Article Open Access October 21, 2025

Trends in Smoking and Flavored Tobacco Use in California: Black–White Disparities, 2003–2023

1
Department of Internal Medicine, Charles R Drew University of Medicine and Science, Los Angeles, CA, USA
2
Department of Psychiatry, Charles R Drew University of Medicine and Science, Los Angeles, CA, USA
3
;Department of Public Health, Charles R Drew University of Medicine and Science, Los Angeles, CA, USA
4
Marginalization-related Diminished Returns (MDRs), Los Angeles, CA, USA
5
Charles R Drew University of Medicine and Science, Los Angeles, CA, USA
6
Department of Psychiatry, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
Page(s): 28-42
Received
June 30, 2025
Revised
August 19, 2025
Accepted
October 18, 2025
Published
October 21, 2025
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright: Copyright © The Author(s), 2025. Published by Scientific Publications
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APA Style
Assari, S. , Assari, S. Najand, B. , Najand, B. Pallera, J. A. , & Pallera, J. A. (2025). Trends in Smoking and Flavored Tobacco Use in California: Black–White Disparities, 2003–2023. Current Research in Public Health, 5(1), 28-42. https://doi.org/10.31586/gjeid.2025.6202
ACS Style
Assari, S. ; Assari, S. Najand, B. ; Najand, B. Pallera, J. A. ; Pallera, J. A. Trends in Smoking and Flavored Tobacco Use in California: Black–White Disparities, 2003–2023. Current Research in Public Health 2025 5(1), 28-42. https://doi.org/10.31586/gjeid.2025.6202
Chicago/Turabian Style
Assari, Shervin, Shervin Assari. Babak Najand, Babak Najand. John Ashley Pallera, and John Ashley Pallera. 2025. "Trends in Smoking and Flavored Tobacco Use in California: Black–White Disparities, 2003–2023". Current Research in Public Health 5, no. 1: 28-42. https://doi.org/10.31586/gjeid.2025.6202
AMA Style
Assari S, Assari SNajand B, Najand BPallera JA, Pallera JA. Trends in Smoking and Flavored Tobacco Use in California: Black–White Disparities, 2003–2023. Current Research in Public Health. 2025; 5(1):28-42. https://doi.org/10.31586/gjeid.2025.6202
@Article{crph6202,
AUTHOR = {Assari, Shervin and Najand, Babak and Pallera, John Ashley and Farhoudian, Ali},
TITLE = {Trends in Smoking and Flavored Tobacco Use in California: Black–White Disparities, 2003–2023},
JOURNAL = {Current Research in Public Health},
VOLUME = {5},
YEAR = {2025},
NUMBER = {1},
PAGES = {28-42},
URL = {https://www.scipublications.com/journal/index.php/GJEID/article/view/6202},
ISSN = {2831-5162},
DOI = {10.31586/gjeid.2025.6202},
ABSTRACT = {Background: Tobacco control policies nationwide have contributed to a substantial decline in cigarette and tobacco use, with particularly sharp reductions observed in states such as California that have implemented restrictive bans, strong prevention measures, and high excise taxes. While these policies have led to overall decreases in tobacco use, progress has not necessarily been distributed equally across racial groups. Understanding long-term trends by race is critical for addressing equity gaps in tobacco prevention and control. Evidence suggests that some racialized groups may experience slower or delayed declines, raising concerns about equity in public health gains. Methods: We analyzed data from the California Health Interview Survey (CHIS) spanning 2003–2023. Trends in current smoking were examined separately for non-Latino Black and non-Latino White adults. We also assessed current use of flavored tobacco products, given California’s statewide ban enacted in 2021. Changes were evaluated in both absolute terms (percentage point declines) and relative terms (percent reduction from baseline). Results: Smoking prevalence declined from 17.2% in 2003 to 5.2% in 2023 among White adults and from 19.9% to 9.0% among Black adults. This represents a 12.0 percentage point (69.8%) decline for Whites compared with a 10.9 percentage point (54.8%) decline for Blacks. For flavored tobacco use, prevalence decreased from 8.0% to 4.7% among White adults but only from 11.9% to 10.8% among Black adults. This corresponds to a 3.3 percentage point (41.3%) decline for Whites compared with a 1.1 percentage point (9.2%) decline for Blacks. Conclusions: Although both Black and White adults in California experienced reductions in smoking over the past two decades, White adults showed larger declines in both absolute and relative terms. Disparities were even more pronounced for flavored tobacco use, where declines were minimal among Black adults despite the statewide ban. These findings suggest that Black populations in California may have been left behind by tobacco control progress, especially regarding flavored products. Given the history of targeted marketing by the tobacco industry, the role of flavors in increasing dependence, and reduced access to cessation resources in Black communities, targeted policies and culturally tailored interventions are needed to ensure equitable reductions in tobacco use. Greater attention to flavored tobacco in Black communities may help narrow these disparities and advance California’s tobacco endgame goals.},
}
%0 Journal Article
%A Assari, Shervin
%A Najand, Babak
%A Pallera, John Ashley
%A Farhoudian, Ali
%D 2025
%J Current Research in Public Health

