Similar softening across different racial and ethnic groups of smokers in California as smoking prevalence declined

Abstract

Smoking prevalence differs among different racial/ethnic groups. Previous research found that as smoking prevalence declined in the U.S., remaining smokers made more quit attempts and smoked fewer cigarettes per day (CPD), indicating so-called softening. We examined California, a state with a highly diverse population, to assess whether there is differential softening among remaining smokers in different racial/ethnic groups. We used the California Tobacco Survey (1990-2008, N: 145,128). We ran logistic and linear regressions for smoking prevalence, CPD, quit attempts and time to first cigarette (30 min) as a function of race/ethnicity (non-Hispanic White, Hispanic, African American, Japanese, Chinese, Filipino, Korean, other Asian/Pacific Islander, American Indian/Alaska Native) controlling for other demographics. Overall prevalence fell from 21.1% in 1990 to 12.3% in 2008 (p < 0.01), showing similar declining trends across all racial/ethnic groups (p = 0.44), albeit from different baseline prevalence levels. In terms of softening indicators the proportion with at least one quit attempt in the past 12 months increased from 46.2% to 59.3%, a factor of 1.25 per decade (95%CI = 1.17, 1.34) in the adjusted model. CPD declined from 16.9 to 10.9, by -2.95 CPD per decade (95%CI = -3.24, -2.67) in the adjusted model. There were no significant changes in the time to first cigarette. Interactions of race/ethnicity and time show similar trends among all subgroups expect Hispanics, whose CPD remained stable rather than declining. Although from different baseline levels, tobacco control policies have benefitted all subgroups of California smokers, exhibiting similar softening as prevalence fell. Interventions are still needed to reduce the baseline differences.

Keywords: Quitting smoking; Racial/ethnic disparities; Tobacco control.