Technical Report on Analytic Methods and Approaches Used in the 2002 California Tobacco Survey Analysis

Transcription

1 Technical Report on Analytic Methods and Approaches Used in the 2002 California Tobacco Survey Analysis VOLUME 3 Methods Used for Final Report Tobacco Control Successes in California: A Focus on Young People A Report to the California Department of Health Services Elizabeth A. Gilpin Martha M. White Charles C. Berry UNIVERSITY OF CALIFORNIA, SAN DIEGO LA JOLLA, CALIFORNIA October 23, 2003

2 This report was prepared under contract # between the University of California, San Diego and the California Department of Health Services, and the value of the contract was $2,304,867. The fieldwork for the 2002 California Tobacco Survey was subcontracted to Westat, Inc., and the value of the subcontract was $1,998,306. Suggested Citation: Gilpin EA, White MM, Berry CC. Technical Report on Analytic Methods and Approaches Used in the 2002 California Tobacco Survey Analysis. Vol 3: Methods Used for Final Report. Tobacco Control Successes in California: A Focus on Young People, Results from the California Tobacco Surveys, La Jolla, CA: University of California, San Diego; 2004.

3 TABLE OF CONTENTS Introduction 1 Chapter 1 Comparison of California to the Rest of the United States.. 2 National Surveys Comparing California to the Rest of the US Per Capita Cigarette Consumption Trends Standardization of Adult Smoking Prevalence Estimates 2 Trends in Tobacco use in California Cross-sectional CTS Standardized Estimates of Adult Smoking Prevalence Adjusted Estimates of Adult Smoking Prevalence for Regions Standardized Estimates of Adolescent Smoking Prevalence Adjusted Estimates of Adolescent Smoking Prevalence for Regions 3-6 None Page 7 Adolescent Smoking Behavior Wave Longitudinal Survey 8 Smoking Cessation: California Smokers Are Trying to Quit.. 12 Definition of Smoker in the Last Year Application of Kaplan-Meyer Survival Model to Smoking Relapse 9-13 None References Glossary.. 16 Descriptive Tables.. 20

4 INTRODUCTION The material presented in this Volume 3 of the technical documentation explains any special methodology used in the analyses for the final report describing the results of the 2002 California Tobacco Survey (CTS) (Gilpin et al., 2004a). While central to the analyses presented in the final report, this description would have detracted from a straightforward presentation of the survey results. Not every chapter included special analyses that needed to be described in the present volume. Chapter 1 of the 2002 report uses several different national surveys to compare tobacco control progress in the US with that in the rest of the US. A brief description of the methodology for these national surveys is presented in this volume under Chapter 1. A brief description of the 2002 CTS is presented in the introduction for Chapter 2, with a more detailed description in this volume in the section for the methods related to Chapter 2. Descriptions of the CTS 1990, 1992, 1993 and 1996 CTS are given in Appendix A to the final report describing the results of the 1996 CTS (Pierce et al., 1998). The description of the 1999 CTS is in Volume 3 of the technical documentation for the 1999 report (Gilpin et al., 2001d). Each chapter of the final report also includes a glossary of terms describing smoking behavior or status, but a complete glossary of all terms used is included in the present volume as well. A set of tables was prepared for the 2002 CTS in the same format as was presented in Appendix B of the report for the 1996 and earlier CTS (Pierce et al., 1998), and in Volume 3 of the technical documentation for the 1999 CTS (Gilpin et al, 2001d). There are some changes in definition of smoking status, footnoted on the tables that make comparisons with the same table for previous years invalid. 1

5 Chapter 1 TOBACCO CONTROL PROGRESS IN CALIFORNIA AND THE REST OF THE U.S. National Surveys Used to Compare California with the Rest of the US Current Population Surveys Tobacco Use Supplement (CPS-TUS) The national Current Population Survey (CPS) periodically includes a special Tobacco Use Supplement (TUS), which was the source of the data for this analysis. The CPS is a continuous survey (over 56,000 households/month) conducted by the US Bureau of the Census, primarily to monitor labor force indicators for the civilian non-institutionalized US population age 15 years and older. The complete CPS methodology is published elsewhere (USDC, 2000). Briefly, the CPS includes a probability sample, based on a stratified sampling scheme of clusters of four neighboring households identified from the most recent decennial census, updated building permits, and other sources. All strata are defined within state boundaries, and the sample is allocated among the states so that state-specific estimates can be computed. The TUS was developed by the National Cancer Institute staff and pretested by trained Bureau of the Census interviewers prior to implementation. TUS were included for the months of September, January and May in , , and , and for the months of June, September and January in The data for the 2001 and 2002 surveys are preliminary estimates, and the files provided did not include the balanced repeated replicate structure for computation of 95% confidence intervals. For the analyses presented in this report, data on adults age 18 years and older from the three months in each period were analyzed. National Household Survey on Drug Abuse (NHSDA) These surveys are conducted by the Substance Abuse & Mental Health Services Administration (SAMHSA, 1999, 2000, 2001) to provide estimates of prevalence and incidence of use of alcohol, tobacco, and illicit drugs in the U.S. These in-home face-toface surveys interview the non-institutionalized U.S. population over the age of 12 years. More information is available from the SAMHSA website. The interviewer first asks questions regarding demographics, then gives a full copy of the questionnaire to the participant. The interviewer reads aloud all the substance use questions, while the participant follows along with his/her copy of the questionnaire and an answer sheet. The participant has exclusive view of the answer sheet. After the questionnaire is completed, the interviewer directs the participant to the nearest mailbox to mail it. For each of the 50 states and the District of Columbia, the NHSDA consisted of a clustered sample of counties or groups of counties, a sub-sample of blocks or block groups, and a sample of households and individuals in those households. The survey oversampled Hispanics and African Americans to increase precision for these groups and also took into account seasonal variation. A weighting factor to correct for sampling probability, nonresponse and oversampling of racial/ethnic minorities is used to obtain population estimates. 2

