Tobacco use disparities by racial/ethnic groups: California compared to the United States

- Cigarette smoking level trends for California are compared to the United States.
- Differences in cigarette use trends were observed by major race/ethnic groups.
- California and US Asian/Pacific Islanders had similar and small effects in quitting.
- California and US Blacks had similar trends for light and intermittent smoking.
- Differences between race/ethnic groups suggest focus on cessation is needed.

Racial/ethnic disparities in cigarette use and cessation persist. This study compared cigarette consumption and former smoking trends in California (CA) with the rest of the United States (US) by racial/ethnic categories of non-Hispanic White, Black, Hispanic/Latino, and Asian/Pacific Islander groups. Data were analyzed from the 1992 to 2011 Tobacco Use Supplement to the Current Population Survey. Consumption levels across decades were examined and adjusted logistic regression models were fit to compare across CA and US.Results indicated steady declines in ever smoking prevalence for all groups with much lower magnitudes of change among US Blacks and Whites compared to their CA counterparts. After controlling for age, gender, and education, CA had significantly fewer heavy smokers (OR = 0.45, 95% CI:0.38-0.54), more light and intermittent smokers (LITS; OR = 1.68, 95%CI: 1.45-1.93), and a greater proportion of former smokers (OR = 1.35, 95%CI: 1.24-1.48) than the rest of US. Data were stratified by race/ethnicity and the patterns shown were mostly consistent with CA performing statistically better than their US counterparts with the exception of Black LITS and Asian/Pacific Islander former smokers. California's success in reducing tobacco use disparities may serve as a prime example of tobacco control policy for the country. CA and the US will need to continue to address tobacco use and cessation in the context of the growing diversity of the population.