Racial, Ethnic Disparities Still Persist in Cigarette Smoking Rates


Even though the number of US adults who smoke has decreased in the last decade, racial and ethnic disparities persist, and equitable interventions are needed.

The number of US adults who smoke cigarettes has decreased over the last 10 years, but racial and ethnic disparities persist, according to study findings in Preventing Chronic Disease.1

Reducing these disparities in cigarette smoking requires equitable implementation of evidence-based interventions to help people in these populations quit smoking.

This study was conducted because although cigarette smoking among US adults fell from 42.4% in 1965 to 12.5% in 2020, prevalence remained higher among certain racial and ethnic groups, including non-Hispanic American Indian and Alaska Native (AIAN) adults. Unjust and unfair systems, practices, policies, and conditions have exacerbated smoking and related health problems worse among certain populations, noted a press release on these findings.2

Trends in current cigarette smoking prevalence, population estimates, and relative disparity among US adults (≥18 years) between 2011 and 2020 were analyzed. Data were used from the National Health Interview Survey (NHIS).

Linear decreases in prevalence and population estimates were seen for non-Hispanic White (20.6% to 13.3%; 32.1 to 20.7 million), non-Hispanic Black (19.4% to 14.4%; 5.1 to 4.0 million), and Hispanic (12.9% to 8.0%; 4.2 to 3.3 million) adults from 2011 to 2020. For non-Hispanic AIAN adults, the prevalence remained near 37% and a linear increase in the population estimate was seen from 400,000 to 510,000. Relative disparity did not change across racial and ethnic categories.

Although more research regarding the drivers of longstanding racial and ethnic disparities are needed, current research shows that many multilevel and interacting factors contribute to tobacco-related health disparities and that some of the driving forces could be structural and sociocultural differences, in addition to smoking-related practices. Another possible reason for the smoking disparities is if tobacco control interventions do not equally and equitably reach and have an impact on all racial and ethnic populations, which then may exacerbate disparities.

The researchers say that additional surveillance can aid in identification of markers of disparity anddrivers of smoking-related inequities.

“This surveillance includes exploring unique and intersecting factors that drive smoking among intersectional population groups,” they emphasized.

The investigators believe this is the first study to observe trends in present cigarette smoking prevalence, estimated the population who smoked, and the disparity ratio in the United States from 2011 to 2020.

Some limitations in this study are that self-reported responses were not validated by biochemical testing and that the NHIS is limited to the noninstitutionalized US civilian population, which limits generalization to institutionalized populations, people in prison, and the military.

“Furthermore, equitable reach and implementation of evidence-based commercial tobacco control interventions (eg, smoke-free policies, cessation access, tobacco price increases, mass media campaigns) are needed, as is ongoing evidence of their impact for unique and intersectional population groups,” concluded the researchers.


1. Arrazola RA, Griffin T, Lunsford NB, et al. US cigarette smoking disparities by race and ethnicity- keep going and going! Prev Chronic Dis. Published online June 1, 2023. doi:10.5888/pcd20.220375

2. There’s more work to be done to reduce racial and ethnic disparities in cigarette smoking among US adults. News release. Preventing Chronic Disease Journal. June 1, 2023. Accessed May 31, 2023.

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