6 For California and a number of other large-population states, the NHSDA can provide statedirect specific estimates; for other states a special estimation procedure is used. In 2001, the response rates were 92% at the household level and 73% for household members. The data presented in the Appendix to Chapter 1 of the final report are for adolescents (12-17 years) and adults (18+ years). The sample sizes for the estimates presented in the Appendix tables are shown below: Adolescents (12-17 Years) Adults (18+ Years) Year California Rest of US California Rest of US ,805 20,398 22, , ,851 20,517 22, , ,798 20,802 24, ,342 National Youth Tobacco Survey (NYTS) The NYTS are self-administered school-based surveys. The first NYTS was sponsored by the American Legacy Foundation in the fall of 1999, and was designed to provide nationally representative estimates of the smoking behaviors of 6 th to 12 th graders. In the spring of 2000, the NYTS was repeated to complement the National Youth Risk Behavior Surveys that are conducted in the spring of odd years (e.g., 1997, 1999). The NYTS was next administered in the spring of The 1999 sample included 15,058 youth from 131 schools, the 2000 sample included 35,828 students in 324 schools, and the 2001 survey included 26,149 students in approximately 246 schools (Healton et al., 2000; Farrelly et al., 2001). A three-stage cluster sample design was carried out to select schools and classes were randomly selected within schools. The first stage comprised a sample of a large county or groups of smaller adjacent counties (1306 total units). From these, 66 were selected from 16 strata formed on the basis of degree of urbanization and race/ethnicity. At the second stage, 145 schools were selected with probability based on enrollment, again with minority schools having a higher probability of selection. At the third stage, 5 classes of a required subject were selected from each school. In 1999, the school response rate was 90% and among students it was 93% (Healton, et al., 2000). Response rates for other years are not yet published. Samples were variously over-selected (by school) to include specific racial/ethnic minorities, so that more precise estimates for these groups could be obtained. A weighting factor was therefore applied to adjust for nonresponse, for the probability of selection, and for oversampling of racial/ethnic groups. The American Legacy foundation provided a code for schools in California so that students in these schools could be contrasted with students in schools in the rest of the US. They also ran the preliminary estimates for the 2002 survey. 3

7 Per Capita Cigarette Consumption Trends A description of how per capita cigarette consumption was determined was presented in Chapter 1 of the final report (Gilpin et al., 2004a), but is repeated here for completeness. Until late 1998 when it was disbanded, the Tobacco Institute compiled cigarette sales data on a monthly basis in each state for federal tax reporting purposes (Tobacco Institute, 1997). Since then, the same group responsible for compiling the earlier data has been producing it through the economic consulting firm of Orzechowski and Walker, with support from the tobacco industry (Orzechowski & Walker, 2003). As these data are from wholesale warehouse removals, variation from one month to the next is considerable; in particular, the levels of removals in the last month of any quarter is strongly correlated with the removals in the first month of the next quarter. This variation has little to do with actual consumption and likely reflects business practice. To partially remove this source of variation, data were combined into 2-month intervals with December/January, February/March, etc., treated as single intervals. To convert the sales data to per capital cigarette consumption, the mean number of packs removed from warehouses in each interval was divided by the total population of adults aged 18 years or older. Presently, these population figures are based on unrevised projections from the 1990 census for , and extrapolation of 2000 data for 2001 and Annual values are interpolated to obtain the populations for each 2-month interval. Even after averaging the sales figures for December/January, February/March, etc., the plots show that enough periodicity remains that it is difficult to determine when there is a change in trend. Thus, to facilitate interpretation of the per capita consumption data, a special procedure was employed that first decomposes a univariate time series into a seasonal component, and an adjusted component from which the seasonal component is removed. Finally, it computes a smoothed or adjusted version of the trend. With the smoothing part of the procedure there are user-specified parameters for the smoother window and how to handle the beginning and end of the time series, which will not have a full window s worth of data for smoothing. The smoothed trend, therefore, is not always as representative of the trend at the tails as it is in the middle of the range. The procedure used is available in S-Plus as the SABL macro (MathSoft, 1999). In the regression models described below, the deseasonalized trend data were used. Standardization of Adult Smoking Prevalence Estimates When comparing trends in smoking prevalence in California to the trends in the rest of the United States, the differences in the demographic distributions for California and the rest of the United States need to be taken into account. California differs from many other areas in the country in its racial/ethnic composition, and perhaps by age and education as well. For consistency with the standardization carried out in previous examinations of the trends in smoking prevalence (Pierce et al., 1998), the following demographic categories were used: gender (male and female), age (18-29, 30-39, 40-49, 50-59, and 60+), race (White and 4

