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William J. McCarthy, PhD, Ritesh Mistry, PhD, Yao Lu, PhD, Minal Patel, MPH, Hong Zheng, MPH and Barbara Dietsch, PhD

William J. McCarthy is with the School of Public Health and the Department of Psychology, University of California, Los Angeles, and WestEd, Los Alamitos, CA. Ritesh Mistry and Minal Patel are with the School of Public Health, University of California, Los Angeles. Yao Lu is with the Department of Sociology, Columbia University, New York, NY. Hong Zheng and Barbara Dietsch are with WestEd.

Correspondence: Correspondence should be sent to William J. McCarthy, PhD, UCLA Division of Cancer Prevention and Control Research, Mail Code 690015, 650 S Charles E. Young Dr, Los Angeles, CA 90095-6900 (e-mail: wmccarth{at}ucla.edu). Reprints can be ordered at http://www.ajph.org by clicking the "Reprints/Eprints" link.

Objectives. We examined the relationship between students' tobacco use and the density and proximity of tobacco retailers near their schools.

Methods. We used data from the 2003–2004 California Student Tobacco Survey and California retail licensing data. Measures included students' self-reported tobacco use and geocoded state-reported locations of tobacco retailers. We used random-intercept generalized linear mixed modeling to jointly evaluate individual-level and school-level predictors.

Results. Density of retailers was associated with experimental smoking (odds ratio [OR] = 1.11; 95% confidence interval [CI] = 1.02, 1.21) but not established smoking (OR = 1.06; 95% CI = 0.94, 1.20). The effects on experimental smoking were confined to high school students (OR = 1.17; 95% CI = 1.06, 1.29) in urban areas (OR = 1.11; 95% CI = 1.01, 1.21); no effects were observed among middle school students or in rural schools. High school students were more likely to obtain cigarettes from a retailer; middle school students relied more heavily on social sources.

Conclusions. Our results support the plausibility of reducing rates of students' experimental smoking, but not established smoking, by restricting their access to commercial sources of tobacco in urban areas.