Rural Communities

The Story of Rural Communities

Rural communities are full of hardworking people who value strength and independence.  Tobacco companies understand this, so they package and advertise their deadly products to play to values of self-reliance and resiliency with images such as cowboys, hunters and racecar drivers.  Big Tobacco aggressively markets cigarettes and smokeless tobacco products, like chew, in rural areas, taking advantage of weaker tobacco retail licensing laws in rural communities.1 This has contributed to increased smokeless tobacco use rates among high school males in rural areas, exceeding the national average.2

Because of these practices, rural counties have some of the highest smoking rates in California,3 and rural residents start smoking at an earlier age.4 Rural counties also suffer higher rates of lung cancer,5 and smoking causes 80-90% of lung cancer cases.  That’s why it’s more important than ever to ensure rural communities are truly free from Big Tobacco’s deadly, addictive products.

  1. 2017 Story of Inequity, Indicator: Proportion of each priority population group protected by a strong Tobacco Retail Licensing Law.
  2. Elizabeth T. Couch, Ellen Darius, Margaret M. Walsh, Benjamin W. Chaffee, Smokeless Tobacco Decision-Making Among Rural Adolescent Males in California, Journal of Community Health,
  3. California Facts and Figures 2016, October 2016, California Department of Public Health, California Tobacco Control Program
  4. Cutting Tobacco’s Rural Roots, Tobacco Use in Rural Communities, 2012, American Lung Association.
  5. Morbidity and Mortality Weekly Report, July 6, 2017, Centers for Disease Control and Prevention.

