摘要：We examined the effect of demographics on California’s low smoking prevalence. We estimated that if the United States had the same demographics as California, then the US adult smoking prevalence in 2005 would have been 19.3%, 1.6 percentage points lower than the reported 20.9% for the United States, but 4.1 percentage points higher than California’s prevalence of 15.2% in 2005. Tobacco control appears to be a much more important factor than demographics in determining California’s low smoking rates. It is undeniable that California has surpassed the nation in its efforts to control smoking. In 2005, the US adult smoking prevalence was 20.9%, whereas California’s smoking prevalence was 15.2%, second lowest in the United States after Utah’s. 1 Since 1988, when California passed Proposition 99, a comprehensive tobacco control initiative in the state, smoking prevalence in California declined from 22.8% to 15.2% in 2005, a 33% reduction. In comparison, during the same time, the prevalence of smoking in the United States decreased from 24.1% to 20.9%, only a 13% decline. 2 California’s success has been attributed to its cigarette tax policy, an aggressive anti-smoking media campaign, its smoke-free indoor air policies, and its effective community tobacco education programs. 3 The observed correlation between California’s tobacco control efforts and ensuing results is encouraging and suggests that California could be used as an example for the United States to learn from and emulate. Correlation, however, does not imply causation. Because the demographics of California and the United States differ, it is conceivable that the low smoking rates found in California are independent of tobacco control efforts and are the result of the normal response of a population that is inherently predisposed against tobacco use. 4 Although California’s experience with tobacco has been documented and discussed in several studies, to our knowledge, not one of these has addressed the potential effect of California’s unique demographics on its low smoking rates relative to the United States. 5 – 7 We explored to what extent California’s demographic composition was responsible for the state’s low smoking prevalence. Our analysis helped to clarify the relative importance of demographics compared with tobacco control efforts in California’s success against tobacco use.
