Effect of tobacco outlet density on quit attempts in Korea: a multi-level analysis of the 2015 Korean Community Health Survey

OBJECTIVES: This study aimed to examine whether the regional density of tobacco outlets in Korea was associated with the likelihood of attempting to quit among smokers METHODS: This study was designed as a secondary data analysis of a cross-sectional study. Data from the 2015 Korean Com-munity Health Survey and tobacco outlet registrations in 17 metropolitan cities and provinces with 254 communities in Korea were used for the analysis. In total, 41,013 current smokers (≥ 19 years of age) were included. Multi-level logistic regression anal-ysis was conducted to investigate regional differences associated with smokers’ attempts to quit and to evaluate the effects of in-dividual and regional characteristics on quit attempts. RESULTS: Higher tobacco outlet density was associated with lower odds of attempting to quit. Smokers who resided in districts with the highest tobacco outlet density were 18% less likely to attempt quitting (odds ratio, 0.82; 95% confidence interval, 0.70 to 0.98) than smokers who resided in the regions with the lowest tobacco outlet density (intraclass correlation coefficient, 0.030). CONCLUSIONS: This study showed that quit attempts were related to community-level factors, such as tobacco outlet density, as well as other individual factors. These findings support the implementation of national policies restricting the number of to-bacco outlets within communities or zones and limiting tobacco marketing in tobacco outlets.