Assessing the causal effect of tobacco retail density on cardiovascular and pulmonary disease hospitalizations in the United States
Year: 2026
Type: article
Study design: Observational Study
Abstract: Objectives: High tobacco retail density is linked to greater tobacco-related disease, but most evidence is cross-sectional limiting causal inference. Here, we use longitudinal data (2002-2016) from 327 counties in five U.S. states to estimate the causal effect of reducing tobacco retail density on hospitalizations for cardiovascular and pulmonary diseases. Methods: County-level data for Kentucky, Maryland, New Jersey, New York, and North Carolina were included. Annual rates of hospitalizations for acute myocardial infarction, asthma, chronic obstructive pulmonary disease (COPD), ischemic heart disease (IHD), and stroke were analyzed; annual tobacco retail density was dichotomized at ≥1.26 retailers per 1000 population. Marginal structural models with stabilized inverse probability weights were used to adjust for time-varying confounders. Results: High tobacco retail density was associated with increased hospitalization incidence rate ratios (IRR) for asthma (IRR = 1.43 [1.21, 1.69]), COPD (IRR = 1.13 [95%CI: 1.01, 1.25]), IHD (IRR = 1.09 [95%CI: 1.00, 1.18]), and stroke (IRR = 1.08 [95%CI: 1.01, 1.15]). Incidence rate differences indicated that had all counties been below the cut point, thousands of hospitalizations would have been prevented over the 15-year study period. Conclusion: These findings provide further evidence supporting retail-focused tobacco control policies as effective strategies to reduce the burden of tobacco-related disease.
Source: Preventive Medicine Reports
Language: English
Subfield: Physiology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,610
Funders: Commonwealth Fund, Biogen, University of North Carolina, University of New Hampshire, Rush University, Japan Agency for Medical Research and Development, Kindai University, Universitaire Stichting, Nature Conservancy, Bethune Charitable Foundation, Union of Concerned Scientists, Samco Foundation, Tokyo Metropolitan Government, Cancer Research UK, Leverhulme Trust, Department of Health and Social Care, Royal Society, Rosetrees Trust, Deutsche Forschungsgemeinschaft, National Natural Science Foundation of China, Universiteit Utrecht, Fonds De La Recherche Scientifique - FNRS, Belgian Federal Science Policy Office, China Postdoctoral Science Foundation, Ministero della Salute, National Research Foundation of Korea, Inamori Foundation, Iran National Science Foundation, Vetenskapsrådet, Mitsubishi Foundation, Natural Science Foundation of Heilongjiang Province, Norges Forskningsråd, Deutsche Krebshilfe, Natural Science Foundation of Shandong Province, Kobayashi Foundation for Cancer Research, Murata Science Foundation, Università degli Studi di Messina, Inter-American Institute for Global Change Research, Sekisui Chemical, Universitas Padjadjaran, Institute of Nano Science and Technology, Major Scientific and Technological Innovation Project of Shandong Province, Leverhulme Research Centre for Functional Materials Design, National Institutes of Health, Canadian Institutes of Health Research, Engineering and Physical Sciences Research Council, Japan Society for the Promotion of Science, Japan Science and Technology Agency, Natural Science Foundation of Anhui Province, Board of Research in Nuclear Sciences, National Key Research and Development Program of China, Guangxi Key Research and Development Program, NIHR Cambridge Biomedical Research Centre, Student Research Committee, Tabriz University of Medical Sciences, National Cancer Institute, National Institute of General Medical Sciences, Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Center for Surveillance, Epidemiology, and Laboratory Services
OpenAlex ID: W7154449682