title: Association Between Distance From Home to Tobacco Outlet and Smoking Cessation and Relapse.
abstract: OBJECTIVE
  Reduced availability of tobacco outlets is hypothesized to reduce smoking, but longitudinal evidence on this issue is scarce.
  
  
  OBJECTIVE
  To examine whether changes in distance from home to tobacco outlet are associated with changes in smoking behaviors.
  
  
  METHODS
  The data from 2 prospective cohort studies included geocoded residential addresses, addresses of tobacco outlets, and responses to smoking surveys in 2008 and 2012 (the Finnish Public Sector [FPS] study, n = 53 755) or 2003 and 2012 (the Health and Social Support [HeSSup] study, n = 11 924). All participants were smokers or ex-smokers at baseline. We used logistic regression in between-individual analyses and conditional logistic regression in case-crossover design analyses to examine change in walking distance from home to the nearest tobacco outlet as a predictor of quitting smoking in smokers and smoking relapse in ex-smokers. Study-specific estimates were pooled using fixed-effect meta-analysis.
  
  
  METHODS
  Walking distance from home to the nearest tobacco outlet.
  
  
  METHODS
  Quitting smoking and smoking relapse as indicated by self-reported current and previous smoking at baseline and follow-up.
  
  
  RESULTS
  Overall, 20 729 men and women (age range 18-75 years) were recruited. Of the 6259 and 2090 baseline current smokers, 1744 (28%) and 818 (39%) quit, and of the 8959 and 3421 baseline ex-smokers, 617 (7%) and 205 (6%) relapsed in the FPS and HeSSup studies, respectively. Among the baseline smokers, a 500-m increase in distance from home to the nearest tobacco outlet was associated with a 16% increase in odds of quitting smoking in the between-individual analysis (pooled odds ratio, 1.16; 95% CI, 1.05-1.28) and 57% increase in within-individual analysis (pooled odds ratio, 1.57; 95% CI, 1.32-1.86), after adjusting for changes in self-reported marital and working status, substantial worsening of financial situation, illness in the family, and own health status. Increase in distance to the nearest tobacco outlet was not associated with smoking relapse among the ex-smokers.
  
  
  CONCLUSIONS
  These data suggest that increase in distance from home to the nearest tobacco outlet may increase quitting among smokers. No effect of change in distance on relapse in ex-smokers was observed.
authors.affiliation: Department of Public Health, University of Turku, Turku, Finland.
authors.forename: Anna
authors.initials: A
authors.lastname: Pulakka
authors.affiliation: Finnish Institute of Occupational Health, Helsinki, Finland.
authors.forename: Jaana I
authors.initials: JI
authors.lastname: Halonen
authors.affiliation: Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, Massachusetts.
authors.forename: Ichiro
authors.initials: I
authors.lastname: Kawachi
authors.affiliation: Finnish Institute of Occupational Health, Helsinki, Finland.
authors.forename: Jaana
authors.initials: J
authors.lastname: Pentti
authors.affiliation: Department of Public Health, University of Turku, Turku, Finland4School of Health Sciences, University of Tampere, Tampere, Finland.
authors.forename: Sari
authors.initials: S
authors.lastname: Stenholm
authors.affiliation: Institute of Behavioural Sciences, University of Helsinki, Helsinki, Finland.
authors.forename: Markus
authors.initials: M
authors.lastname: Jokela
authors.affiliation: Department of Geography and Geology, University of Turku, Turku, Finland.
authors.forename: Ilkka
authors.initials: I
authors.lastname: Kaate
authors.affiliation: Clinicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland.
authors.forename: Markku
authors.initials: M
authors.lastname: Koskenvuo
authors.affiliation: Department of Public Health, University of Turku, Turku, Finland8Turku University Hospital, Turku, Finland.
authors.forename: Jussi
authors.initials: J
authors.lastname: Vahtera
authors.affiliation: Finnish Institute of Occupational Health, Helsinki, Finland7Clinicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland9Department of Epidemiology and Public Health, University College London Medical School, London, England.
authors.forename: Mika
authors.initials: M
authors.lastname: Kivimäki
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015331:Cohort Studies; D003132:Commerce; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012907:Smoking / Q000453:epidemiology*; D016540:Smoking Cessation / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D062789:Tobacco Products; D016138:Walking; D055815:Young Adult