UC Irvine

INTRODUCTION: Tobacco control policies aim to limit access, reduce initiation, and mitigate tobacco-related harms, particularly among youth. However, the effectiveness of these policies relies on consistent enforcement to ensure widespread compliance and achieve their intended public health impacts. Socioeconomic vulnerability and neighborhood characteristics have been shown to influence retailer compliance, although existing studies often primarily focus on compliance violations instead of inspections. This study uses Los Angeles (LA) County, California to explore the associations between compliance inspections, violations, and neighborhood social vulnerability. METHODS: We identified inspection and violation data from the Food and Drug Administration (FDA) Tobacco Compliance Check Outcomes database for Los Angeles County, CA (January 1, 2021 to December 31, 2023) and linked these data to census tract level data from the 2022 Centers for Disease Control and Prevention Social Vulnerability Index (SVI). All analyses were conducted at the census-tract level, with separate multivariable models adjusted for tobacco retailer density, and used to examine the relationship between inspections, violations, and neighborhood social vulnerability. FINDINGS: Neighborhood-level social vulnerability significantly predicted the likelihood of tobacco retailer inspections, but not violations. Census tracts with greater socioeconomic vulnerability and housing vulnerability had higher odds of inspections, while census tracts with higher proportions of racial/ethnic minority residents were less likely to undergo compliance inspections. CONCLUSION: The uneven distribution of FDA compliance inspection efforts in socially vulnerable neighborhoods highlights systemic inequities. The results underscore the importance of utilizing equitable enforcement frameworks that leverage tools like SVI to pinpoint high-need areas, optimize resource allocation, and support comprehensive tobacco policy implementation. IMPLICATIONS: This study reveals disparities in Food and Drug Administration compliance inspections with a concentration of inspections identified in socioeconomically vulnerable areas and gaps in predominantly racial/ethnic minority communities. No direct link was found between social vulnerability and violations, suggesting heightened retailer compliance may stem from successful outreach, past regulatory scrutiny, or other factors. Leveraging the Centers for Disease Control and Prevention Social Vulnerability Index can strengthen tobacco control enforcement in high-need areas, ensuring inspections are more equitable and targeted where enforcement gaps and tobacco access remain most pronounced.