8 Non-White), and education (some college and no college). This set of demographic categories yields 2 x 5 x 2 x 2=40 cells. The cell population totals for the direct standardization procedure were from the sums of the weights for the various cells from the 2002 CTS screener survey. The population totals used to develop these weights were from the Current Population Survey annual demographic file of March In the direct standardization procedure (Fleiss, 1981), weighted (survey weights) prevalence is computed for the respondents in each of the 40 cells, and then the results are multiplied by the fraction that particular cell represents of the total population, and the results are summed over all 40 cells to obtain the standardized estimate. 5

9 Chapter 2 TRENDS IN TOBACCO USE IN CALIFORNIA 2002 Cross-Sectional CTS The 2002 California Tobacco Survey (CTS) consisted of three surveys. First, as in previous CTS, a five-minute screener interview was conducted with a household adult. The screener respondent provided demographic information on all household residents, including smoking status. In addition, the screener respondent was asked about household smoking restrictions and household income. Based on the information from the screener, certain household residents were selected for extended interviews. The design of the 2002 CTS was very similar to that of the 1990, 1992, and 1999 CTS (Pierce et al., 1998). In 1993 and 1996, a short extended interview was conducted with the screener respondent. In 1993, because of lack of funds, that was the only adult interview conducted, and in 1996 the short interview with the screener respondent was retained (if the screener respondent was not selected for the longer extended interview), so that comparisons could be made with the 1993 CTS results. However, a comparison of results from the short and long interviews in 1996 showed that the estimates for the items included on each (the short interview was a subset of the longer interview) were nearly identical. For that reason, the 1999 and 2002 CTS design reverted to the earlier model employed in 1990 and As in the earlier CTS, the probability of selection for an adult extended interview in 2002 was much higher if the person had been a smoker within the past five years. For a complete description of the sampling methodology both at the household and individual level see the survey technical documentation (Gilpin et al., 2001b, 2004b). The 2002 CTS attempted to interview all adolescents in the household between 12 and 17 years, as in all other CTS except the 1999 CTS, which randomly selected just one adolescent. Another change in the 2002 CTS was the selection of all young adults between 18 and 29 years for an extended interview. A special section of the adult interview was designed to capture young adult smoking behavior and attitudes. To make room for this section and maintain the same average length, other sections of the standard adult instrument from 1999 were revised to omit some questions. It is anticipated that some of these questions will be reinstated on future CTS. Interviewers attempted to contact 76,877 households (see flowchart). The screener survey was completed for 35,133 (45.7%) of these selected telephone numbers. Of the 95,791 people enumerated in these households, 8,796 were between 12 and 17 years of age, and completed youth extended interviews were obtained for 5,857 (66.6%). Also, 16,128 persons between 18 and 29 years were enumerated, and completed extended interviews were obtained for 9,455. Finally, 55,105 adults age 30 years and older were enumerated. Of these 16,526 were selected for an extended interview based on their reported smoking status, and 11,070 competed the adult extended interview (67.0%). Details of the sampling methodology are in another technical report (Gilpin et al., 2001c, 2004c). 6

10 2002 California Tobacco Survey FLOWCHART Eligible Households Called 76,877 Includes percentage of telephone numbers with no answer after 15 calls. These were assumed to be households. 45.7% Response Households Interviewed 35,133 Persons Enumerated 95,791 <12 Years of Age 15, Years of Age 8, Years of Age 16, Years of Age 55,105 Total 18+ Years of Age 71,233 Selected for Extended Interview 8,796 Selected for Extended Interview 16,128 Selected for Extended Interview 16,526 Selected for Extended Interview 32, % Response 58.6% Response 67.0% Response 62.8% Response Interviewed 5,857 Interviewed 9,455 Interviewed 11,070 Interviewed 20,525 7

11 Standardized Estimates of Adult Smoking Prevalence As for the results presented in Chapter 1, the prevalence estimate trends from the CTS needed to be standardized so that trends could be compared over time. All estimates were standardized by the distribution of the population totals for the demographic subgroups (see section on Chapter 1) obtained from the sums of the weights from the 2002 CTS screener survey. These reflect the population totals from the March 2002 Current Population Survey (CPS, 2002) and data from the US Census used in the poststratification procedure for computing the screener survey weights (Gilpin et al., 2004c). When examining trends within specific demographic groups, the standardization procedure used the cells defined the other demographic groups within the group of interest. For instance, when examining trends by gender, the 5(age) x 2(race/ethnicity) x 2(education) = 20 cells within each gender were the basis for the direct standardization procedure. For examining estimates within gender by race/ethnicity, 5(age) x 2(education) = 10 cells were used, etc. Adjusted Estimates of Adult Smoking Prevalence for Regions Because the sample size within region was sometimes small enough that direct standardization was not an option, an alternative procedure was employed to compute modified survey weights for each survey based on a single set of population totals using a raking methodology (Deming & Sephan, 1940). Preliminary analyses in 1999 showed that the choice of which year s population totals to use made little difference to the resulting trends, so 2002 population totals were used for the data reported in Chapter 2 of the 2002 report. Further analyses indidated there were nonzero counts for every survey for every region for the following individual demographic categories: Sex (male and female), age (18-30, 31-49, and 50+), race/ethnicity (Non- Hispanic White and Other), education (no college and some college). Thus, these variables were each combined with region as a set of indices for the raking marginals. In addition, at the statewide level, there were positive counts for all combinations of these the demographic categories: Age(18-24, 25-44, 45-64, and 65+), race/ethnicity (Hispanic, Non-Hispanic White, African American, and Asian/Other), education (<12 years, 12 years, years and 16+ years). As these provide a finer set of categories for describing population changes over time, these were also used (but not crossed with region) as another set of indices for the raking marginals. The actual raking to compute the adjusted weights was carried out using routines written in S-Plus (MathSoft, 1999) and the programming language C. Finally, using these modified weights for each survey, the adjusted prevalence estimates were computed for each region from each of the CTS. 8

