Researchers at CRESH (Centre for Research on Environment, Society and Health) from the Universities of Edinburgh and Glasgow have launched a new map of alcohol and tobacco outlets across Scotland. Dr Roberto Valiente Borox, a CRESH researcher and member of SPECTRUM, explains the potential of this publicly available tool to explore the availability of alcohol and tobacco at a neighbourhood level in Scotland. Why alcohol and tobacco environment matters? Alcohol and tobacco consumption are drivers of non-communicable diseases which is a global public health concern contributing significantly to preventable morbidity and mortality. In Scotland, over 11,000 deaths and 66,000 hospitalisations annually were attributed to alcohol or tobacco use. Despite these alarming figures, alcohol and tobacco products remain very accessible in our day-to-day environment. Previous studies by SPECTRUM researchers have identified several pathways through which alcohol and tobacco availability is related to higher consumption rates and health related problems 1, 2. First, higher concentration of alcohol and tobacco retailers in an area may lead to a higher physical accessibility to these products, with people travelling shorter distances to purchase them. It may also enhance market competition making these products more affordable due to price reductions. Moreover, the presence of alcohol and tobacco retailers can contribute to the normalisation and social acceptance of their use, potentially leading to higher rates of use. The availability of alcohol and tobacco and its health-related consequences vary across different geographies. In Scotland, the most deprived neighbourhoods have 2 and 1.4 times larger densities of tobacco and alcohol retailers respectively compared with the least deprived neighbourhoods 3. Similarly, deaths resulting from alcohol and tobacco use were 5.6 and 16.8 times greater in more deprived neighbourhoods 4, 5. All data at a glance: a small tour across the mapper The CRESHMap provides a user-friendly interface for interacting with diverse data. A step-by-step menu allows selection of different topics, including alcohol and tobacco retail availability and sociodemographic information. Within each topic, you can choose from various outcomes. For example, in the alcohol retail option, you can explore different forms of alcohol availability, filtering by off-trade (e.g., convenience stores), or on-trade (e.g., restaurants) retailers. The multi-step menu enables exploration of availability across different geographies and years. Data can be displayed for 14 different geographies, including Scottish Government data zones, Local Authority Government, and NHS Health Boards. Additionally, the CRESHMap included three specific time-points (2012, 2016 and 2020) for temporal analysis. Figure 1: Overview of mapper In addition to alcohol and tobacco availability, the CRESHMap displays contextual information about the sociodemographic factors such as income, employment, or crime rates, population density estimates or urban/rural neighbourhood status. It also provides relevant health indicators such as drug prescriptions, alcohol-related hospitalisations, and standardised mortality ratios at the data zone level. The strength of the CRESHMap lies in the vast heterogeneity of data it utilises. The CRESH team has established data agreements with official and reliable sources, such as local licensing boards, the Police Scotland InnKeepers Database, and the Register of Tobacco and Nicotine Vapour Product Retailers. An anonymised form of this data can be downloaded upon request. A useful tool for designing more liveable neighbourhoods The CRESHMap is a tool with tremendous potential. It allows you to easily identify specific areas of interest, compare data between them, and explore the relationship between alcohol and tobacco availability and other complex sociodemographic and economic indicators in each neighbourhood. Figure 2: Comparing alcohol outlet density with different socioeconomic and health indicators in a Central-East Glasgow City neighbourhood In summary, this tool is an excellent resource for policy decision-making. You can easily identify and delineate areas with alcohol and tobacco retail overprovision and/or concerning health indicators related to the use of these substances. Researchers, policymakers and the public can benefit from the information visualised in this tool to advocate for, or plan specific policy actions, addressing alcohol and tobacco overprovision and improving population health in the studied areas. The CRESHMap is a live tool. CRESH researchers continue working to incorporate new relevant data and upgrade tool functionalities. Planned future updates include expanding the geographical coverage to other regions within the UK as well as the geocoding of qualitative quotes that capture individual resident perceptions and experiences regarding alcohol and tobacco use and their availability in the environment. This addition will complement the objective data displayed in the mapper, providing users with a comprehensive understanding of people’s interactions with alcohol and tobacco environments and the impacts on their health. Access the CRESHMap tool Author Dr Roberto Valiente Borox | The University of Edinburgh profile Acknowledgements The web map was developed through funding provided through two sources: the SPECTRUM Consortium, funded by the UK Prevention Research Partnership (UKPRP), a multi-funder initiative that supports novel research into the primary prevention of non-communicable diseases to improve population health and reduce health inequalities. The Medical Research Council is the administrator of this grant under grant reference (MR/S037519/1). an Economic and Social Research Council (ESRC) funded study: ‘Change in alcohol and tobacco availability, population health and the lived experience’ awarded to CRESH researchers: Professor Niamh Shortt, Professor Jamie Pearce, Dr Tom Clemens, Professor Rich Mitchell, and Professor Carol Emslie (ES/S016775/1) References Shortt NK, Tisch C, Pearce J, Richardson EA & Mitchell R (2016). The density of tobacco retailers in home and school environments and relationship with adolescent smoking behaviours in Scotland. Tobacco Control, 25(1), 75-82. https://doi.org/10.1136/tobaccocontrol-2013-051473 Shortt NK, Rind E, Pearce J, Mitchell R & Curtis S (2018). Alcohol risk environments, vulnerability and social inequalities in alcohol consumption [Cross sectional]. Annals of the Association of American Geographers, 108(5), 1210-1227. https://www.tandfonline.com/doi/full/10.1080/24694452.2018.1431105 Shortt NK, Tisch C, Pearce J, Mitchell R, Richardson EA, Hill S, & Collin J (2015). A cross-sectional analysis of the relationship between tobacco and alcohol outlet density and neighbourhood deprivation. BMC Public Health 15, 1014. https://doi.org/10.1186/s12889-015-23211 The Scottish Public Health Observatory. Public Health Scotland (2023). https://scotland.shinyapps.io/ScotPHO_profiles_tool/ Public Health Scotland. Monitoring and Evaluating Scotland’s Alcohol Strategy (MESAS) (2022). Report. https://publichealthscotland.scot/media/13693/mesas-2022_english_jun2022.pdf This article was published on 2023-06-28
