Abstract B018: Changes in prevalence and correlates of tobacco use in 13 high-risk states in the United States from 2023-2024

Abstract Significance: Overall tobacco use rates are higher in the Midwest and Southern regions of the United States (US) than the rest of the US, yet little is known on correlates of tobacco use, or how rates are changing in recent years. This study examines current correlates of tobacco use among individuals living in the 13 most high-risk states in the US over two years. Methods: First, we examined the prevalence of tobacco use and related correlates in a rapid response survey of 4,550 adults collected between April-May 2023 (18+ years) living in the 13 high-risk states collected by the American Cancer Society. Data were weighted to be representative of the states’ population. Bivariate analyses for demographic characteristics were conducted examining cigarette use, e-cigarette use, and cigar use. Additional data collected from April-May 2024 in a second wave of cross-sectional data (n=4,500) for comparison between years and are currently being analyzed to reflect potential changes in correlates from 2023 to 2024. Results: Respondents in Wave 1 were aged 18-65 (Mean = 41.85; SD=0.32) and were majority Non-Hispanic White (70.9%) and female (51.9%). 47.5% of respondents reported an annual household income of <$75,000 USD. Although most respondents lived in urban (50.2%) or mostly urban areas (26.6%), several participants still resided in mostly rural (11.0%) or all rural (10.2%) as defined by US Census demographic data. The prevalence of any tobacco use was high across all 13 states (33.1%), with 29.5% reporting cigarette, e-cigarette and/or cigar use.21.1% of respondents were persons who currently smoke vs. 11.5% for the national average, while 20.7% were persons who previously smoked and 8.0% were persons who occasionally smoke. 14.0% of respondents reported current e-cigarette use vs 4.5% for the national average and 17.5% reported previous e-cigarette use. 8.7% of respondents reported current cigar use vs 3.5% for the national average and 24.1% reported previous cigar use. Respondents identifying as male (<.001) and with a household income <$75,000 (<.001), a disability (p=.014), or military/veteran status (p=.031) were more likely to currently smoke. Respondents who were male (p=.004) or reported household income <$75,000 (p=.011) were more likely to report current e-cigarettes use; higher use was associated with increasing age (<.001). Respondents who were male (<.001), and nonwhite (<.001) were more likely to report current cigar use; higher use was associated with increasing age. Conclusions: Cigarette use is high among individuals living in this region, and is related to lower household income, military/veteran status, disability status, and male identity. E-cigarette and cigar use increased with age. These high tobacco use rates lead to increased health inequities, with related high rates of cancer and cardiovascular disease. Given that tobacco use continues to be high in these states, tailored cessation programs could help reduce the heavy burden of tobacco use among this population. Citation Format: Minal Patel, Laurel Gibson, Presley Cannon, Shanshan Wang, Nigar Nargis. Changes in prevalence and correlates of tobacco use in 13 high-risk states in the United States from 2023-2024 [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B018.