Most Latino smokers in California are low-frequency smokers

Aims We examine the phenomenon of low-frequency smoking (non-daily smoking or smoking <= 5 cigarettes daily) among California Latinos and address its implications for addiction theory and population tobacco control. Design, setting and participants Data gathered in 2001 and 2003 through the California Health Interview Survey (CHIS), the largest general health survey in California. The present study focused on Latino current smokers (n = 1254 for CHIS 2001; n = 946 for CHIS 2003). Measurement Latino smokers reporting either non-daily smoking or smoking <= 5 cigarettes daily were identified and grouped into one category: low-frequency smokers. Findings Weighted by population parameters, more than 70% of Latino smokers in California were found to be low-frequency smokers [70.7% (CI = 67.2%, 73.9%) in 2001 and 70.8% (CI = 67.1%-74.2%) in 2003]. This high proportion cut across all demographic dimensions in both surveys, suggesting pervasiveness and reliability of this phenomenon. Proportions for non-daily smokers and low-rate daily smokers were 48.6% and 22.1% in 2001 and 54.9% and 15.9% in 2003. In both surveys, more than 80% of non-daily smokers consumed <= 5 cigarettes on their smoking days. Conclusions The fact that most Latino smokers are low-frequency smokers calls for a new theoretical framework-beyond withdrawal-based theories-to account for the prevalence of this behavior on the population level. It also calls into question the harm-reduction approach as a tobacco control strategy for California Latino populations. Strategies emphasizing that every cigarette can hurt, and encouraging complete cessation, seem more fitting for this group of smokers.