Hispanic and Latino People Encounter Barriers to Quitting Successfully
The majority of people who smoke want to quit, and more than half of them try to do so each year. Among Hispanic adults who smoked cigarettes:
- An estimated 67% report that they want to quit compared with 73% of Black, 68% of White, 70% of Asian, and 56% of American Indian/Alaska Native adults.50
- An estimated 56% report attempting to quit in the past year compared with 63% of Black, 53% of White, and 69% of Asian adults.51
- Hispanic adults quit smoking at similar rates to those of White adults and the overall population.50 Research shows that Hispanic people who smoke express high motivation to quit and can be motivated by the health effects that smoking can have on their children and family. Nevertheless, Hispanic people who smoke may try to quit without using cessation medication or counseling support.50,52
Proven treatments, such as FDA-approved medicines and behavioral counseling, make it more likely that people will quit smoking successfully. Hispanic/Latino people who smoke can run into barriers when trying to find and use these treatments.
- In 2015, Hispanic adults who smoked were less likely to receive advice to quit from a healthcare professional than non-Hispanic white adults who smoked.50,53
- In 2015, Hispanic adults who smoked were less likely to use any evidence-based treatment (counseling or medication) to quit than non-Hispanic white adults, though use of treatment varied by Hispanic subgroup.50,53
- Fewer Hispanic adults who smoke have health insurance coverage than non-Hispanic white adults who smoke.53 This may help to explain differences between these groups in use of proven quit-smoking treatments.
- The use of tobacco-cessation quitlines among Hispanic persons remains low, especially among those who speak Spanish.54
Connecting every person who wants to quit with treatment proven to help them quit for good is important for improving people’s health.
Examples of strategies that states and communities can use are:
Provide barrier-free, widely promoted, coverage for all evidence-based cessation treatments by all types of health insurance.
For example, as of 2018, only 15 state Medicaid programs fully covered tobacco cessation (quitting) services for all enrollees in traditional Medicaid.53
Integrate clinical screening and treatment for commercial tobacco* use in all healthcare settings and with all types of patients.
Community health centers and low-cost health clinics serve people who are more likely to use commercial tobacco products.56,57 Talking to people about commercial tobacco use and quitting as a regular part of healthcare visits in these settings will help make sure that all groups can get effective treatment to help them quit.
Increase access to culturally tailored cessation services.
When it comes to health issues, one size does not fit all. Different people and communities have varying needs and make decisions in different ways. For example, Hispanic/Latino people may smoke intermittently or smoke less than 10 cigarettes per day.58 Different cessation strategies may be helpful for individuals with these smoking patterns.51 In addition, treatment approaches developed by and for Hispanic/Latino communities that build on cultural values and priorities may be helpful.59
Share health messages that feature Hispanic/Latino people and their experiences.
Mass media campaigns are proven to increase smoking cessation, prevent tobacco use initiation, and reduce the prevalence of tobacco use.11,51 Anti-commercial tobacco messaging and mass media campaigns can feature testimonials from people from many racial and ethnic groups. CDC’s Tips From Former Smokers® (Tips®) is one example of a campaign that has done this. When Tips® was translated into Spanish, publicized on Spanish-language television, and included a phone number (1-855-DÉJELO-YA) that routed callers to state-specific Spanish language services, more Hispanic/Latinx people who smoke called to get advice on how to quit.59
Support community-based delivery of tobacco cessation and prevention interventions.
Community-based intervention models can include promotores de salud/community health workers, charlas/community discussions, and trainer-of-trainers models.60 Such models can integrate community-specific cultural and linguistic elements for tailored outreach and education.60
- Kaplan RC, Bangdiwala SI, Barnhart JM, et al. Smoking among U.S. Hispanic/Latino adults: the Hispanic community health study/study of Latinos. Am J Prev Med. 2014;46(5):496‐506 [accessed 2022 Mar 1].
- Cornelius ME, Loretan CG, Wang TW, Jamal A, Homa DM. Tobacco Product Use Among Adults — United States, 2020. MMWR Morb Mortal Wkly Rep. 2022; 71:397–405
- Pérez-Stable EJ, Ramirez A, Villarea R, Talavera GA, Trapido E, et al. Cigarette smoking behavior among US Latino men and women from different countries of origin. American Journal of Public Health. 2001; 91(9):1424-1430 [accessed 2022 Mar 1].
- Substance Abuse & Mental Health Data Archive. National Survey on Drug Use and Health: 2-Year RDAS (2018 to 2019) online analysis tool [accessed 2022 Mar 1].
