Extensive efforts in the United States (U.S.)1 have led to a decline in cigarette smoking prevalence from 20.9% (2005) to 14.0% (2019).1, 2 However, dramatic differences in prevalence and other use patterns exist among the Hispanic/Latino population, 1, 3 which is projected to increase by nearly 50% in 2060.4

The Hispanic/Latino population has a lower cigarette smoking prevalence (9.8% vs. 15.0%) and smokes fewer cigarettes-per-day (CPD; 6.7 vs. 14.9) than non-Hispanic (NH)/Whites.5, 6 However, certain heritage groups have a smoking prevalence over 30%, demonstrating marked disparities.3 Hispanic/Latino heritage groups are also less likely to receive smoking cessation advice,7, 8 despite being as successful at quitting as NH/Whites. 9, 10 Furthermore, smoking cigarettes is a known risk factor for cancer and cardiovascular diseases,1 which disproportionately burden the Hispanic/Latino population.11

Acculturation, or the multi-dimensional process of retaining one’s original culture, adopting a new culture, and the interactional context,12, 13, 14 may explain observed differences. Some Hispanic/Latino heritages may acculturate to U.S. mainstream society more or less than average,15, 16 which may subsequently influence cigarette consumption behaviors. One theory posits acculturation level may interact with socioeconomic status –a proxy for social mobility – to influence the health of Hispanic/Latino populations partially through changes in health behaviors.17 Greater acculturation level has been associated with greater odds of smoking in women but not men,18, 19, 20, 21, 22, 23, 24 and lower odds of attempted cessation in Hispanic/Latinos,25, 26 with heterogeneity in associations among certain heritage groups noted by sex,18, 27 educational attainment,22 and migration status.25, 28 While no studies have longitudinally examined acculturation with individual-level changes in smoking behaviors, we expect to detect associations and variation by socioeconomic factors, consistent with theory.17

Given observed differences in smoking burden,3 smoking-associated conditions,11 and receiving cessation advice,7, 8 efforts to reduce smoking behaviors should be culturally tailored.29, 30 Evaluating changes in CPD, a mediating factor for successful cessation,31 and quitting rates is imperative,32 and the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) is well-suited for said investigation. The current study examined associations of language acculturation – a unidimensional construct that accounts for most variation in acculturation measures27, 33 – and changes in cigarette consumption behaviors within subgroups of sex, educational attainment, and migration status.