Tobacco Use in California

The landmark 1988 California Tobacco Tax and Health Promotion Act (Proposition 99) made California the first state to implement a comprehensive tobacco control program. Since its inception 20 years ago, the California Tobacco Control Program has been charged with reducing tobacco use across the state and with decreasing tobacco-related disease and death by protecting Californians from secondhand smoke.

Significant progress has been made since 1988 as tobacco consumption has dramatically decreased and health outcomes have improved:

• The prevalence of smoking among adults fell from 26.7 percent in 1985 to 12 percent in 2011.¹ The Healthy People 2020 goal for adult smoking prevalence is at or below 12 percent. California is one of two states that have already met that goal.
• Per capita consumption fell from 123 packs per adult per year in 1990 to 34 packs in 2011, representing a drop of more than 72 percent.²
• Even lung and bronchial cancers have declined much faster in California than in the rest of the United States. Yet despite this progress, over 3.6 million Californians still smoke, and prevalence is still high in certain groups.

Californians who use tobacco today are more likely to be light or non-daily consumers, which has tremendous implications for cessation messaging and treatment. For example, medications are not recommended for this group, and they may not even consider themselves to be “real” smokers if they smoke on a non-daily basis.³ Also, certain demographic groups, most notably Latinos, are more likely than others to be light or non-daily smokers.⁴

¹ Behavioral Risk Factor Surveillance System (BRFSS). Smoking prevalence among California and U.S. minus California adults, 1984 – 2011. Prepared by: California Department of Public Health, Tobacco Control Program, March 2012.

^{*The data are weighted to the 2000 California population. State BRFSS data are weighted to 2000 national populations based on each state’s population. Note and adjustment was made to address the change of smoking definition in 1996 that included more occasional smokers.}

^{2 California Department of Public Health, California Tobacco Control Program, 2012. State Health Officer’s Report on Tobacco Use and Promotion in California. Sacramento.}

^{3 Tong, E.K., M.K. Ong, E. Vittinghoff, and E.J. Pérez-Stable. 2006. Nondaily smokers should be asked and advised to quit. American Journal of Preventive Medicine, 30(1):23-30.}

^{4 Zhu, S-H, K. Pulvers, Y. Zhuang, and L. Baezconde-Garbanati. 2007. Most Latino smokers in California are low consumption smokers. Addiction, (S2):104-111.}