​Summary: Nationally, Latino smokers are less likely than non-Latino white smokers to receive advice and assistance from health professionals to quit smoking. California’s Medicaid expansion included the Patient Protection and Affordable Care Act’s comprehensive tobacco cessation benefits; however, it is unknown whether expanded coverage helped resolve this disparity.

Researchers examine the association between race and ethnicity (Latino and non-Latino white) and health professional cessation advice and assistance among smokers with Medi-Cal insurance in the post–Affordable Care Act period.

This repeated cross-sectional study was conducted with the 2014 and 2016–2018 California Health Interview Survey (CHIS). A total of 1,861 Latino and non-Latino white current smokers aged 18 to 64 years who had Medi-Cal insurance and consulted a health professional in the past 12 months were included. Data were analyzed between Dec. 1, 2019, and April 30, 2021.

Findings: Among 1,861 participants, 44.8% were Latino, 53.8% were aged 40 years or older, 54.1% were male, and 59.9% had less than a high school education. Latino smokers were less likely than non-Latino white smokers to receive health professional advice (38.3% Latino smokers vs. 55.3% non-Latino white smokers) or assistance (21.8% Latino smokers vs. 35.7% non-Latino white smokers). In the unadjusted model, compared with non-Latino white smokers, Latino smokers were less likely to receive advice and also less likely to receive assistance.

However, in the adjusted model, race was no longer significant. Smokers with more office visits and those with at least one chronic disease were more likely to receive advice from a health professional. Additionally, daily smokers compared with nondaily smokers were more likely to receive assistance.

In this cross-sectional study, more office visits, having a chronic disease, and daily smoking were associated with an increased likelihood of receiving smoking cessation advice or assistance. Use of strategies to engage tobacco users outside of the clinic, such as proactive outreach and community-based engagement, may help address this disparity.