Place-Based Approaches to Tobacco Control in China

Lung cancer is the leading cause of cancer-related death globally, with tobacco consumption being the primary cause. Various tobacco control interventions have been successful in reducing the burden of tobacco-attributable deaths, but these successes have not been uniform in all countries and socio-demographical groups. The development of place-based approaches using a range of novel spatial methods offers new policy opportunities for effective tobacco control. This chapter provides an overview of place-based approaches to tobacco control adopted in various jurisdictions, followed by a brief review of the types of spatial methods that have been applied in this field of research. We focus on methodological approaches examining the patterning of tobacco retail (e.g., kernel density estimation, k-function analysis, GPS exposure), investigating the drivers of retail patterning and smoking behaviours (e.g., spatial regressions such as geographically weighted regression, multilevel modelling, generalised additive modeling), as well as methods for considering the likely impacts of place-based tobacco control approaches (e.g., simulations and agent-based modelling). Finally, we use China, the largest consumer and producer of tobacco, and a country experiencing an increasing burden of tobacco-attributable lung cancer, as a case study to interrogate the application of spatial methods to understand the local tobacco retail market and the potential impacts of place-based retail restrictions on the local market. This chapter argues that spatial methods offer the opportunity to enhance our context-specific understanding of the local tobacco retail market and smoking behaviours, with significant potential to inform effective tobacco control policymaking and prevent cancers attributable to tobacco smoking.