Using GIS to map the geographical distribution of tobacco use policies; implications for local health department strategic planning

Background: Tobacco control policies reduce tobacco-related disease by making environments smokefree, which then encourage cessation and discourage initiation, thus reducing tobacco use prevalence.  Neighborhoods with fewer such policies may increase residents’ risk of tobacco-related disease. Despite overall increases in tobacco control policies, the geographic distribution of such policies has been uneven, with disparities increasing in communities lacking strong tobacco control regulation.

Methods:  All major tobacco use policies adopted in Los Angeles County (LAC) were compiled and geocoded at the city level (N=88) using geographic information services (GIS). Polices were spatially joined to census demographic data TIGER files. Hotspot analyses were conducted to identify areas with fewer policies. Further analyses will include joining current smoking prevalence from the 2011 LAC Health Survey using spatial regression methods in ArcGIS and STATA.

Results:  Types of policies included tobacco retail licensing (n=40), multi-unit housing (n=8), comprehensive outdoor areas (n=14), outdoor dining (n=7), parks (n=40), beaches (n=13), e-cigarette tobacco retail licensing (n=62), and e-cigarette bans in public places (n=19). Hotspots in LAC were identified at the city level.  Further analyses will address tobacco control policies and tobacco use rates throughout California, in relationship to census demographic data.

Conclusion: Ecological analyses utilizing GIS hotspot methodology and spatial regression can identify areas lacking tobacco control policies, thus aiding health department strategic planning. Preliminary results highlight hotspot areas in LAC that have relatively few tobacco control policies. These results can assist local health departments in strategic planning and community groups in targeting advocacy and cessation efforts.