Associations between smoking-induced deprivation, cigarette purchase price, and coupon use among California adults...

California has reduced overall smoking prevalence but people with low income still experience disparities in tobacco use. We examined the associations between recent smoking-induced deprivation (SID; spending on cigarettes instead of other needs), daily smoking, cigarette prices, and coupon use.

Weighted data from two waves of the Online California Adult Tobacco Survey Supplement collected between November 2022 and November 2023 were combined then limited to current smoking and other variables (n = 2288; weighted n = 1,718,238) for bivariate analysis and multivariable stepwise logistic regression with an interaction term to produce estimates of recent SID.

Nearly one-third of California adults (33.04%; CI: 29.36, 36.94%) reported recent SID. We found a significant interaction (p < 0.01) for coupon use at last purchase and non-daily smoking (aOR: 6.85; CI: 4.00, 11.73). Cigarette pack price was not significantly associated with recent SID. Other factors associated with SID were inability to meet basic expenses, higher educational attainment, female gender, and younger age.

Policymakers should consider increasing cessation outreach to populations more likely to report recent SID paired with coupon and minimum pack price policies. Interventionists should also consider new programs to address those who do not smoke daily or have high educational attainment.