States or municipalities can limit where tobacco products are sold, proximity of tobacco retailers to each other, and to homes and schools via zoning regulations, retailer licensing laws, and other regulations (e.g., bans on sales). Licensing laws restrict which businesses can sell tobacco products; zoning regulations prohibit sale of tobacco products in designated zones (e.g., near youth oriented facilities such as schools, parks, or playgrounds)1. Municipalities may also ban the sale of tobacco products in pharmacies and educational institutions2. Laws can be enacted individually or as part of broader land use and development plans3.
Note: The term “tobacco” in this strategy refers to commercial tobacco, not ceremonial or traditional tobacco. County Health Rankings & Roadmaps recognizes the important role that ceremonial and traditional tobacco play for many Tribal Nations, and our tobacco-related work focuses on eliminating the harms and inequities associated with commercial tobacco.
Expected Beneficial Outcomes (Rated)
Reduced youth smoking
Other Potential Beneficial Outcomes
Reduced tobacco use
Evidence of Effectiveness
Limiting tobacco retail outlets around homes and schools is a suggested strategy to reduce smoking, especially among youth1, 2, 4, 5, 6. Higher tobacco retail outlet density is associated with greater levels of youth experimentation with tobacco7, 8, youth smoking4, 5, 8, 9, 10, and adult smoking4, 11, even when controlling for neighborhood factors such as land use, racial composition, and poverty12. However, additional evidence is needed to confirm effects2.
Studies of regulations in Massachusetts and California suggest banning tobacco sales in pharmacies can decrease tobacco retailer density2, 13. Licensing restrictions2, 14 and other regulations2 that set minimum allowable distances between retailers and schools or ban sales near schools may also reduce tobacco retailer density6. Zoning restrictions appear to prevent new retailers from locating in designated areas but are not likely to alter existing tobacco retailer density2.
Tobacco retail outlet density is often highest in low income neighborhoods15, 16, 17, 18, neighborhoods with primarily minority residents19, 20, particularly black16, 21 or Hispanic residents17, 21, and high poverty, urban areas22.
Adults who are attempting to quit smoking and live near tobacco retail outlets appear less likely to quit smoking than adults who live farther from such outlets23.
Impact on Disparities
As of 2018, there are 186 municipalities, primarily in Massachusetts and California, with tobacco-free pharmacy laws in place24. CVS Health voluntarily stopped selling tobacco products in all municipalities in 201413, 25. Effective January 1, 2019, New York City will prohibit tobacco sales in pharmacies26.
San Francisco and Philadelphia are two examples of cities with tobacco retailer density caps. San Francisco set a cap of 45 tobacco retailer licenses per district in 201527 and Philadelphia set a density cap and banned tobacco retailers from locating within 500 feet of local schools, effective in early 201728. As of 2014, most US states have taken some form of action to reduce tobacco retailer density29.
CTFK-TFR - Campaign for Tobacco-Free Kids (CTFK), Tobacco Free Retailers (TFR). You can shop tobacco-free: find stores that don't sell tobacco products.
PHTPC-TRL - Public Health and Tobacco Policy Center (PHTPC). Tobacco retail licensing (TRL): Promoting health through local sales regulations. Boston: Public Health Advocacy Institute, Northeastern University School of Law; 2018.
PHLC-Tobacco zoning - Tobacco Control Legal Consortium (TCLC). Land use/zoning. Saint Paul: Public Health Law Center (PHLC).
CPHSS TCLC-Brossart 2014 - Brossart L, Moreland-Russell S, Walsh H, et al. Policy strategies: A tobacco control guide. St. Louis: Center for Public Health Systems Science (CPHSS), George Warren Brown School of Social Work, Washington University, Tobacco Control Legal Consortium (TCLC); 2014.
ANRF-Tobacco-free pharmacies - American Nonsmokers’ Rights Foundation (ANRF). Colleges, hospitals, housing, & more: Municipalities with tobacco-free pharmacy laws. 2018.
CounterTobacco-Licensing and zoning - CounterTobacco.org. Licensing and zoning. University of North Carolina.
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1 PHLC-Licensing and zoning - Tobacco Control Legal Consortium (TCLC). Using licensing and zoning to regulate tobacco retailers: Tips and tools. Saint Paul: Public Health Law Center (PHLC). 2016.
2 Ackerman 2017 - Ackerman A, Etow A, Bartel S, Ribisl KM. Reducing the density and number of tobacco retailers: Policy solutions and legal issues. Nicotine & Tobacco Research. 2017;19(2):133-140.
3 TCN 2012 - Tobacco Control Network (TCN). Executive summary: 2012 Policy platform on tobacco prevention and control. Atlanta: Tobacco Technical Assistance Consortium (TTAC); 2012.
4 AHA-Mozaffarian 2012 - Mozaffarian D, Afshin A, Benowitz NL, et al. Population approaches to improve diet, physical activity, and smoking habits: A scientific statement from the American Heart Association (AHA). Circulation. 2012;126(12):1514-63.
5 Gwon 2017* - Gwon SH, DeGuzman PB, Kulbok PA, Jeong S. Density and proximity of licensed tobacco retailers and adolescent smoking: A narrative review. The Journal of School Nursing. 2017;33(1):18-29.
