Changes in the proximity of alcohol outlets to schools after the introduction of convenience store alcohol sales in Ontario, Canada: A descriptive study

Objectives Off-premise alcohol sales in Ontario, Canada, occur via a government-run wholesaler and retail store monopoly with limited private retailers. In September 2024, the Government of Ontario allowed convenience stores to begin selling alcohol. This study aimed to evaluate changes after the policy in the proximity of off-premise alcohol outlets to schools. Study design Pre-post spatial analysis. Methods The location of all off-premise alcohol outlets and schools was collected in August (1 month pre-policy) and December 2024 (3 months post-policy). We evaluated changes in the number of outlets within 500 m of a school and distance to the closet outlet overall and by school-level characteristics (socioeconomic status, rurality, grade-level, and public versus private funding) using analysis of covariance. Results The number of off-premise alcohol outlets in Ontario increased 2.8-fold from 2935 in August 2024 to 8232 outlets in December 2024 with 59% (n = 4845) of alcohol outlets being convenience stores in December 2024. The proportion of schools with an alcohol outlet within 500 m tripled from 13% to 38% post policy. The median distance between schools and the nearest alcohol outlet decreased from 1311 (interquartile range [IQR]: 781-2099) meters to 705 (IQR: 405, 1145) meters. This change was more pronounced for schools in lower-SES areas, urban areas, and public relative to private schools. Conclusion The introduction of alcohol sales in convenience stores in Ontario led to substantial increases in the availability of alcohol outlets around schools. This rapid expansion may have implications for alcohol consumption and consequent harms in youth.