Inequitable exposure to tobacco product litter among adolescents in California, USA - PubMed (original) (raw)
Inequitable exposure to tobacco product litter among adolescents in California, USA
Benjamin W Chaffee et al. Tob Prev Cessat. 2025.
Abstract
Introduction: Tobacco waste is a costly, widespread blight and environmental toxicant that is not distributed equally across geographical areas. This investigation reports on the prevalence of noticing tobacco litter and potential inequities in tobacco litter exposure among adolescents in California, USA.
Methods: Data from the 2023 Teens, Nicotine, and Tobacco (TNT) Online Survey (N=4910), a statewide, online cross-sectional survey of California adolescents aged 12-17 years, were analyzed for the self-reported frequency of noticing tobacco product litter. All participants were asked to report how often they notice tobacco product litter (closed-ended response options: almost always, sometimes, once in a while, never). Survey-weighted multivariable regression models were fitted to quantify the odds of noticing tobacco litter 'almost always' according to participant characteristics (age, sex, gender/sexual identity, race/ethnicity, location, family finances, and own and household tobacco use). Data were weighted for geographical and demographic representativeness and response quality.
Results: The prevalence of noticing tobacco litter almost always was 44.6% overall and higher among participants who identified as Hispanic/Latino (50.9%) or LGBTQ+ (53.3%), lived in a small town (57.8%), or whose families were financially disadvantaged (52.7%). These inequities persisted in multivariable models, including adjustment for own and household tobacco use. For example, Hispanic/Latino participants had 1.66-times the adjusted odds of almost always noticing tobacco litter (95% CI: 1.32-2.07; reference: non-Hispanic White); the adjusted odds ratio for LGBTQ+ identity was 1.39 (95% CI: 1.04-1.87; reference: non-LGBTQ+).
Conclusions: The pervasive exposure to tobacco litter observed in this study suggests a need for stronger efforts to reduce tobacco waste, with an emphasis on advancing equity.
Keywords: adolescent health; environment and public health; health inequities; tobacco products.
© 2025 Chaffee B.W. et al.
Conflict of interest statement
The authors have completed and submitted the ICMJE form for Disclosure of Potential Conflicts of Interest. The authors declare that they have no competing interests, financial or otherwise, related to the current work. B.W. Chaffee, E.T. Couch, N.F. Cheng and S.A. Gansky report that since the initial planning of the work, this research has been supported by the California Department of Public Health and payment was made to the University of California San Francisco (Contract numbers: CDPH-20-10026 and CDPH-23-10363). S.A. Gansky also reports that this research has also been supported by the National Institutes of Health and payment was made to the Institution. B.W. Chaffee reports that in the past 36 months, he has received support from the National Center for Advancing Translational Sciences, the National Institutes of Health (Grant number: UL1 TR001872 to the University of California San Francisco) and the National Heart Lung and Blood Institute, National Institutes of Health (Grant number: U54 HL147127 to University of California San Francisco). He has also received consulting fees from Westat for work related to the Population Assessment of Tobacco and Health Study. Additionally, he declares receiving lecture honoraria from the Arcora Foundation, the California Dental Association, the Fresno Madera Dental Society, and JBS International. B.W. Chaffee has also been a Board member at large at the American Association for Dental, Oral, and Craniofacial Research (unpaid role). S.A. Gansky reports that in the past 36 months he received support from the University of Illinois Chicago – NIH subcontract, the UCLA – NIH subcontract, the Boston University – NIH subcontract, the Case Western Reserve Univ – NIH subcontract, the Rowpar Pharmaceuticals Inc and payments were made to the Institutions. He has also received consulting fees from the University of Iowa (NIH grant). Additionally, he has received support for attending meetings from the Task Force on Design and Analysis in Oral Health Research.