Smoke detector: Are you at risk to start smoking?

Cigarette smoking is the leading cause of preventable illness and death. Because it diminishes lung capacity, research suggests that smokers are at a higher risk of developing COVID-19 complications, according to the World Health Organization. Moreover, by having their fingers near their mouths, smokers may inadvertently increase the chance of transmitting the virus.

Nevertheless, it can be challenging to quit — and one reason might be the smoker’s address.

With my colleagues in ChristianaCare’s Value Institute, I conducted a study that found a link between smoking and the number of tobacco outlets in New Castle County, Delaware. A tobacco outlet is any store that sells cigarettes, including convenience and liquor stores.

The results were published in Preventing Chronic Disease: Public Health Research, Practice, and Policy, a journal of the Centers for Disease Control and Prevention. Here’s more about what we learned:

Which areas in New Castle County have the highest number of tobacco outlets?

Wilmington has double the concentration of outlets of anywhere else in New Castle County. There are more than 40 tobacco outlets within a half-mile radius of Wilmington Hospital at 12th and Washington streets.

Is there a link between the outlets’ location and low-income residents?

The highest number of tobacco outlets were in areas with high rates of poverty. Residents were predominately minority in terms of race and ethnicity.

But can’t people make a personal choice when it comes to smoking?

There is a reason why cigarette advertising was banned on TV and elsewhere; it was having a significant impact on people’s choices. Pretend you are on a diet. You go to work with no intention of eating chocolate cake, but someone has left one in the breakroom. Suddenly, the chances of you eating a piece go up dramatically.

Tobacco marketing is relatively unregulated in tobacco outlets. The windows are plastered with advertising. So, if you live in a community full of cigarette advertising, it might make quitting more difficult.

What’s more, tobacco products are generally less expensive in low-income areas than in affluent communities. A higher price can be a deterrent.

What if people stay out of the stores that sell cigarettes?

When areas have a higher rate of smoking, you are exposed to the smell and sight of people smoking — which trigger cravings.

How does the study help decision-makers?

Policymakers can institute more tobacco-control measures or impose a minimum price law so tobacco companies can’t offset the impact of taxation in low-income neighborhoods to reduce the price to the consumer.

In other research, we’re investigating innovative ways to increase the impact of smoking-cessation treatments. We’re tailoring them specifically for underserved people who are exposed to smoking at higher rate.

Learn more about how to stop smoking with ChristianaCare’s free Smoking Cessation Program and read five success stories about people who kicked the habit.

Scott Siegel, Ph.D., MHCDS, is director of Population Health Research at ChristianaCare’s Value Institute.