Background:
Restricting tobacco availability is likely to be central to the next generation of international tobacco control policies. In Spain, tobacco sales are limited to tobacco exclusive outlets and associated vending machines. Laws regulating the geographical concentration of tobacco outlets demand a minimum distance of 150-metres between them, unless they exceed an established legal sales-threshold to justify their closeness. Distances to other public facilities (e.g. schools, playgrounds, or health-centres) are not regulated. We aimed to evaluate the implementation of tobacco outlets' minimum distances, and to examine their proximity to schools, playgrounds and health-centres.

Methods:
Our study area was Madrid municipality. Performing a proximity-analysis with Geographic Information Systems, we identified outlets that were less than 150-metres between them. We checked whether these outlets exceeded the legal sales-threshold, (established in three-times the average of sales of whole tobacco outlets within the municipality). Accessibility from schools, playgrounds, and health-centres to tobacco outlets were estimated. Sociodemographic data were used to characterize areas where tobacco outlets are closer than 150-meters to other retailers and, to schools, playgrounds and health-centres.

Results:
We geocoded 638 tobacco outlets, of which 34 were within a 150-metres of another tobacco outlet. From those, 24 registered a sales volume lower than the legal sales-threshold, located in central neighbourhoods, with high density of leisure venues and high-educational level. Results also showed that 29%, 20% and 6% of tobacco outlets were closer than 150-metres to schools, playgrounds, and health-centres, respectively.

Conclusions:
This study examines tobacco outlets distribution under a restricted market framework. Results showed little examples of over provision of tobacco retailing, empathising that the evaluation of Spanish policies could provide keys to improve regulations on tobacco sales restriction in other countries. However, we identified a significant number of stores close to schools, playgrounds and health-centres that suggest the need to enforce minimum distances to these facilities.