- Gentzke AS, Wang TW, Cornelius M, et al. Tobacco Product Use and Associated Factors Among Middle and High School Students — National Youth Tobacco Survey, United States, 2021. MMWR Surveill Summ 2022;71(No. SS-5):1–29. DOI: http://dx.doi.org/10.15585/mmwr.ss7105a1
- U.S. Census Bureau. Annual Estimates of the Resident Population by Sex, Age, Race, and Hispanic Origin for the United States and States: April 1, 2010 to July 1, 2019. U.S. Census Bureau, Population Division. Release Date: June 2020 [accessed 2022 Mar 1].
- U.S. Census Bureau. Annual Estimates of the Resident Population for the United States, Regions, States, and Puerto Rico: April 1, 2010 to July 1, 2019. U.S. Census Bureau, Population Division. Release Date: December 2019 [accessed 2022 Mar 1].
- Centers for Disease Control and Prevention. Vital Signs: Leading Causes of Death, Prevalence of Diseases and Risk Factors, and Use of Health Services Among Hispanics in the United States—2009–2013. MMWR Morbidity & Mortality Weekly Report 2015;64(17):469–78 [accessed 2022 Mar 1].
- Heron M. Deaths: Leading causes for 2010. [PDF - 5.1 MB] National Vital Statistics Reports, 2013; 62(6) [accessed 2022 Mar 1].
- Xu JQ, Murphy SL, Kochanek KD, Bastian BA. Deaths: Final data for 2013. [PDF - 7.3 MB] National Vital Statistics Reports, 2016;64(2) [accessed 2022 Mar 1
- U.S. Department of Health and Human Services. The Health Consequences of Smoking: 50 Years of Progress. A Report of the Surgeon General. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office of Smoking and Health, 2014 [accessed 2022 Mar 1].
- 2018 National Health Interview Survey, Centers for Disease Control and Prevention, National Center for Health Statistics [accessed 2022 Mar 1].
- Feagin, J.R., & Cobas, J.A. (2014). Latinos Facing Racism: Discrimination, Resistance, and Endurance (1st ed.). Routledge [accessed 2022 Mar 1].
- Carrigan WD, Clive W. The lynching of persons of Mexican origin or descent in the United States, 1848 to 1928. Journal of Social History. 2003: 411-438 [accessed 2022 Mar 1].
- Langton L, Masucci M. US Department of Justice, Office of Justice Programs, Bureau of Justice Statistics 2017. Hate Crime Victimization, 2004-2015 [PDF - 588 KB] [accessed 2022 Mar 1].
- Ochoa EC. From Tortillas to Low-carb Wraps: Capitalism and Mexican Food in Los Angeles since the 1920s. Diálogo. 2015;18(1): 33-46 [accessed 2022 Mar 1].
- Hernández-Valero MA, Bustamante-Montes LP, Hernández M, Halley-Castillo E, Wilkinson AV, Bondy ML, et al. Higher risk for obesity among Mexican-American and Mexican immigrant children and adolescents than among peers in Mexico. Journal of Immigrant and Minority Health. 2012; 14(4): 517–522 [accessed 2022 Mar 1].
- Armstrong, K, Ravenell KL, McMurphy S, Putt, M. Racial/ethnic differences in physician distrust in the United States. American Journal of Public Health. 2007; 97(7): 1283–1289 [accessed 2022 Mar 1].
- Novak NL, Lira N, O’Connor KE, Harlow SD, Kardia SL, Stern AM. Disproportionate sterilization of Latinos Under California’s Eugenic Sterilization Pprogram, 1920–1945. American Journal of Public Health. 2018; 108(5): 611-613 [accessed 2022 Mar 1].
- Perreira, Krista M., and Juan M. Pedroza. Policies of exclusion: implications for the health of immigrants and their children. [PDF - 349 KB] Annual review of public health 40 (2019): 147-166 [accessed 2022 Mar 1].
- Pedraza FI, Nichols VC, LeBrón AMW. Cautious citizenship: the deterring effect of immigration issue salience on health care use and bureaucratic interactions among Latino US citizens. J. Health Polit. Policy Law. 2017, 42(5):925–60 [accessed 2022 Mar 1].
- Philbin MM, Flake M, Hatzenbuehler ML, Hirsch JS. State-level Immigration and Immigrant-Focused Policies as Drivers of Latino Health Disparities in the United States. Social Science & Medicine. 2018; 1982(199): 29-38 [accessed 2022 Mar 1].
- Carson NJ, Rodriguez D, Audrain-McGovern J. Investigation of mechanisms linking media exposure to smoking in high school students. Prev Med 2005;41(2): 511-20 [accessed 2022 Mar 1].