6 Myers 2015* - Myers AE, Hall MG, Isgett LF, Ribisl KM. A comparison of three policy approaches for tobacco retailer reduction. Preventive Medicine. 2015;74:67-73.
7 Schleicher 2016* - Schleicher NC, Johnson TO, Fortmann SP, Henriksen L. Tobacco outlet density near home and school: Associations with smoking and norms among US teens. Preventive Medicine. 2016;91:287-293.
8 Adams 2013 - Adams ML, Jason LA, Pokorny S, Hunt Y. Exploration of the link between tobacco retailers in school neighborhoods and student smoking. Journal of School Health. 2013;83(2):112-118.
9 Lipperman-Kreda 2016* - Lipperman-Kreda S, Grube JW, Friend KB, Mair C. Tobacco outlet density, retailer cigarette sales without ID checks and enforcement of underage tobacco laws: Associations with youths’ cigarette smoking and beliefs. Addiction. 2016;111(3):525-532.
10 Lipperman-Kreda 2014* - Lipperman-Kreda S, Mair C, Grube JW et al. Density and proximity of tobacco outlets to homes and schools: Relations with youth cigarette smoking. Prevention Science. 2014;15(5):738-744.
11 Cantrell 2016* - Cantrell J, Pearson JL, Anesetti-Rothermel A, Xiao H, Kirchner TR, Vallone D. Tobacco retail outlet density and young adult tobacco initiation. Nicotine & Tobacco Research. 2016;18(2):130-137.
12 Novak 2006 - Novak SP, Reardon SF, Raudenbush SW, Buka SL. Retail tobacco outlet density and youth cigarette smoking: A propensity-modeling approach. American Journal of Public Health. 2006;96(4):670–6.
13 Jin 2016* - Jin Y, Lu B, Klein EG, Berman M, Foraker RE, Ferketich AK. Tobacco-free pharmacy laws and trends in tobacco retailer density in California and Massachusetts. American Journal of Public Health. 2016;106(4):679-685.
14 Coxe 2014* - Coxe N, Webber W, Burkhart J, et al. Use of tobacco retail permitting to reduce youth access and exposure to tobacco in Santa Clara County, California. Preventive Medicine. 2014;67(Suppl 1):S46-S50.
15 Frick 2013* - Frick M, Castro MC. Tobacco retail clustering around schools in New York City: Examining “place” and “space.” Health & Place. 2013;19(1):15-24.
16 Ribisl 2016* - Ribisl KM, Luke DA, Bohannon DL, Sorg AA, Moreland-Russell S. Reducing disparities in tobacco retailer density by banning tobacco product sales near schools. Nicotine & Tobacco Research. 2016;19(2):239-244.
17 D’Angelo 2016* - D’Angelo H, Ammerman A, Gordon-Larsen P, et al. Sociodemographic disparities in proximity of schools to tobacco outlets and fast-food restaurants. American Journal of Public Health. 2016;106(9):1556-1562.
18 Fakunle 2016* - Fakunle DO, Milam AJ, Furr-Holden CD, et al. The inequitable distribution of tobacco outlet density: The role of income in two Black Mid-Atlantic geopolitical areas. Public Health. 2016;136:35-40.
19 Peterson 2011* - Peterson NA, Yu D, Morton CM, et al. Tobacco outlet density and demographics at the tract level of analysis in New Jersey: A statewide analysis. Drugs: Education, Prevention, and Policy. 2011;18(1):47–52.
20 Siahpush 2010* - Siahpush M, Jones PR, Singh GK, Timsina LR, Martin J. Association of availability of tobacco products with socio-economic and racial/ethnic characteristics of neighbourhoods. Public Health. 2010;124(9):525–9.
21 Loomis 2013* - Loomis BR, Kim AE, Goetz JL, Juster HR. Density of tobacco retailers and its association with sociodemographic characteristics of communities across New York. Public Health. 2013;127(4):333-338.
22 Davis 2015a* - Davis B, Grier S. A tale of two urbanicities: Adolescent alcohol and cigarette consumption in high and low-poverty urban neighborhoods. Journal of Business Research. 2015;68(10):2109-2116.
23 Reitzel 2011 - Reitzel LR, Cromley EK, Li Y, et al. The effect of tobacco outlet density and proximity on smoking cessation. American Journal of Public Health. 2011;101(2):315–20.
24 ANRF-Tobacco-free pharmacies - American Nonsmokers’ Rights Foundation (ANRF). Colleges, hospitals, housing, & more: Municipalities with tobacco-free pharmacy laws. 2018.
25 CVS-Tobacco-free - CVS Health. Be the first tobacco-free generation.
26 Truth Initiative-Retailers - Truth Initiative. How some local governments are keeping the number of tobacco retailers in check. 2017.
27 SF Tobacco-free - San Francisco Tobacco-Free. Reducing tobacco retail density in San Francisco. 2016.
28 PDPH-Tobacco retailing - City of Philadelphia, Department of Public Health (PDPH). Commissioner’s Office: Regulation relating to tobacco retailing.
29 Luke 2016 - Luke DA, Sorg AA, Combs T, et al. Tobacco retail policy landscape: A longitudinal survey of US states. Tobacco Control. 2016;25(Suppl 1):i44-i51.
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