Abstract
Introduction: The Northern Territory (NT) is a geographically large, sparsely populated territory in Australia. It has the highest smoking prevalence in Australia (13.3% compared to 8.3% nationwide). Although international and national studies report associations between tobacco retailer density and higher smoking prevalence, no Australian state or territory currently regulates the location or density of tobacco outlets.
Methods: In this article, we map the locations of retailers licensed to sell tobacco in the NT, analyse tobacco retailer density, and explore associations between tobacco retailer density, population density, percentage of First Nations residents, geographic remoteness and area socioeconomic status. We obtained licensing data in November 2023 from Licensing NT and, using Australian Bureau of Statistics Statistical Area 2 as our unit of analysis, we geolocated retailers and used multiple regression to analyse associations between tobacco retailer density and explanatory variables, including socioeconomic status, population density, percentage of First Nations residents and remoteness.
Results: The mean tobacco retailer density in the NT was 1.81 per 1000 residents (95% confidence interval 1.38-2.23 per thousand) and tobacco retailer density increased with remoteness (p=0.02), although this relationship did not follow a strict gradient because remote areas did not show a significant increase relative to outer regional areas. In bivariate analyses, population density and percentage of First Nations residents, and remoteness were significantly associated with tobacco retailer density. In the multivariate analysis, only remoteness remained statistically significant.
Conclusion: In the NT, tobacco retailer density increased with geographic remoteness, consistent with findings elsewhere in Australia. This finding is probably influenced by small population denominations. Compliance and enforcement are more difficult in small and geographically isolated communities, making it crucial that strategies to address tobacco supply are generated with community support. Policies should also ensure equitable access to smoking cessation support for people who are already addicted to nicotine.