- Charlesworth A, Glantz SA. Smoking in the movies increases adolescent smoking: A review. Pediatrics 2005;116(6): 1516-28 [accessed 2022 Mar 1].
- National Cancer Institute. The Role of the Media in Promoting and Reducing Tobacco Use. Tobacco Control Monograph No. 19. Bethesda, MD: U.S. Department of Health and Human Services, National Institutes of Health, National Cancer Institute. NIH Pub. No. 07-6242, June 2008.
- Robinson RG, Barry M, Bloch M, Glantz S, Jordan J, Murray KB, Popper E, et al. Report of the Tobacco Policy Research Group on Marketing and Promotions Targeted at African Americans, Latinos, and Women. Tobacco Control. 1992; 1 (Suppl 1): S24-S30 [accessed 2022 Mar 1].
- Smiley SL, Kintz N, Rodriguez YL, Barahona R, Sussman S, Cruz TB, Chou CP, Pentz MA, et al. Disparities in Retail Marketing for Little Cigars and Cigarillos in Los Angeles, California. Addictive Behaviors Reports. 2019; 9:100149[accessed 2021 Dec 8].
- Ganz O, Rose SW, Cantrell J. Swisher Sweets ‘Artist Project’: Using Musical Events to Promote Cigars. Tobacco Control. 2018; 27:e93-e95 [accessed 2022 Mar 1].
- Robertson L, McGee R, Marsh L, Hoek J. A Systematic Review on the Impact of Point-of-Sale Tobacco Promotion on Smoking. Nicotine & Tobacco Research. 2015:17(1): 2-17[accessed 2022 Mar 1].
- Slopen N, Kontos EZ, Ryff CD, Ayanian JZ, Albert MA, Williams DR. Psychosocial stress and cigarette smoking persistence, cessation, and relapse over 9-10 years: a prospective study of middle-aged adults in the United States. Cancer Causes Control. 2013;24(10):1849-1863 [accessed 2022 Mar 1].
- Slopen N, Dutra LM, Williams DR, et al. Psychosocial stressors and cigarette smoking among African American adults in midlife. Nicotine Tob Res. 2012;14(10):1161-1169 [accessed 2022 Apr 28].
- Purnell JQ, Peppone LJ, Alcaraz K, et al. Perceived discrimination, psychological distress, and current smoking status: results from the Behavioral Risk Factor Surveillance System Reactions to Race module, 2004-2008. Am J Public Health. 2012;102(5):844-851 [accessed 2022 Apr 28].
- U.S. Census Bureau. Current Population Survey, 2009 to 2020. Current Population Survey Annual Social and Economic Supplement (CPS ASEC) [accessed 2022 Mar 1].
- Coleman-Jensen A, Rabbitt MP, Gregory CA, Singh A. Household Food Security in the United States in 2019, ERR-275, U.S. Department of Agriculture, Economic Research Service. Economic Research Service. 2020 [accessed 2022 Mar 1].
- Slavich GM. Life Stress and Health: A Review of Conceptual Issues and Recent Findings. Teaching of Psychology. 2016; 43(4): 346-355[accessed 2022 Mar 1].
- Discrimination in America: Experiences and Views on Effects of Discrimination Across Major Population Groups in the United States. Harvard T.H. Chan School of Public Health, Robert Wood Johnson Foundation and National Public Radio. 2017 [accessed 2022 Mar 1].
- Discrimination in America: Experiences and Views of Latinos [PDF-1.0 MB]; a 2017 poll developed by the Harvard T.H. Chan School of Public Health, Robert Wood Johnson Foundation and National Public Radio (NPR). [accessed 2022 Mar 1].
- Juster RP, McEwen BS, Lupien SJ. Allostatic load biomarkers of chronic stress and impact on health and cognition. Neuroscience & Biobehavioral Reviews. 2010;35(1): 2-16 [accessed 2022 Mar 1].
- Guyll M, Matthews KA, Bromberger JT. Discrimination and unfair treatment: relationship to cardiovascular reactivity among African American and European American women. Health Psychology. 2001;20(5): 315 [accessed 2022 Mar 1].
- National Center for Health Statistics. National Health and Nutrition Examination Survey, 2015–2018 [PDF - 148 KB] [accessed 2022 Mar 1].
- Wilson KM, Klein JD, Blumkin AK, Gottlieb M, Winickoff JP. Tobacco-smoke exposure in children who live in multiunit housing. Pediatrics. 2011; 127 (1): 85-92 [accessed 2022 Mar 1].
