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Racial/ethnic minorities bear a disproportionate burden of smoking-related diseases. In part, higher rates of smoking may contribute to this unfortunate situation. However, even within racial/ethnic groups there could be undiscovered smoking disparities that worsen the picture for those who are already at a disadvantage. For example, smoking rates for racial/ethnic groups have been shown to vary greatly depending on age, gender, education level and English language usage. Unfortunately, little is known about disparities in such smoking trends over time, including changes in initiation and cessation, among racial/ethnic minorities, with this level of detail in California. Further, recent reductions in cigarette smoking have been accompanied by increases in the use of non-cigarette-nicotine-or-tobacco-products (NCNTPs), including chewing tobacco, cigars, flavored little cigars/cigarillos, pipes, water pipes/hookahs and electronic cigarettes. Unfortunately, there is little research studying NCNTP use in relation to cigarette use behaviors, especially how NCNTPs affect the age periods of cigarette initiation and population distributions along a quitting continuum for priority groups in California. And no studies have examined California's progress relative to other states in the nation. We will analyze collections of large, representative, tobacco use datasets, particularly the U.S. Census Bureau's Tobacco Use Supplements to the Current Population Survey and complement them with analyses of the California Tobacco Surveys. Such analyses will allow for us to study disparities in smoking trends, initiation and cessation, and how they are affected by NCNTP use, for priority groups over time at the population level. Our analyses will focus specifically on following racial/ethnic groups: African Americans/Blacks, American Indians/Alaska Natives, Asian Americans, Hispanics/Latinos, Native Hawaiians and other Pacific Islanders. Within these priority populations will consider age, gender and education-level disparities between and within groups, as well as nationality subgroup differences within Asian Americans (e.g., Chinese, Filipino, Japanese, Korean) and Hispanics/Latinos (e.g., Central/South American, Cuban, Mexican, Puerto Rican). For populations that may speak a language other than or in addition to English, we will also consider disparities by English language use. The Specific Aims of this project are as follows: 1. Examine trends and correlates in the prevalence of cigarette smoking behaviors (e.g., light and non-daily smoking, heavy smoking, menthol use) and NCNTP use among California's priority populations. 2. Examine how cigarette smoking initiation and cessation rates in California have changed over time, including: a. variations in smoking initiation rates and the age period during which priority population groups become smokers, b. changes in the age of successful quitting for priority populations, and c. the population distribution of priority groups along the cigarette quitting continuum. 3. Examine the use of NCNTPs in relation to cigarette smoking, including menthols, in California. We will examine how NCNTP use is associated with concurrent use of cigarettes by studying: a. how cigarette smoking initiation rates and levels of consumption change if NCNTPs are used, b. how the age of cigarette smoking initiation and cessation changes with NCNTP use, and c. how NCNTP use affects the distribution along the cigarette quitting continuum, specifically whether NCNTP use is associated with temporarily or successfully quitting cigarettes. 4. Analyze the TUS CPS to compare findings from California relative to other states in the U.S. for each of the above Aims. Results from this project will highlight current and emerging challenges regarding cigarette smoking and NCNTP use for specific priority groups in the state and can guide prevention, control and intervention efforts to reduce tobacco-related disparities, especially among populations experiencing the greatest such burdens. |
