People With Low Socioeconomic Status Encounter Barriers to Quitting Successfully

At a glance

  • Most people who smoke want to quit, and more than half of them try to do so each year.
  • Connecting every person who wants to quit with treatment proven to help them quit for good is important for improving people's health.
  • Descriptions of strategies that states and communities can use to help people quit smoking are below.
Man working in a large warehouse.

Barriers to quitting

Most people who smoke want to quit, and more than half try to do so each year. People with lower incomes and less education try to quit using commercial tobacco similarly to other sociodemographic groups:A

  • In 2015, an estimated 56% of adults who live below the poverty level and smoke cigarettes tried to quit smoking, compared to 55% of those living at or above the poverty level.1
  • Also in 2015, an estimated 50% of adults who smoke cigarettes and who also had not earned a high school diploma tried to quit smoking, compared with 58% of those with some college education.2

Proven treatments, such as U.S. Food and Drug Administration (FDA)-approved medicines and behavioral counseling, make it more likely that people will quit smoking successfully.3 However, people with low socioeconomic status (SES) can run into barriers when trying to quit.2

  • In 2015, few (nearly 30%) adults living below the poverty level reported using proven treatments to quit smoking, though use was similar to adults living at or above the poverty level (about 32%).1
  • Also in 2015, fewer uninsured people who smoked received advice from a health care professional to quit smoking or used proven treatment to quit than those with private insurance.1

Connecting people with resources to quit is key‎

Connecting every person who wants to quit with treatment proven to help them quit for good is important for improving people's health.

What states and communities can do

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.4

Integrate clinical screening and treatment for commercial tobacco use in all health care 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 Talking to people about commercial tobacco use and quitting as a regular part of health care visits in these settings will help make sure that all groups can get effective treatment to help them quit.

Share health messages that feature people with low SES and their experiences

Mass media campaigns are proven to increase smoking cessation, prevent tobacco use initiation, and reduce the prevalence of tobacco use. Anti-commercial tobacco messaging and mass media campaigns can feature testimonials from people with low SES. CDC's Tips From Former Smokers® (Tips®) is one example of a campaign that has done this. Anti-commercial tobacco messaging and mass media campaigns that are culturally appropriate can also be helpful for people and communities with lower incomes. Positive reactions to Tips ads have been shown to lead to more quit attempts.

Fact sheets and guides

Websites

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Content Source:
National Center for Chronic Disease Prevention and Health Promotion; Office on Smoking and Health
  1. "Commercial tobacco" means harmful products that are made and sold by tobacco companies. It does not include "traditional tobacco" used by Indigenous groups for religious or ceremonial purposes.
  1. DiGiulio A, Jump Z, Babb S, Schecter A, Williams KS, Yembra D, 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. DOI: http://dx.doi.org/10.15585/mmwr.mm6906a2.
  2. 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. Am J Public Health. 2015; 105 (1): 180-188. DOI: 10.2105/AJPH.2013.301691
  3. Campaign for Tobacco-Free Kids. Tobacco and Socioeconomic Status [PDF - 225 KB]. Published November 3, 2021. Accessed March 21, 2022. https://assets.tobaccofreekids.org/factsheets/0260.pdf
  4. 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 188. DOI: http://dx.doi.org/10.5888/pcd14.160510.
  5. S. Department of Health and Human Services. Smoking Cessation. A Report of the Surgeon General [PDF - 9.8 MB]. 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 March 21, 2022. https://www.hhs.gov/sites/default/files/2020-cessation-sgr-full-report.pdf
  6. Davis KC, Duke J, Shafer P, Patel D, Rodes R, Beistle D. Perceived Effectiveness of Antismoking Ads and Association With Quit Attempts Among Smokers: Evidence from the Tips from Former Smokers Campaign. Health Commun. 2017; 32(8): 931-938. DOI: 10.1080/10410236.2016.1196413.