Uneven Access to Smoke-Free Laws and Policies and Its Effect on Health Equity in the United States: 2000-2019

Am J Public Health. 2019 Nov;109(11):1568-1575. doi: 10.2105/AJPH.2019.305289. Epub 2019 Sep 19.


Tobacco control measures have played an important role in the reduction of the cigarette smoking prevalence among US adults.However, although overall smoking prevalence has declined, it remains high among many subpopulations that are disproportionately burdened by tobacco use, resulting in tobacco-related health disparities. Slow diffusion of smoke-free laws to rural regions, particularly in the South and Southeast, and uneven adoption of voluntary policies in single-family homes and multiunit housing are key policy variables associated with the disproportionate burden of tobacco-related health disparities in these subpopulations.Developing policies that expand the reach of comprehensive smoke-free laws not only will facilitate the decline in smoking prevalence among subpopulations disproportionately burdened by tobacco use but will also decrease exposure to secondhand smoke and further reduce tobacco-caused health disparities in the United States.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Health Equity / statistics & numerical data*
  • Health Status Disparities*
  • Humans
  • Poverty
  • Racial Groups
  • Smoke-Free Policy / legislation & jurisprudence*
  • Socioeconomic Factors
  • Tobacco Smoke Pollution / prevention & control
  • United States


  • Tobacco Smoke Pollution