SAVI Community Trends Report: Unequal Access Tobacco Epidemic Report 2017 FINAL | Page 10

SAVI community trends » unequal access: tobacco retail in the indianapolis metro area
and resources need to be targeted. Our results
demonstrate that access to tobacco products
in Indianapolis occurs in greater proximity to
disadvantaged populations than it does to the
population-at-large. Understanding tobacco
access informs discussion of potential policy
change and interventions for reduced tobacco
use, and several IOM recommendations (30, 32
and 35) address geographically-based meth-
ods for limiting tobacco access. As the tobacco
industry continues its efforts to introduce and
“place” new products, the public health sector
must consider these strategies and others to
reduce population access to harmful tobacco
products and population exposure to associated
marketing.
Indianapolis occur in concentrated geographic
areas, it makes sense to consider geographically-
focused action.
Some examples are given below.
• The Marion County Public Health Depart-
ment (MCPHD) has been surveying apart-
ment complexes over time to determine the
smoke-free status of their properties. They
are working with some of the communities
that have indicated interest in putting in
smoke-free air policies. Because of these
efforts, MCPHD has data on where there
are smoking-free apartments available and
where there are gaps. As such, we can look
for geographic patterns in terms of which
apartment complexes are not self-designat-
ing as smoke-free and target outreach about
the benefits of smoke-free residential
environments to those communities.
• The Indianapolis Public Housing Authority
put a smoke-free policy in place for all of
their apartment communities almost two
years before the late 2016 final ruling of
the U.S. Department of Housing and
Urban Development (HUD) that mandates
all multi-family public housing to be
smoke-free.
• Hospitals have the opportunity to invest in
smoking cessation and counter-marketing
programs that are designed for the most
vulnerable populations in their service areas.
Nonprofit hospitals can invest in such pro-
grams as part of their required community
benefit investments.
• The Nurse Family Partnership (NFP), which
connects first-time, low-income moms with
registered nurses for home visits, trains its
nurses on evidence-based smoking cessa-
tion interventions. Because NFP is a home
visiting program that targets vulnerable
mothers, its cessation programming is a
valuable complement to the Baby & Me
Tobacco Free program offered via health-
care providers and to the Indiana Tobacco
Quitline, Indiana’s telephone-based tobacco
cessation service.
Coordinated data collection efforts on POS
marketing are occurring across the State of
Indiana in an effort to understand how POS
marketing is being handled in Indiana and
the potential impact on our population. This
knowledge will be used to educate our citizens
and inform future policy initiatives.
Indiana policymakers should debate whether
the state should regulate retail POS tobacco
products, similar to what is occurring else-
where in the country. For example, other
states and communities have successfully
capped the number of tobacco retail outlets,
required a minimum distance between outlets,
regulated price discounting, and prohibited
the sale of tobacco products at certain types
of establishments, such as in pharmacies and
restaurants. [27] [73-76]
In Indiana, such action at the local level is not
feasible because our state’s preemptive tobac-
co control laws, long supported by the tobacco
industry, [77] prohibit localities from enacting
tobacco control ordinances that are more
stringent than state laws.
Despite the legal barriers in Indiana, tobacco
control is not totally dependent on government
action. Options for action still exist. Because the
socioeconomic disparities in tobacco access in
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