The changing retail landscape for tobacco: dollar stores and the availability of cheap cigarettes among tobacco-related priority populations

IntroductionDollar stores are rapidly altering the retail landscape for tobacco. Two of the three largest chains sell tobacco products in more than 24 000 stores across the USA. We sought to examine whether dollar stores are more likely to be located in disadvantaged neighbourhoods and whether dollar stores charge less for cigarettes than other tobacco retailers.MethodsData were collected from a statewide random sample of licensed tobacco retailers in California (n=7678) in 2019. Logistic regression modelled odds of a census tract containing at least one dollar store as a function of tract demographics. Linear mixed models compared price of the cheapest cigarette pack by store type, controlling for tract demographics.ResultsCensus tracts with lower median household income, rural status and higher proportions of school-age youth were more likely to contain at least one dollar store. The cheapest cigarette pack cost less in dollar stores compared with all store types examined except tobacco shops. Estimated price differences ranged from $0.32 (95% CI: 0.14 to 0.51) more in liquor stores and $0.39 (95% CI: 0.22 to 0.57) more in convenience stores, to $0.82 (95% CI: 0.64 to 1.01) more in small markets and $1.86 (95% CI: 1.61 to 2.11) more in stores classified as ‘other’.ConclusionsDollar stores may exacerbate smoking-related inequities by contributing to the availability of cheaper cigarettes in neighbourhoods that are lower income, rural and have greater proportions of youth. Pro-equity retail policies, such as minimum price laws and density reduction policies, could mitigate the health consequences of dollar stores’ rapid expansion.

Food Shopping Experiences Among Dollar Store Shoppers in Fresno and Boston During the COVID-19 Pandemic

Objectives In this qualitative study, we examined the impact of the COVID-19 pandemic on motivations, decision-making, and food shopping among dollar store shoppers in Fresno, CA and Boston, MA. Eligible participants were ≥18 years old, lived in Boston or Fresno, spoke English or Spanish, and shopped at a dollar store within the past month. Methods Using convenience sampling, participants were recruited via flyers at 10 dollar stores in low-income neighborhoods in Fresno and Boston and posts in community Facebook groups. Interviews in Boston (n = 25) and Fresno (n = 26) were conducted remotely from August-December 2020. Results Our participants were primarily low-income, English-speaking women who shopped at dollar stores about once per week. Preliminary qualitative content analysis shows that key shopper motivations included low prices, product variety, and convenience. Shelf-stable foods and snacks were frequently purchased, especially for children. Shoppers in Fresno relied more on dollar stores for groceries and fresh produce, while Boston shoppers primarily purchased shelf-stable foods or snacks. Shoppers in both cities desired increased availability of fresh foods. Shoppers reported fear of shopping, limited stock, financial stress, and fewer trips early in the pandemic. Shopping increased by summer. Shoppers with children reported increased food expenditures during the pandemic, including at dollar stores, as closed schools meant that children consumed meals at home. Conclusions Dollar stores continue to be an important food resource despite challenges related to the pandemic. Considering frequent use, food purchases, and desire for more fresh foods among shoppers, dollar stores chains may find a receptive audience for increasing their fresh food stock. Funding Sources Ethical approval was provided by the Tufts University Social, Behavioral & Educational Research Institutional Review Board. Funding was provided by the Bergstrom Foundation and Tufts Friedman School of Nutrition Science and Policy.

Equity Impacts of Dollar Store Vaccine Distribution

We use geospatial data to examine the unprecedented national program currentlyunderway in the United States to distribute and administer vaccines against COVID-19. We quantify the impact of the proposed federal partnership with the companyDollar General to serve as vaccination sites and compare vaccine access with DollarGeneral to the current Federal Retail Pharmacy Partnership Program. Although dollarstores have been viewed with skepticism and controversy in the policy sector, we showthat, relative to the locations of the current federal program, Dollar General stores aredisproportionately likely to be located in Census tracts with high social vulnerability;using these stores as vaccination sites would greatly decrease the distance to vaccinesfor both low-income and minority households. We consider a hypothetical alternativepartnership with Dollar Tree and show that adding these stores to the vaccinationprogram would be similarly valuable, but impact different geographic areas than theDollar General partnership. Adding Dollar General to the current pharmacy partnersgreatly surpasses the goal set by the Biden administration of having 90% of the popu-lation within 5 miles of a vaccine site. We discuss the potential benefits of leveragingthese partnerships for other vaccinations, including against influenza.