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 10