Louise Marsh, Ali Ajmal, Rob McGee, Lindsay Robertson, Claire Cameron, Crile Doscher

Evidence suggests inconsistent findings on the relationship between density of tobacco outlets around schools and risk of smoking among students. This study examines the density of tobacco outlets around secondary schools in New Zealand (NZ) and current smoking, experimental smoking, susceptibility to smoking, and attempted and successful tobacco purchasing. Smoking data came from the 2012 ASH Year 10 survey, a national survey of youth smoking in NZ. Geographic Information Systems were used to map tobacco retail outlets; a layer of secondary school locations was obtained from Koordinates.com. Logistic regression examined the relationship between density of outlets around schools and smoking behaviours, adjusting for individual-level and school-level confounders. Of the 27 238 students surveyed, 3.5% (952) were current smokers, 4.1% (n=1 128) were experimental smokers, and 39.8% (10 454) of nonsmokers were susceptible to smoking. An inverse relationship was found between the density of tobacco retail outlets and current smoking. Current smokers were significantly more likely to attempt to purchase tobacco if the density of tobacco retail outlets around their school was high. Non-smoking students were more likely to be susceptible to smoking if the density of tobacco outlets around their school was high. There was no statistically significant association between density of tobacco outlets and successful purchasing, nor experimental smoking. Restricting the permitted density of tobacco retail outlets around schools should be part of comprehensive tobacco control. In this regard, both smokers and non-smokers support the introduction of increased regulation of the tobacco retail environment to achieve our national smoke-free 2025 goal.