%@ 2831-5162
%V 5
%N 1
%P 28-42

%T Trends in Smoking and Flavored Tobacco Use in California: Black–White Disparities, 2003–2023
%M doi:10.31586/gjeid.2025.6202
%U https://www.scipublications.com/journal/index.php/GJEID/article/view/6202
TY  - JOUR
AU  - Assari, Shervin
AU  - Najand, Babak
AU  - Pallera, John Ashley
AU  - Farhoudian, Ali
TI  - Trends in Smoking and Flavored Tobacco Use in California: Black–White Disparities, 2003–2023
T2  - Current Research in Public Health
PY  - 2025
VL  - 5
IS  - 1
SN  - 2831-5162
SP  - 28
EP  - 42
UR  - https://www.scipublications.com/journal/index.php/GJEID/article/view/6202
AB  - Background: Tobacco control policies nationwide have contributed to a substantial decline in cigarette and tobacco use, with particularly sharp reductions observed in states such as California that have implemented restrictive bans, strong prevention measures, and high excise taxes. While these policies have led to overall decreases in tobacco use, progress has not necessarily been distributed equally across racial groups. Understanding long-term trends by race is critical for addressing equity gaps in tobacco prevention and control. Evidence suggests that some racialized groups may experience slower or delayed declines, raising concerns about equity in public health gains. Methods: We analyzed data from the California Health Interview Survey (CHIS) spanning 2003–2023. Trends in current smoking were examined separately for non-Latino Black and non-Latino White adults. We also assessed current use of flavored tobacco products, given California’s statewide ban enacted in 2021. Changes were evaluated in both absolute terms (percentage point declines) and relative terms (percent reduction from baseline). Results: Smoking prevalence declined from 17.2% in 2003 to 5.2% in 2023 among White adults and from 19.9% to 9.0% among Black adults. This represents a 12.0 percentage point (69.8%) decline for Whites compared with a 10.9 percentage point (54.8%) decline for Blacks. For flavored tobacco use, prevalence decreased from 8.0% to 4.7% among White adults but only from 11.9% to 10.8% among Black adults. This corresponds to a 3.3 percentage point (41.3%) decline for Whites compared with a 1.1 percentage point (9.2%) decline for Blacks. Conclusions: Although both Black and White adults in California experienced reductions in smoking over the past two decades, White adults showed larger declines in both absolute and relative terms. Disparities were even more pronounced for flavored tobacco use, where declines were minimal among Black adults despite the statewide ban. These findings suggest that Black populations in California may have been left behind by tobacco control progress, especially regarding flavored products. Given the history of targeted marketing by the tobacco industry, the role of flavors in increasing dependence, and reduced access to cessation resources in Black communities, targeted policies and culturally tailored interventions are needed to ensure equitable reductions in tobacco use. Greater attention to flavored tobacco in Black communities may help narrow these disparities and advance California’s tobacco endgame goals.
DO  - Trends in Smoking and Flavored Tobacco Use in California: Black–White Disparities, 2003–2023
TI  - 10.31586/gjeid.2025.6202
ER  -