Local Retail Tobacco Environment Regulation: Early Adoption in the United States

Objectives: In this paper, we identify sociodemographic and policy environment characteristics of early adopters of retail tobacco control policies in US localities. Methods: We interviewed a sample of local tobacco control programs on policy progress for 33 specific policies, along with other program characteristics. We combine these results with secondary data in logistic regression analysis. Results: We interviewed personnel from 80 (82% of 97) county tobacco control programs from 24 states. Localities with lower smoking rates (OR: 0.7; 95%: 0.6-0.9) or higher excise taxes (OR: 6.0; 95%: 1.4-26.0) were more likely to have adopted a retail policy by late 2015. Early adopters were less likely to have voted majority Republican in the 2012 election (OR: 0.03; 95%: 0.00-0.34) or to have higher percentages of African-American population (OR: 0.9; 95%: 0.8-0.99). Conclusions: Whereas localities with more resources, eg, program capacity, political will or policy options, were more likely to adopt policies by 2015, those with higher smoking rates and proportions of priority populations were less likely to do so. As local retail policy work becomes more commonplace, only time will tell if this "rich-get-richer" trend continues, or if the contexts in which retail policies are adopted diversify.