Examining trends in health care access measures among low-income adult smokers in Ohio: 2012–2019

•Changes to access to care measures among low-income smokers following Medicaid expansion have not been characterized.•Health care access measures among smokers related to affordability of care and unmet needs improved following Medicaid expansion in Ohio.•The was no change in having a usual source of care, an important indicator of preventive care use.•A comprehensive improvement on access to care is essential for tobacco cessation efforts, early management of health problems, and reduction in smoking-related health care costs and disparities.