Racial/Ethnic Differences in Light of 100% Smoke-free State Laws: Evidence from Adults in the United States.

Abstract

This study estimates racial/ethnic differences in the association between 100% smoke-free state laws and smoking, as well as self-reported health, to facilitate policy aimed at reducing disparities. Data pertain to adults aged 18 years and older, obtained from the public-use Behavioral Risk Factor Surveillance System (2002-2014). The authors exploit variation in the timing of 100% smoke-free state laws using a difference-in-differences model. Examining heterogeneity across racial/ethnic minority groups, the authors consider the association between smoke-free laws and the probability of being: a daily smoker (versus occasional); an occasional smoker (versus former); and at the top of the self-reported health scale (versus the bottom). The authors find that 100% smoke-free state laws were not correlated with smoking among women. Moreover, racial/ethnic minority men who smoked occasionally were less likely to quit than white men, and results suggest that smoke-free laws did not reduce these disparities. However, there is evidence that smoke-free laws reduced the probability of being a daily smoker for Asian and Hispanic/Latinx men, but not the probability of quitting or being at the top of the self-reported health scale. More generally, smoke-free laws were not associated with self-reported health, except that there may have been an improvement among nonsmoking American Indian/Alaska Native women. These findings underscore the importance of looking beyond average effects to consider how 100% smoke-free state laws impact racial/ethnic minorities. There is evidence that they reduced smoking and improved self-reported health for some groups, but a suite of tobacco control policies is necessary to reduce racial/ethnic disparities more broadly.