Butte County Tobacco
Disparity Study and Strategic Plan


BBC conducted an assessment of tobacco use and disparities among underserved population groups in Butte County, California, and used the information to develop a strategic plan for Butte County Public Health Department’s efforts to reduce tobacco use. We used information from the Center for Disease Control’s Behavioral Risk Factor Surveillance System, the American Community Survey, and in-person intercept surveys to help Butte County understand tobacco use in the region. Based on that information and insights from in-depth interviews we conducted with key community stakeholders, we created a strategic plan to help Butte County prioritize investments in tobacco education and cessation programs.

Disparity studies

Policy analysis

Program development

Qualitative research

Quantitative research

Survey research


Disparity results: Nearly all of the underserved populations we studied showed higher rates of tobacco use compared with typical Butte County residents. Qualitative research suggested that underserved populations are also more likely to use e-cigarettes and vaping products. Overall, county residents showed higher tobacco use than other California residents.


Strategic plan: Working with stakeholders and staff, BBC developed five key goals for the Butte County Health Department and Tobacco Coalition:

  • Strengthen community partnerships;
  • Treat tobacco use holistically;
  • Foster continuity in leadership and staff;
  • Implement monitoring metrics and conduct follow-up research; and
  • Promote tobacco control polices throughout the county.


For each goal, BBC developed objectives, strategies, and specific action items for implementation.