Effects of smokefree laws and alcohol use on smoking and quit attempts among US adults: New innovations are needed for young adults and minority smokers

Background: Light and intermittent smoking has become increasingly common. Smokefree laws and alcohol use affect smoking behavior. We examined whether 100% smokefree laws, especially bar laws, and alcohol use are associated with light/intermittent smoking and quit attempts.

Methods: We linked 2009 National Health Interview Survey database with the American Nonsmokers' Rights Foundation US Tobacco Control Database. Dependent variables included current smoking, nondaily smoking, very light daily smoking (daily smokers who smoked 1-5 cigarettes per day [CPD]), very light nondaily smoking (nondaily smokers who smoked 1-3 CPD), infrequent smoking (smoked ≤8 days in past 30 days), and quit attempts. Multivariate logistic regression models were conducted among different smoking subgroups to determine if the outcomes were associated with smokefree law coverage and drinking status, controlling for demographics and cigarette pack price.

Results: Greater smokefree law (or bar law) coverage scores were associated with decreased odds of current smoking, but were not associated with light/intermittent smoking. Drinking was associated with current smoking, but rarely showed a relationship with light/intermittent smoking. Young people aged 18-24 and Blacks and Hispanics were more likely to report light/intermittent smoking than 45-64-year-olds and Whites respectively. Smokefree law coverage and drinking were not associated with quit attempts, but very light daily smokers and infrequent smokers exhibited a positive association between drinking frequency and quit attempts.

Conclusions: Stronger smokefree law coverage predicts less current smoking, but was not associated with smoking intensity or quit attempts. Novel interventions are needed to reach light and intermittent smokers, which is younger and minority.