12 Standardized Estimates of Adolescent Smoking Prevalence The sample sizes for the adolescent survey in each year were adequate for a direct standardization procedure. Within each demographic category, the prevalence estimates were standardized for all other demographic categories. For instance, within gender, the estimates were standardized by age (12-13, 14-15, and years) and race/ethnicity (Non Hispanic White, Hispanic, African American/Other, and Asian), and within age group, estimates were standardized by gender (male and female) and race/ethnicity. As with the adult standardized estimates, the other group was combined with African Americans for computing cell fractions, but they were omitted when computing the cell prevalence for African Americans. Adjusted Estimates of Adolescent Smoking Prevalence by Region As for the regional adult prevalence estimates, the adolescent estimates required adjustment so that trends within region can be discerned, as well as comparisons made among regions at a given point in time. The same approach used for the adult adjusted estimates was used for the adolescents (see above). Again, preliminary analyses indicated that to minimize variance inflation, the data should be adjusted to the 2002 population totals. Based on the cell sizes, three separate indices were used for the raking marginals. These indices were sex by region, age (12-14 vs years) by region, and ethnicity (Non-Hispanic White, Hispanic, African American, and Asian/other) by region. 9

13 Chapter 7 ADOLESCENT SMOKING BEHAVIOR 3-Wave Longitudinal Survey Data from a 3-way longitudinal survey were used in this chapter to determine rates of future smoking initiation among never smokers at baseline. The baseline sample consisted of 12- to 15-year-olds interviewed as part of the 1996 CTS (N=4,274, see flowchart). An interview was attempted with all these adolescents in 1999 when they were years of age. All of the adolescents successfully followed in 1999 (N=2,825) were eligible for a second followup in 2002, when they were years of age, and completed interviews were obtained for Longitudinal Survey FLOWCHART 1996 CTS Youth 6,252 Eligible Youth (12-15) 4, % Response 1999 Adolescents Interviewed (15-18) 2, % Response 2002 Young Adults Interviewed (18-21) 2,034 10

14 For both follow-ups, extensive tracking was employed to locate eligible youth. Of youth located, some refused (or the parent refused in 1999, youth could consent themselves in 2002), a few were deceased, a few incarcerated, and some were living outside the US. Of those located in 1999, the cooperation rate was 77%, and in 2002 it was 79%. The analyses presented in Chapter 7 were for never smokers at baseline in 1996 (N=3,166). Not all were successfully followed: 1999 (N= 2,119), 2002 (N=1,572). For a detailed methodological description of how sample weights were calculated and adjusted for non-response, see the technical reports for the cohort survey (Westat, 2000, 2003). 11

15 Chapter 8 SMOKING CESSATION Definition of Smoker in the Last Year To evaluate the percentage of the California population of smokers who have made a quit attempt, it is necessary to establish a time frame for when the attempt occurred and to define the group being evaluated. In previous reports of CTS results, a rather elaborate set of criteria was used to identify which subjects constitute the denominator, smokers in the last year, and for defining the numerator, quitters, for the computation of the quit attempt rate (Pierce et al., 1998). In the present report, a simplified algorithm was adopted; whether the subject was a current smoker at the time of the survey or a former smoker is key. Current Smokers at the Time of the Survey All current smokers were included in the denominator, and were asked: During the past 12 months, have you quit smoking intentionally for one day or longer? Anyone answering in the affirmative was counted in the numerator. Current smokers who claimed that they had quit for a day or longer were asked: How long did you actually stay off cigarettes during that quit attempt? If these smokers failed to provide valid information on the length of this quit attempt (2.3% of current smokers with a quit attempt in the 2002 CTS), they were given credit for 1 day. Former Smokers at the Time of the Survey To determine when former smokers last smoked they were asked: ywere you smoking at all around this time 12 months ago? When did you last smoke regularly? Former smokers who were smoking a year previously, and who gave a valid date for when they quit in the past year, were included in the numerator and denominator. A few more former smokers who did not give a valid quit date (0.1% of former smokers smoking a year previously in the 2002 CTS) were also included and given credit for a 30-day quit attempt if they answered no to the following question: Did you smoke any cigarettes during the past 30 days? Those who responded yes were treated as current smokers (see above). The time since the former smoker had quit was then calculated as the difference in the quit date and the date of the interview. 12

