Article Text

Download PDFPDF
Place-based inequities in cigarette smoking across the USA
  1. Eric C Leas,
  2. John P Pierce,
  3. Nora Satybaldiyeva
  1. Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla, California, USA
  1. Correspondence to Dr Eric C Leas, Herbert Wertheim School of Public Health and Human Longevity Science, University of California: San Diego, School of Medicine, University of California San Diego, La Jolla, California, USA; ecleas{at}

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

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.


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 smoking for all census tracts with available estimates (N=70 338). We also obtained state-level estimates of adult self-reported …

View Full Text


  • Contributors ECL developed the concept for the study and performed the analytic calculations. All authors contributed to the interpretation of the results and the final version of the manuscript.

  • Funding The work is funded by Grants T31IR1584 and 28IR-0066 from the Tobacco Related Disease Research Program. NS also acknowledges salary support from the National Institute of Mental Health (Grant 5T32MH122376).

  • Disclaimer The study sponsors took no part in the study design; collection, analyses and interpretation of data; writing of the manuscript; or decision to submit the manuscript for publication.

  • Map disclaimer The depiction of boundaries on this map does not imply the expression of any opinion whatsoever on the part of BMJ (or any member of its group) concerning the legal status of any country, territory, jurisdiction or area or of its authorities. This map is provided without any warranty of any kind, either express or implied.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.