Place-based inequities in cigarette smoking across the USA

There are inequities in the way that smoking prevalence has declined across US communities.1 In 2021, the Population Level Analysis and Community Estimates (PLACES)2—a collaboration between the US Centers for Disease Control and Prevention (CDC) and the Robert Wood Johnson Foundation—released estimates of smoking prevalence across all US census tracts, allowing these inequities to be quantified. Using methods developed for analyses of census tracts in the 500 largest US cities,3 we characterised inequities in cigarette smoking both between and within US states and in relation to state smoking prevalence.

Methods

PLACES provides model-based estimates of health indicators from the 2019 Behavioral Risk Factor Surveillance Survey (BRFSS) at census-tract level.2 A census tract is generally smaller than a city, larger than a block group and a fairly permanent subdivision of a county. We analysed the census-tract prevalence estimates of adult (18+ years) self-reported current…

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