16 This procedure could have excluded a few former smokers who were not smoking a year previously, who relapsed to smoking later, but who were abstinent again at the time of the interview. In early reports (before 1999), any former smoker with a quit date in the previous year was included. However, the quit date was taken as the date the former smoker last smoked or had a puff on a cigarette, rather than the date the former smoker last smoked regularly. This procedure was carried out to be as conservative as possible. However, there were a considerable number of long-term former smokers in each year that quit smoking regularly years before the survey, but had a cigarette recently, presumably on a relatively rare special occasion. By including these former smokers in the denominator for smokers in the last year and in the numerator, the quit rate was artificially inflated. Application of Kaplan-Meyer Survival Model to Smoking Relapse The section above explains how the duration of the most recent quit attempt was determined for both current smokers (relapsers) and for former smokers at the time of the survey. For recent former smokers, the risk of relapse is high, and many may relapse following the interview. Since no information on their status is available after the interview, all that is known is that they remained abstinent up until they were interviewed. This is analogous to the situation in a prospective clinical study of survival, where patients are enrolled over a period of months or even years, but survival status is evaluated at a fixed point of time. At the time of the evaluation, which may be only a few months after study entry for some patients, survival status is available, but since these patients have not been followed for a long enough time to evaluate their eventual status, they are censored from the analysis at the point they were last known to be alive. The survival or relapse curves shown in Chapter 8 are standard Kaplan-Meyer curves computed in exactly the same manner as for a prospective survival study (Miller, 1981). The current smokers at the time of the study were the deaths and the former smokers the survivors, who were censored at the time of evaluation (the interview date). 13

17 REFERENCES Current Population (CPS). Annual Demographic File, dated March Deming WE, Stephan FF. On least square adjustment of a sampled frequency table when the expected marginal totals are know. Annals of Mathematical Statistics. 1940;11: Farrelly MC, Vilsaint MC, Lindsey D, Thomas KY, Messeri P. Legacy First Look Report 7. Cigarette Smoking among Youth: Results from the 2000 National Youth Tobacco Survey. Washington DC: American Legacy Foundation, Fleiss JL. Statistical Methods for Rates and Proportions. 2 nd ed. New York: John Wiley & Sons, Gilpin EA, Emery SL, Farkas AJ, Distefan JM, White MM, Pierce JP. The California Tobacco Control Program: A Decade of Progress, , Results from the California Tobacco Surveys, La Jolla, CA: University of California, San Diego; 2001a. ( Gilpin EA, Pierce JP, Berry CC, White MM. Technical Report on Analytic Methods and Approaches used in the 1999 California Tobacco Survey Analysis. Vol. 1: Data Collection Methodology. La Jolla, CA: University of California, San Diego; 2001b. ( Gilpin EA, Pierce JP, Berry CC, White MM. Technical Report on Analytic Methods and Approaches Used in the 1999 California Tobacco Survey Analysis. Vol. 2: Statistical Methodology, Public Use Data File Documentation, Individual Item Responses. La Jolla, CA: University of California, San Diego; 2001c. ( Gilpin EA, Emery S, Berry CC. Technical Report on Analytic Methods and Approaches Used in the 1999 California Tobacco Survey Analysis. Vol. 3: Methods Used for Final Report, The California Tobacco Control Program: A Decade of Progress, La Jolla, CA: University of California, San Diego; 2001d. ( Gilpin EA, White MM, White VM, Distefan JM, Trinidad DR, James L, Lee L, Major J, Keiley S, Pierce JP. Tobacco Control Successes in California: A Focus on Young People, Results from the California Tobacco Surveys, La Jolla, CA: University of California, San Diego; 2004a. Gilpin EA, White MM, Berry CC. Technical Report on Analytic Methods and Approaches used in the 2002 California Tobacco Survey Analysis. Vol. 1: Data Collection Methodology. La Jolla, CA: University of California, San Diego; 2004b. Gilpin EA, White MM, Berry CC,. Technical Report on Analytic Methods and Approaches Used in the 2002 California Tobacco Survey Analysis. Vol. 2: Statistical Methodology, 14

18 Public Use Data File Documentation, Individual Item Responses. La Jolla, CA: University of California; 2004c. Healton C, Messeri P, Reynolds J, Wolfe C, Stokes C, Ross J, Flint K, Robb W, Farrelly M. Tobacco use among middle and high school students United States, MMWR 2000;49(03): MathSoft. S-Plus 2000 User s Guide. Seattle, WA; Data Analysis Products Division, MathSoft; Miller RG Jr. Survival Analysis. NY: John Wiley, Orzechowski & Walker. The Tax Burden on Tobacco. Historical Compilation. Vol Arlington, VA: Orzechowski & Walker, Pierce JP, Gilpin EA, Emery SL, Farkas AJ, Zhu SH, Choi WS, Berry CC, Distefan JM, White MM, Soroko S, Navarro A. Tobacco Control in California: Who s Winning the War? An Evaluation of the Tobacco control Program, La Jolla, CA: University of California, San Diego; 1998 Substance Abuse and Mental Health Services Administration (SAMHSA). National Household Survey on Drug Abuse (NHSDA). Data and Documentation; 1999, ( The Tobacco Institute. The Tax Burden on Tobacco. Vol. 32, Monthly State Cigarette Tax Reports I Street, N.S. Washington, DC 20006; US Department of Commerce (USDC). Current Population Survey. Design and methodology. Technical Paper 63. Washington, DC: US Department of Commerce, Bureau of the Census; Westat, Inc Adolescent and Parent Follow-up Survey Methodology Report. Prepared for UCSD, August 10, Westat, Inc Young Adult Follow-up Survey Methodology Report. Prepared for UCSD, June 4,

