Digital Communication Inequalities Among US Adults Reporting Current Cigarette Use

Introduction: To reduce tobacco-related health problems, it is critical to reach people who smoke with smoking cessation information and treatment. However, digital communication inequalities may limit access to online information sources. Methods: Digital device ownership, high-speed internet access, and online health informationseeking were examined among adults reporting current smoking in the Health Information National Trends Survey (n=847). Data were collected in 2019 and 2020 and analyzed in 2022. Multivariable logistic regression models examined associations between demographics, digital technology access, and online health information-seeking. Results: Only 47.6% (95% CI 39.0%, 56.3%) of adults aged 65+, 54.2% of Black/African American adults (95% CI 37.8%, 69.8%), and 59.6% with high school or less education (95% CI 51.5%, 67.1%) reported high-speed internet access (vs. 74.0% overall, 95% CI 68.9%, 78.6%). Inequalities in device ownership, high-speed internet access, and online health information-seeking were found by education and income. Adults with high school or less education (vs. college or more) had 78% lower odds of digital device ownership (aOR 0.22, 95% CI 0.08, 0.59) and 75% lower odds of high-speed internet access (aOR 0.25, 95% CI 0.09, 0.71). High-speed internet access (vs. no digital device or high-speed internet) was associated with 4.9 times greater odds of online health information-seeking (95% CI 1.81, 13.4). Conclusions: Digital communication inequalities among adults who smoke exist. Understanding digital technology access among lower income populations could inform the development and delivery of interventions and health communication strategies to improve health outcomes among this population.