Health Disparities in Tobacco Use: Can Tobacco Control Policies Help Narrowing the Gap?

Background: Over the past 50 years, the prevalence of smoking in the U.S declined by 50% while the establishment of home and workplace smoking bans has increased steadily. However, racial and socioeconomic disparities persist. Methods: We used the 2006/07 Current Population Survey Tobacco Use Supplement and information on statewide tobacco control policies(i.e., smoke-free air laws, tobacco control funding, cigarette excise taxes, and media campaigns.Socioeconomic disparities in smoking rates, home and workplace bans were calculated for the nation and by state. Multivariate regressions were estimated to explore the association between statewide tobacco control policies and socioeconomic disparities in these indicators at the state level. Results: By state, smoking prevalence ranged 12% to 28%; 60% to 92% of people reported a home smoking ban; and 53% to 84% reported a workplace ban. Among states, the mean disparity in smoking prevalence between the highest and lowest socioeconomic strata was 14%(SD=4.8%); the mean disparity in home bans was 18%(SD=5.6%); and the mean disparity in workplace bans was 11%(SD=5.5%). Better state smoke-free air laws and the existence of statewide media campaigns were significantly associated with lower smoking rates and higher prevalence of home bans (p<0.05). Smoke-free air laws were associated with smaller socioeconomic disparities regarding prevalence of smoking, home and work bans (p<0.05). Conclusions: The results indicate that stricter statewide smoke-free air laws and media campaigns are associated with lower smoking rates and higher prevalence of home bans. Smoke-free air laws contribute to decreased socioeconomic disparities in smoking prevalence, and work and home smoking restrictions.