- Merianos AL, Jandarov RA, Choi K, Mahabee-Gittens EM. Tobacco smoke exposure disparities persist in U.S. children: NHANES 1999-2014. Prev Med. 2019;123:138-142 [accessed 2022 Apr 28].
- Cancer Trends Progress Report. National Cancer Institute, NIH, DHHS, Bethesda, MD, July 2021 [accessed 2022 Mar 1].
- Brody DJ, Lu Z, Tsai J. Secondhand Smoke Exposure Among Nonsmoking Youth: United States, 2013-2016. [PDF - 500 KB] NCHS Data Brief, 2019 [accessed 2022 Mar 1].
- Pizacani BA, Maher JE, Rohde K, Drach L, and Stark MJ. Implementation of a smoke-free policy in subsidized multiunit housing: effects on smoking cessation and secondhand smoke exposure. Nicotine Tob Res 2012;14(9): 1027-1034 [accessed 2022 Mar 1].
- Shopland DR, Anderson CM, Burns DM, Gerlach KK. Disparities in smoke-free workplace policies among food service workers. Journal of Occupational and Environmental Medicine. 2004;46(4): 347-356 [accessed 2022 Mar 1].
- Holmes LM, Ling PM. Workplace secondhand smoke exposure: a lingering hazard for young adults in California. Tobacco Control.2017; 26(e1): e79–e84 [accessed 2022 Mar 1].
- Hafez AY, Gonzalez M, Kulik MC, Vijayaraghavan M, Glantz S. Uneven access to smoke-free laws and policies and its effect on health equity in the United States: 2000–2019. American Journal of Public Health. 2019; 109(11): 1568-1575 [accessed 2022 Mar 1].
- Americans Nonsmokers’ Rights Foundation. Bridging the Gap: Status of Smokefree Air in the United States [PDF - 149 KB] [accessed 2022 Mar 1].
- Babb S, Malarcher A, Schauer G, Asman K, Jamal A. Quitting Smoking Among Adults—United States, 2000-2015. Morbidity and Mortality Weekly Report 2017;65(52):1457-64 [accessed 2022 Mar 1].
- U.S. Department of Health and Human Services. Smoking Cessation: A Report of the Surgeon General. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2020 [accessed 2022 Mar 1].
- Carter-Pokras OD, Feldman RH, Kanamori M, et al. Barriers and facilitators to smoking cessation among Latino adults. J Natl Med Assoc. 2011;103(5):423– 431 [accessed 2022 Mar 1].
- Babb S, Malarcher A, Asman K, Johns M, Caraballo R, VanFrank B, et al. Disparities in Cessation Behaviors Between Hispanic and Non-Hispanic White Adult Cigarette Smokers in the United States, 2000–2015. Prev Chronic Dis 2020;17:190279 [accessed 2022 Mar 1].
- Zhang L, Babb S, Johns M, Mann N, Thompson J, Shaikh A, et al. Impact of US antismoking TV ads on Spanish-language quitline calls. American Journal of Preventive Medicine.2018; 55(4): 480-487 [accessed 2022 Mar 1].
- DiGiulio A, Jump Z, Babb S, et al. State Medicaid Coverage for Tobacco Cessation Treatments and Barriers to Accessing Treatments — United States, 2008–2018. MMWR Morb Mortal Wkly Rep 2020;69:155–160 [accessed 2022 Mar 1].
- Lebrun-Harris LA, Fiore MC, Tomoyasu N, and Ngo-Metzger Q. Cigarette Smoking, Desire to Quit, and Tobacco-Related Counseling Among Patients at Adult Health Centers. American Journal of Public Health 2015; 105 (1): 180-188 [accessed 2022 Mar 1].
- Flocke SA, Hoffman R, Eberth JM, Park H, Birkby G, Trapl E, et al. The Prevalence of Tobacco Use at Federally Qualified Health Centers in the United States, 2013. Prev Chronic Dis 2017; 14:160510 [accessed 2022 Mar 1].
- Castro Y. Determinants of Smoking and Cessation Among Latinos: Challenges and Implications for Research. Social and Personality Psychology Compass. 2016;10(7): 390-404 [accessed 2022 Mar 1].
- Borrelli B, McQuaid EL, Novak SP, Hammond SK, Becker B. Motivating Latino caregivers of children with asthma to quit smoking: a randomized trial. J Consult Clin Psychol. 2010;78(1):34‐43 [accessed 2022 Mar1].
- Centers for Disease Control and Prevention. Best Practices User Guide: Health Equity in Tobacco Prevention and Control. [PDF - 5.0 MB] Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2015 [accessed 2022 Apr 28].