UC Davis

The dissertation focus is on the tobacco use behaviors in California’s health care and school settings, with an emphasis on Latinos and the context of location. Chapter one used data from the California Health Interview Survey to examine the association between race/ethnicity (Latino and Non-Latino white) and provider cessation advice and assistance among smokers with California Medicaid in the post-Affordable Care Act period. Logistic regression was used to examine the association between race/ethnicity and each outcome, adjusted for sociodemographic, tobacco behavior, health care factors, and acculturation measures. Chapter two was a pragmatic randomized trial to examine the impact of a local area code with a proactive outreach strategy among unassisted patients who smoke on the outcome of consenting to an e-referral to evidence-based tobacco treatment with the state quitline. Log-binomial regression was used to examine the association between area code and patient consent to a Helpline e-referral among self-reported smokers, adjusted for age, gender, and preferred language (English and Spanish). Chapter three used data from the California Department of Public Health to examine the association of urbanicity and school staff reports of e-cigarettes on high school grounds. Data were linked from the California Department of Education and California Healthy Kids Survey to include school-level factors, such as student demographics and student past 30-day e-cigarette use prevalence. Logistic regression was performed to assess the association between urbanicity and school staff observation of e-cigarettes on school grounds, adjusted for both individual-level school staff and school-level characteristics. Altogether, two of the chapters contribute to the gap in knowledge around why Latino smokers are advised less by providers, while the last study aims to contribute to the limited research around school staff perspectives and e-cigarettes at high schools.