Do Legal Drug Outlets Specializing in Selling Tobacco, Medical Marijuana, and Alcohol Endanger the Public Health of Residents in a Low-Income Community of Color?

Background and Purpose:  In California, retail businesses specializing in distributing tobacco, tobacco-related paraphernalia, and synthetic drugs (smoke shops), medical marijuana (medical marijuana dispensaries), and packaged alcohol (off-sale alcohol outlets) are legal and pervasive in many low-income communities of color. Yet, the public health impact of these three legal drug outlet types on these communities is unclear. While off-sale alcohol outlets are known to attract high levels of crime and violence to their immediate locations—creating dangerous public nuisances that threaten the health and well-being of neighborhood residents—minimal research has examined whether smoke shops and medical marijuana dispensaries similarly promote neighborhood crime and violence in these vulnerable communities. This mixed methods community-based participatory research is the first to examine the associations of crime and violence with these three legal drug outlets types in South Los Angeles, a large low-income urban community of color.

Methods: Qualitative data from community stakeholders (i.e., residents, organizers, public health officials, gang interventionists) were captured via 'community mapping:' a participatory method using paper maps that asked participants to spatially identify their community's highest crime locations. Participants identified smoke shops, medical marijuana dispensaries, and off-sale alcohol outlets as major neighborhood crime attractors. Guided by this qualitative data, we used geographic information systems (GIS) to spatially analyze the incidence of all property, violent, and total crimes (N = 37,575) committed in 2014 at 100, 200, 500, and 1,000 feet buffers around all smoke shops (n = 41), medical marijuana dispensaries  (n = 38), and off-sale alcohol outlets  (n = 99) in 7 South Los Angeles zip codes (population of 520,104 residents). For comparison, crime rates around the legal drug outlets were subsequently contrasted with those of community grocery/convenience stores  (n = 23) licensed to sell alcohol and tobacco—i.e., control businesses—via Kruskall-Wallis H tests.

Results: As anticipated based on our 'community mapping' stakeholder data, mean property and violent crime rates within 100 and 200 feet buffers of smoke shops and off-sale alcohol outlets—but not medical marijuana dispensaries—significantly exceeded the mean crime rates within 100 and 200 feet buffers: (1) around control grocery/convenience stores, and (2) for the entire target area. For example, the mean violent crime rate within 200 feet buffers of smoke shops and alcohol outlets were 6.78 and 7.92 violent crimes, respectively, versus 2.39 and 2.07 crimes around grocery/convenience stores and community-wide, respectively. These differences disappeared at 500 and 1,000 feet buffers. Also, few significant crime rate differences were found between the legal drug outlet types at any buffer distance.

Conclusions and Implications: Present study findings linked smoke shops and off-sale alcohol outlets—though not medical marijuana dispensaries—to increased neighborhood crime and violence; suggesting these two legal drug outlet types may generate public nuisances that directly threaten public health and safety in low-income urban communities of color. Implementing and enforcing policies to reduce the density of smoke shops and alcohol outlets in these communities may improve community health by addressing an important root cause of crime and violence in low-income communities of color.