The Proof is in the Data

Indicator
Rural Communities
General Population
Adult Tobacco Use
1.Adult Cigarette Use: Adult cigarette smoking prevalenceThe estimate is significantly higher than the California general population.14.9%11.0%
  • California Health Interview Survey, 2016-17. Los Angeles, CA: UCLA Center for Health Policy Research.
2.Change in Adult Cigarette Use: Rate of change in adult cigarette smoking, 2014 to 20178.0%-11.3%
  • California Health Interview Survey, 2016-17. Los Angeles, CA: UCLA Center for Health Policy Research.
  • California Health Interview Survey, 2013-14. Los Angeles, CA: UCLA Center for Health Policy Research.
3.Adult Tobacco Use: Adult tobacco use prevalence (e.g. cigarettes, e-cigarettes and other vaping products, other tobacco products)The estimate is significantly higher than the California general population.25.6%14.6%
  • California Behavioral Risk Factor Surveillance System, 2017. Sacramento, CA: California Department of Public Health.
Youth Tobacco Use
4.Youth Cigarette Use: Youth cigarette smoking prevalence3.1%2.0%
  • California Student Tobacco Survey, 2017-18. San Diego, CA: Center for Research and Intervention in Tobacco Control, University of California, San Diego.
5.Youth Tobacco Use: Youth tobacco use prevalence (e.g. cigarettes, e-cigarettes and other vaping products, other tobacco products)13.3%12.7%
  • California Student Tobacco Survey, 2017-18. San Diego, CA: Center for Research and Intervention in Tobacco Control, University of California, San Diego.
Availability of Tobacco & Tobacco Industry Influence
6.Cheapest Cigarettes: Average price for the cheapest pack of cigarettes$4.43$4.58
  • Healthy Stores for a Healthy Community, 2016. Sacramento, CA: California Department of Public Health, California Tobacco Control Program.
  • American Community Survey, 2011-2015. Suitland, MD: U.S. Census Bureau.
7.Flavored Little Cigar Price: Average price for a single flavored little cigar/cigarillo$0.97$0.97
  • Healthy Stores for a Healthy Community, 2016. Sacramento, CA: California Department of Public Health, California Tobacco Control Program.
  • American Community Survey, 2011-2015. Suitland, MD: U.S. Census Bureau.
8.Tobacco Retail Licensing: Proportion of population protected by a strong tobacco retail licensing law33.5%36.9%
  • Policy Evaluation Tracking System, December 2018. Sacramento, CA: California Department of Public Health, California Tobacco Control Program.
  • American Community Survey, 2013-2017. Suitland, MD: U.S. Census Bureau.
  • Decennial Census, 2010. Suitland, MD: U.S. Census Bureau.
9.Tobacco Stores: Density of stores selling tobacco per 100,000 residentsThe estimate is higher than 89.6 stores per 100,000 residents (10.0 stores per 100,000 more than the California general population's density of 79.6 stores per 100,000).93.079.6
  • California Cigarette and Tobacco Products Retailer Licensees, October 2016. Sacramento, CA: California Department of Tax and Fee Administration.
  • American Community Survey, 2013-2017. Suitland, MD: U.S. Census Bureau.
  • Decennial Census, 2010. Suitland, MD: U.S. Census Bureau.
10.Flavored Tobacco: Proportion of stores that sell flavored non-cigarette tobacco products83.2%81.8%
  • Healthy Stores for a Healthy Community, 2016. Sacramento, CA: California Department of Public Health, California Tobacco Control Program.
  • American Community Survey, 2011-2015. Suitland, MD: U.S. Census Bureau.
11.Menthol Cigarettes: Proportion of stores that sell menthol cigarettes93.1%92.2%
  • Healthy Stores for a Healthy Community, 2016. Sacramento, CA: California Department of Public Health, California Tobacco Control Program.
  • American Community Survey, 2011-2015. Suitland, MD: U.S. Census Bureau.
12.Tobacco Advertising: Proportion of stores that keep 90% of their storefront free from any advertising41.7%37.0%
  • Healthy Stores for a Healthy Community, 2016. Sacramento, CA: California Department of Public Health, California Tobacco Control Program.
  • American Community Survey, 2011-2015. Suitland, MD: U.S. Census Bureau.
Secondhand Smoke
13.Adult Secondhand Tobacco Exposure: Proportion of adults exposed to secondhand smoke44.5%45.3%
  • California Behavioral Risk Factor Surveillance System, 2017. Sacramento, CA: California Department of Public Health.
14.Smoke-free Multi-unit Housing: Proportion of population protected by a smoke-free multi-unit housing law24.6%29.0%
  • Policy Evaluation Tracking System, December 2018. Sacramento, CA: California Department of Public Health, California Tobacco Control Program.
  • American Community Survey, 2013-2017. Suitland, MD: U.S. Census Bureau.
  • Decennial Census, 2010. Suitland, MD: U.S. Census Bureau.
15.Smoke-free Homes: Proportion of adults with smoke-free homes87.4%86.6%
  • California Behavioral Risk Factor Surveillance System, 2017. Sacramento, CA: California Department of Public Health.
Cessation
16.Quitting: Proportion of smokers who tried quitting in the last 12 months52.8%58.4%
  • California Health Interview Survey, 2016-17. Los Angeles, CA: UCLA Center for Health Policy Research.

Organizations around the state are working
to fix tobacco-related health disparities.

Find out more about what each organization is doing to fight the
tobacco industry's predatory tactics.

How you can help

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Fix It!

A Story of Inequity

Tobacco's Impact on Health Disparities in California

For decades, the tobacco industry has aggressively targeted California’s diverse communities with predatory practices. Internal documents from Big Tobacco outline their strategies – many of which are shocking attempts to peddle deadly products by way of product discounts and manipulative advertising. They even gave away free products to youth in the past. These tactics masquerade as support for communities under the guise of cultural celebration.

Unfortunately, the tactics have worked. Big Tobacco aggressively targeted communities and, as a result, some populations have higher rates of tobacco use, experience greater secondhand smoke exposure at work and at home, and have higher rates of tobacco-related disease than the general population.1

Addressing tobacco-related health inequities is key to California’s efforts to fight tobacco, our state’s number one cause of preventable death and disease.2 Tobacco use, pricing, and its impact across California were analyzed where significant disparities were found across various populations. See how Big Tobacco affects each community in the Nation’s most diverse state.

A Story Of Inequity Methodology >

  1. Centers for Disease Control and Prevention and Tobacco-Related Disparities
  2. Extinguishing the Tobacco Epidemic in California, April 11, 2017, Centers for Disease Control and Prevention