health benefits and our results motivate the need for future longitudinal studies to confirm this hypothesis.
authors.affiliation: Centre for the Built Environment and Health, School of Population Health, The University of Western Australia, 35 Stirling Hwy, Crawley, Western Australia 6009, Australia. Electronic address: rosiebarnes97@gmail.com.
authors.forename: Rosanne
authors.initials: R
authors.lastname: Barnes
authors.affiliation: Centre for the Built Environment and Health, School of Population Health, The University of Western Australia, 35 Stirling Hwy, Crawley, Western Australia 6009, Australia.
authors.forename: Sarah A
authors.initials: SA
authors.lastname: Foster
authors.affiliation: Center for Perinatal Pediatric and Environmental Epidemiology, School of Medicine, Yale University, 1 Church Street, 6th Floor, New Haven, CT 06510, USA; Telethon Kids Institute, The University of Western Australia, 100 Roberts Rd., Subiaco, Western Australia 6008, Australia.
authors.forename: Gavin
authors.initials: G
authors.lastname: Pereira
authors.affiliation: McCaughey VicHealth Centre for Community Wellbeing, School of Population and Global Health, The University of Melbourne, Level 5, 207 Bouverie Street, Parkville, 3010 Melbourne, Victoria, Australia.
authors.forename: Karen
authors.initials: K
authors.lastname: Villanueva
authors.affiliation: Centre for the Built Environment and Health, School of Population Health, The University of Western Australia, 35 Stirling Hwy, Crawley, Western Australia 6009, Australia.
authors.forename: Lisa
authors.initials: L
authors.lastname: Wood
mesh_terms: D002318:Cardiovascular Diseases / Q000175:diagnosis; D003132:Commerce / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000175:diagnosis; D010343:Patient Admission / Q000706:statistics & numerical data*; D012111:Residence Characteristics; D012907:Smoking / Q000453:epidemiology* / Q000523:psychology; D011795:Surveys and Questionnaires; D062789:Tobacco Products / Q000600:supply & distribution*; D014904:Western Australia / Q000453:epidemiology
keywords: Cardiovascular; Environment; Epidemiology; Respiratory; Smoking