Does tobacco retailer availability influence changes in smoking from pregnancy to postpartum?

Evidence suggests that built environments influence consumptive behaviors such as smoking. This study examined whether tobacco retailer density affects smoking cessation among pregnant women in Oregon. Using geocoded data from the Pregnancy Risk Assessment Monitoring System and tobacco retailer locations, we applied multinomial logistic regression to compare women who relapsed postpartum or smoked throughout pregnancy with those who maintained cessation 2–6 months postpartum. In high-density urban areas, retailer density was not associated with relapse (RRR=1.02, 95% CI: 0.93–1.14) or continued smoking (RRR=1.04, 95% CI: 0.93–1.15). Conversely, in low-density areas, retailer presence was inversely associated with relapse (RRR=0.22, 95% CI: 0.05–0.99) and showed a similar trend for sustained smoking. Findings suggest that tobacco retail environments may influence initiation more than cessation in urban settings, while relationships in rural areas are complex.