Smoking prevalence in California has steadily declined since the comprehensive tobacco control program began in 1989. Adult smoking prevalence in California declined by 51.1% between 1988 and 2014, from 23.7% to 11.6% (Figure 1.1); this drop represents approximately 3.3 million fewer adult smokers in California. The decline in prevalence was most pronounced during the early years of California Tobacco Control Program. California has the second lowest adult smoking prevalence rate in the United States, second only to Utah.
The California Facts & Figures Report (2016) is a comprehensive review of tobacco-related data across the state of California. The report includes data on smoking prevalence, tobacco consumption, secondhand smoke exposure, cancer incidence and mortality, tobacco industry spending, and smoking cessation.
The California Department of Public Health (CDPH), California Tobacco Control Program (CTCP) was established in 1989, after California voters passed the Tobacco Tax and Health Protection Act (California Proposition 99) in November of 1988. As the longest running comprehensive tobacco control program in the nation, CTCP seeks to change tobacco use norms in the larger physical and social environment and to create an environment in which tobacco use becomes less desirable, less acceptable, and less accessible.1 Declines in cigarette consumption and smoking prevalence in California are attributed to the success of the media campaign and state and community interventions.2
California Tobacco Facts and Figures 2016 serves as a quick reference on the current status of tobacco use in California and progress over time.
CA adult smoking rates have dropped by more than 50% since the California Tobacco Control Program began in 1989.
Several data sources are used in the report. Each data source is based on a different survey or surveillance tool, and therefore may report slightly different rates. However, these differences are not statistically significant and represent the most accurate and complete picture of California to the best of our knowledge. Some of the major data sources used include:
- California Behavioral Risk Factor Survey – The California Behavioral Risk Factor Survey, also known as the California Behavioral Risk Factor Surveillance System (BRFSS), is an annual random-dial telephone health survey assessing a variety of public health topics. The California Adult Tobacco Survey (CATS), which was incorporated into the third track of the BRFSS, assesses adult tobacco usage in California.
Some of the figures using BRFSS data display data breaks in 1996 and 2012. These breaks were inserted to account for changes in survey questions or methodology. The Centers for Disease Control and Prevention (CDC) does not recommend comparing data from before or after each data break. These changes are described in detail elsewhere.3 Previously reported 2014 BRFSS data has been revised due to revisions to the sample weights.
- California Cancer Registry – The California Cancer Registry (CCR) is a statewide population-based cancer surveillance system. The State of California mandates that all cancer diagnosed in California to be reported to the CCR since 1988. The CCR monitors the incidence and mortality of cancer among Californians from patient’s medical records. 4
- California Health Interview Survey – The California Health Interview Survey (CHIS) is an annual random-dial telephone health survey. Due to the sample design, CHIS is able to provide statewide estimates for California’s overall non-institutionalized population and provide county-level estimates for medium- and large-sized counties and groups of small-sized counties based on population.4 AskCHIS is a free online query system that allows analysis for most variables in the CHIS datasets.
- California Healthy Kids Survey – The California Healthy Kids Survey (CHKS) is an anonymous, large-scale survey funded by the California Department of Education Tobacco-Use Prevention Education program. The survey is administered to a randomly-selected representative sample of California students in grades 5, 7, 9, and 11. CHKS provides various indicators, including the health and overall well-being of students.
- California Smokers’ Helpline – The California Smokers’ Helpline (Helpline) is a free statewide telephone-based tobacco cessation program. The Helpline offers telephone counseling and self-help materials in English, Spanish, Mandarin, Cantonese, Korean, and Vietnamese. The Helpline also collects data from participants for population research.
- California Student Tobacco Survey – The California Student Tobacco Survey (CSTS) is a large-scale, in-school survey of tobacco use among California middle (grades 6–8) and high school (grades 9–12) students. The purpose of the survey is to assess behavior and attitudes regarding tobacco usage. CSTS is typically conducted every two to three years.
- California Tobacco Advertising Survey – The California Tobacco Advertising Survey (CTAS) is designed to assess retail availability, promotion and placement of tobacco products and marketing materials for tobacco products. The survey also assesses the availability and promotion of flavored tobacco products as well as electronic smoking devices.
- Online California Adult Tobacco Survey – The online California Adult Tobacco Survey (Online CATS) is an online health survey aimed at assessing tobacco-related behaviors and attitudes of California adults age 18 through 64 years old. The survey also assesses awareness and attitudes toward electronic cigarettes. The first survey was conducted in 2016.
- Youth Tobacco Purchase Survey – The Youth Tobacco Purchase Survey (YTPS) is an annual statewide survey with the purpose of capturing the percentage of retailers who sell tobacco to youth under 18. YTPS is a random sample survey of retail outlets that sell tobacco products and is performed by underage inspectors who attempt to purchase cigarettes in unannounced checks of the retail outlets in the random sample.