19 GLOSSARY Adolescents Committed never smoker a never smoker who answers definitely not in answer to three questions: trying a cigarette soon, accepting a cigarette if offered by a best friend, and likelihood of smoking in the next year. Current established smoker has smoked a cigarette on at least one day in the past month and has smoked at least 100 cigarettes in his or her lifetime. Current experimenter has smoked a cigarette on at least one day in the past month, but has not yet smoked 100 cigarettes in his or her lifetime. Current smoker has smoked a cigarette on at least one day in the past month. Current (Smokeless Tobacco, Cigar, Bidi) user answers yes to the question about whether he or she used the product on any of the last 30 days. Daily smoker answers 25 or more days to the question about how many days in the last month he or she smoked. Established smoker has smoked at least 100 cigarettes in his or her lifetime. Ever smoker has smoked a cigarette (excludes puffers). Ever (smokeless tobacco, cigar, bidi) user answers yes to the question about whether he or she has ever used the product. Experimenter has smoked a cigarette (excludes puffers), but has not smoked at least 100 cigarettes in his or her lifetime. Former established smoker an established smoker who has not smoked a cigarette on any days of the past month. Never smoker has never smoked or even puffed on a cigarette. Non-current established smoker see former established smoker. Non-current experimenter has not smoked a cigarette on any days in the past month, and has not smoked at least 100 cigarettes in his or her lifetime. Non-current smoker has not smoked a cigarette on any days in the past month. Nonsmoker never smoker or non-current smoker. 16

20 Occasional (or non-daily adolescent smoker) answers less than 25 days to the question about how many days in the last month he or she smoked. Puffer someone who has not smoked a cigarette, but admits to puffing on one. Susceptible never smoker a never smoker who fails to answer definitely not to all three questions about trying a cigarette soon, accepting a cigarette if offered by a best friend, and their likelihood of smoking in the next year. Young Adults Committed never smoker a never smoker who answers definitely not in answer to two questions: trying a cigarette soon, and likelihood of smoking in the next year. Current experimenter an experimenter who has had a cigarette in the past 30 days or admits to smoking once in a while. Current smoker has smoked at least 100 cigarettes in his or her lifetime and smokes now (old question) or now either everyday or some days (new question) at the time of the survey. Established smoker has smoked at least 100 cigarettes in his or her lifetime. Experimenter has smoked a cigarette, but has not smoked at least 100 cigarettes in his or her lifetime. Former smoker an established smoker who now smokes not at all. Moderate-to-heavy smoker a current smoker who smokes 15 or more cigarettes a day. Light smoker a current smoker who smokes fewer than 15 cigarettes a day (includes nondaily smokers). Never-daily, non-daily smoker a non-daily smoker who has never smoked everyday for a period of 6 months or longer. Never smoker answered none or zero to the question about the total number of cigarettes smoked ever (asked of non-established smokers). Non-daily smoker a current smoker who says he or she now smokes some days. Once-daily, non-daily smoker a non-daily smoker who has smoked everyday for a period of 6 months or longer. 17

21 Social smoker a current experimenter or smoker who says he or she only smokes when others are smoking. For analysis, this group was restricted to non-daily smokers. Susceptible never smoker a never smoker who fails to answer definitely not to both questions about trying a cigarette soon, and their likelihood of smoking in the next year. Vulnerable former smoker a former smoker who still thinks about smoking or situations in which he or she might smoke again. Adults Current (cigar, pipe, smokeless tobacco) user answers yes to the question about whether he or she currently uses the product. Current smoker has smoked at least 100 cigarettes in his or her lifetime and smokes now (old question) or now either everyday or some days (new question) at the time of the survey. Daily smoker a current smoker who has smoked on every day of the past month (old question sequence) or who now smokes everyday (new question). Ever (cigar, pipe, smokeless tobacco) user answers yes to the question about whether he or she has ever used the product. Ever smoker or established smoker has smoked at least 100 cigarettes in lifetime. Former smoker has smoked at least 100 cigarettes in lifetime, but does not smoke now (old question) or now smokes not at all (new question). Former smoker in the last 5 years has smoked at least 100 cigarettes in his or her lifetime, but quit smoking in the past 5 years. Heavy smoker a current daily smoker who smokes 25 or more cigarettes a day. Moderate smoker a current daily smoker who smokes cigarettes a day. Moderate-to-heavy smoker a current smoker who smokes 15 or more cigarettes a day. Light smoker a current smoker who smokes fewer than 15 cigarettes a day (includes nondaily smokers). Never smoker has smoked fewer than 100 cigarettes in his or her lifetime. Non-daily smoker a current smoker who smoked on at least 1 day but less than 30 days in the past month (old question sequence) or who says he or she now smokes some days (new question). 18

22 Recent former smoker someone who has smoked sometime in the past year, but was a former smoker at the time of the survey. Smoker in the last year Either a current smoker or a former smoker who smoked regularly a year before the survey. 19

