Availability and accessibility of South Asian tobacco products in the United States

Background/Significance: Tobacco use continues to rise in South Asia, and despite the rapid growth of the South Asian population in the U.S., tobacco use among this second largest Asian American subgroup remains an underappreciated community health concern. Recent efforts have focused on assessing prevalence and predictors of cultural products, especially smokeless tobacco. However, scant attention has been paid to the availability and accessibility of these distinct forms of tobacco in the U.S. retail environment. Objective/Purpose: To examine the availability and accessibility of culturally-specific tobacco products in 16 U.S. cities with large South Asian ethnic enclaves, and identify similarities and differences based on region and population characteristics. Methods: Using a standardized data collection instrument adapted from California's Tobacco Control Program, we collected information on commercial outlets selling cultural tobacco products, including retailer license laws, breadth of products, and ease of accessibility. For available products we examined regulatory labeling, such as warning labels (constituent ingredients, health warnings) and evidence of tax payments (state, import). Results: We will present similarities and differences regarding availability and accessibility of culturally-specific tobacco products between research sites (ethnic enclaves) and among various types of commercial outlets. We highlight relationships between specific characteristics of the ethnic enclaves (e.g. South Asian population density, concentration of ethnic outlets) and degree of availability and accessibility. Discussion/Conclusions: Availability and ease of access has considerable impact on tobacco use norms. As cultural tobacco products are ubiquitous in the South Asian subcontinent, it is important to gauge if, and to what extent, such products are present in ethnic enclaves in the U.S. Understanding the degree of availability/accessibility and level of adherence with established tobacco control regulations will aid in contributing to an ecological approach to reducing use of these distinct products and associated disparities in the understudied South Asian population in the United States.