23 DESCRIPTIVE TABLES 20

24 TABLE LIST Table 2002 California Tobacco Survey (CTS) Title 1 Smoking Prevalence (2002 Screener) 2 Workplace Smoking Policy (2002 Adult CTS) 3 Exposure of Indoor Workers to ETS (2002 Adult CTS) 4 Home Smoking Restriction (2002 Adult CTS) 5 Uptake Continuum Among Adolescents (2002 Teen CTS) 6 Promotional Item Status (2002 Teen CTS) 7 Smoking Status Among Adolescents (2002 Teen CTS) 8 Average Daily Consumption for All Smokers (2002 Adult CTS) 9 Detailed Current Smoking Status (2002 Adult CTS) 10 Quitting Status Among People Who Smoked in the Last Year (2002 Adult CTS) 11 The Quitting Continuum for People Who Smoked in the Last Year (2002 Adult CTS) 12 Assistance in Quitting Smoking (2002 Adult CTS) 13 Price Sensitivity 14 Support for Cigarette Tax Increase (2002 Adult CTS) 15 Favorite Ad of Adults (2002 Adult CTS) Favorite Ad of Adolescents (2002 Teen CTS) 16 Exposure to Anti-Smoking Media (2002 Adult CTS) Exposure to Anti-Smoking Media (2002 Teen CTS) 17 How Do You Usually Get the Cigarettes You Smoke (2002 Teen CTS) 18 Compliance With School Nonsmoking Rules (2002 Teen CTS) 19 Use of Light Cigarettes (2002 Adult CTS) 20 Support of Regulation of Tobacco Advertising and Promotion (2002 Adult CTS) 21 Health Beliefs on ETS (2002 Adult CTS) 22 Current Tobacco Use Status (2002 Adult CTS) Any Use of Tobacco (2002 Teen CTS)

25 TABLE 1: SMOKING PREVALENCE (2002 SCREENER) Former Smoker Quit Ratio in Current Smoker in Last 5 Years Last 5 Years (%) Population OVERALL (%) +/- 95% CI (%) +/- 95% CI +/- 95% CI (n) Sample (n) TOTAL / / / ,612,991 71,308 SEX Male / / / ,962,871 34,105 Female / / / ,650,120 37, / / / ,654,134 10, / / / ,642,990 27, / / / ,996,254 23, / / / ,319,613 10,561 Hispanic / / / ,276,337 17,654 Non-Hispanic White / / / ,986,175 41,510 African-American / / / ,468,506 3,654 Asian/PI / / / ,192,655 6,561 Other / / / ,318 1,929 < / / / ,258,232 26, / / / ,188 2, / / / ,348,249 19, / / / ,246,322 22,516 $10,000 or less / / / ,834,853 4,302 $10,001 to $20, / / / ,473,049 6,164 $20,001 to $30, / / / ,714,687 7,320 $30,001 to $50, / / / ,820,703 11,205 $50,001 to $75, / / / ,752,378 11,528 Over $75, / / / ,822,498 22,018 Missing / / / ,194,823 8,771 REGION Los Angeles / / / ,912,193 11,794 San Diego / / / ,073,206 3,871 Orange / / / ,090,354 3,409 Santa Clara / / / ,246,475 3,423 San Bernadino / / / ,154,521 3,754 Alameda / / / ,062,135 3,080 Riverside / / / ,077,935 3,971 Sacramento / / / ,052 3,424 Contra Costa / / / ,486 3,212 San Francisco / / / ,381 2,721 San Mateo, Solano / / / ,402 3,317 Marin, Napa, Sonoma / / / ,006 3,225 Butte, Colusa, Del Norte, Glenn, etc / / / ,807 4,045 San Luis Obispo, Santa Barbara, Ventura / / / ,029,419 3,570 Amador, Alpine, Calaveras, El Dorado, etc / / / ,433 3,769 Monterey, San Benito, Santa Cruz / / / ,632 3,280 Fresno, Madera, Merced, Stanislaus / / / ,086,274 3,745 Imperial, Inyo, Kern, Kings, Mono, Tulare / / / ,280 3,698

26 TABLE 1: SMOKING PREVALENCE (2002 SCREENER) Current Smoker (%) +/- 95% CI Former Smoker in Last 5 Years Quit Ratio in Population Last 5 Years (%) (n) Sample (n) SEX Male / / / ,890,107 5, / / / ,303,555 13, / / / ,354,294 11, / / / ,414,915 4,557 Hispanic / / / ,632,486 8,598 Non-Hispanic White / / / ,844,036 19,837 African-American / / / ,535 1,660 Asian/PI / / / ,489,246 3,104 Other / / / , < / / / ,013,931 12, / / / ,512 1, / / / ,949,891 9, / / / ,675,537 11,315 $10,000 or less / / / ,010 1,758 $10,001 to $20, / / / ,153,166 2,757 $20,001 to $30, / / / ,303,612 3,397 $30,001 to $50, / / / ,868,629 5,340 $50,001 to $75, / / / ,852,017 5,620 Over $75, / / / ,488,729 11,118 Missing / / / ,515,708 4,115 SEX Female / / / ,764,027 4, / / / ,339,435 14, / / / ,641,960 12, / / / ,904,698 6,004 Hispanic 7.2 +/ / / ,643,851 9,056 Non-Hispanic White / / / ,142,139 21,673 African-American / / / ,971 1,994 Asian/PI 6.8 +/ / / ,703,409 3,457 Other / / / ,750 1,023 < / / / ,244,301 13, / / / ,676 1, / / / ,398,358 10, / / / ,570,785 11,201 $10,000 or less / / / ,053,843 2,544 $10,001 to $20, / / / ,319,883 3,407 $20,001 to $30, / / / ,411,075 3,923 $30,001 to $50, / / / ,952,074 5,865 $50,001 to $75, / / / ,900,361 5,908 Over $75, / / / ,333,769 10,900 Missing 8.8 +/ / / ,679,115 4,656

27 TABLE 2: WORKPLACE SMOKING POLICY (2002 ADULT CTS) Total Ban (%) of Workplace < Population (n) Sample (n) Total Ban (%) Population (n) Sample (n) TOTAL ,719,516 6, ,750,813 4,445 SEX Male ,531,333 2, ,941,145 2,003 Female ,188,183 3, ,809,668 2, ,310,265 2, ,669 1, ,252,602 2, ,143,374 2, ,909,853 1, ,836,622 1, , , Hispanic ,131,110 1, ,364, Non-hispanic White ,319,207 3, ,809,885 2,350 African-American , , Asian/PI , ,014, Other , , < ,426,945 2, ,435,981 1, , , ,842,337 2, ,460,627 1, ,224,981 1, ,627,671 1,800 $10,000 or less , , $10,001 to $20, , , $20,001 to $30, , , $30,001 to $50, ,165,384 1, , $50,001 to $75, ,203,140 1, ,048, Over $75, ,082,701 1, ,493,420 1,732 Missing , , REGION Los Angeles ,846, ,707, San Diego , , Orange , , Santa Clara , , San Bernadino , , Alameda , , Riverside , , Sacramento , , Contra Costa , , San Francisco , , San Mateo, Solano , , Marin, Napa, Sonoma , , Butte, Colusa, Del Norte, Glenn, etc , , San Luis Obispo, Santa Barbara, Ventura , , Amador, Alpine, Calaveras, El Dorado, etc , , Monterey, San Benito, Santa Cruz , , Fresno, Madera, Merced, Stanislaus , , Imperial, Inyo, Kern, Kings, Mono, Tulare , ,

28 TABLE 2: WORKPLACE SMOKING POLICY (2002 ADULT CTS) Total Ban (%) of Workplace < Population (n) Sample (n) Total Ban (%) Population (n) Sample (n) SEX Male ,297 1, , ,755,270 1, ,602, , , , , Hispanic ,148, , Non-hispanic White ,682,861 1, ,461,688 1,056 African-American , , Asian/PI , , Other , , < ,333,235 1, , , , , , ,234, ,413, $10,000 or less , , $10,001 to $20, , , $20,001 to $30, , , $30,001 to $50, , , $50,001 to $75, , , Over $75, ,157, ,388, Missing , , SEX Female TOTAL ,188,183 3, ,809,668 2,442 SEX Female ,188,183 3, ,809,668 2, ,968 1, , ,497,332 1, ,541,370 1, , , , , Hispanic , , Non-hispanic White ,636,346 1, ,348,197 1,294 African-American , , Asian/PI , , Other , , < ,093,710 1, , , , ,047 1, , , ,213, $10,000 or less , , $10,001 to $20, , , $20,001 to $30, , , $30,001 to $50, , , $50,001 to $75, , , Over $75, , ,104, Missing , ,

29 TABLE 3: EXPOSURE OF INDOOR WORKERS TO ETS (2002 ADULT CTS) Overall (%)+/- Population Sample 95%CI (n) (n) TOTAL 12.0+/ ,507,113 7,896 SEX Male 13.3+/-1.6 5,330,079 3,490 Female 10.6+/-1.5 5,177,034 4, /-1.9 1,601,192 2, /-2.0 5,356,753 3, /-1.7 3,226,371 1, / , Hispanic 15.6+/-2.5 3,016,428 2,128 Non-Hispanic White 10.4+/-1.3 5,095,405 4,086 African-American 9.5+/ , Asian/PI 11.3+/-3.4 1,519, Other 11.1+/ , < /-2.2 3,066,476 2, / , /-1.9 2,720,152 2, /-1.6 4,351,986 2,741 $10,000 or less 12.2+/ , $10,001 to $20, / , $20,001 to $30, / , $30,001 to $50, /-3.4 1,649,456 1,368 $50,001 to $75, /-2.1 1,876,831 1,473 Over $75, /-1.6 4,032,054 2,733 Missing 12.4+/ , REGION Los Angeles 12.8+/-2.5 2,990,537 1,373 San Diego 12.7+/ , Orange 12.5+/ , Santa Clara 8.3+/ , San Bernadino 12.0+/ , Alameda 13.0+/ , Riverside 16.7+/ , Sacramento 14.4+/ , Contra Costa 7.4+/ , San Francisco 8.3+/ , San Mateo, Solano 13.4+/ , Marin, Napa, Sonoma 9.0+/ , Butte, Colusa, Del Norte, Glenn, etc. 9.1+/ , San Luis Obispo, Santa Barbara, Ventura 11.1+/ , Amador, Alpine, Calaveras, El Dorado, etc. 9.2+/ , Monterey, San Benito, Santa Cruz 8.4+/ , Fresno, Madera, Merced, Stanislaus 12.4+/ , Imperial, Inyo, Kern, Kings, Mono, Tulare 15.4+/ ,