Tobacco Is a Social Justice Issue

Tobacco Is a Social Justice Issue

Social justice issues are ones based on equality and human rights. It is the idea that everyone, regardless of circumstance, should have equal access to health, opportunity and the privileges that society offers. One of the major barriers to achieving social justice is tobacco use. For years, the tobacco industry disproportionately targeted specific populations, such as African Americans, the LGBTQ+ community and individuals of low socioeconomic status, leaving them to suffer the negative health consequences related to tobacco use.[1] For smokers and those around them, they watch their families get sick, they lose their income, they die earlier.[2] When asked why he didn’t smoke, an R.J. Reynold’s executive replied “We don’t smoke that s***. We just sell it. We reserve the right to smoke for the young, the poor, the black and stupid.” This why tobacco use is a social justice issue.

African Americans

In the U.S., approximately nine out of 10 African American smokers aged 12 years and older prefer menthol cigarettes.[3]Does this seem high? It is. And it is not a coincidence. For years, the marketing and promotion of menthol cigarettes heavily targeted the black community using culturally tailored advertising images and messages.[4] As a result, black smokers are nearly 11 times more likely to use menthol cigarettes compared to white smokers.[5] Menthol makes cigarette smoking easier to start and harder to quit.[6] The flavoring found in menthol allows the lungs to expand further causing more of the toxic and cancer-causing chemicals to be absorbed into the body.[7],[8] This is one of the reasons why African Americans are more likely to die from a tobacco-related disease compared to white Americans, even though they smoke fewer cigarettes and start smoking at an older age.[9],[10],[11],[12],[13],[14]

LGBTQ+ Community

Lesbian, gay, bisexual, queer and transgender adults smoke at higher rates  compared to the general population.[15] The daily stress related to the prejudice and stigma they experience is just one of the smoking-related risk factors that this community faces.[16],[17] Some risk factors, however, are a direct result of tobacco companies taking advantage of these communities. High rates of tobacco use among members of the LGBTQ+ community are also due in part to the marketing tactics used by tobacco companies. Big Tobacco would sponsor events, bar promotions and giveaways in an attempt to appeal to the LGBTQ+ community.[18],[19],[20] These marketing practices may also have contributed to a general lack of awareness about the dangers of smoking among the LGBTQ+ community.[21] Members of the LGBTQ+ community may also be more hesitant to quit smoking. In the U.S., LGBTQ+ individuals are five times more likely to never seek a smoking cessation quitline, compared to other groups.[22]

Low Socioeconomic Status (SES) Individuals

Individuals who are unemployed, have lower education levels and oftentimes live at, near or below the poverty level are of lower socioeconomic (SES) status. Low-SES individuals do not have the same access to resources and support compared to individuals of higher economic status. They may not have adequate health insurance or the same educational advantages. Low-SES communities have higher rates of cigarette smoking compared to the general population.[23],[24] People with a high school education smoke cigarettes for twice as long compared to people with at least a bachelor’s degree.[25]

The lack of access to proper healthcare among low SES populations makes it more likely that they will be diagnosed in the later stages of diseases and conditions. [26] Catching these health issues later on makes smoking-related diseases much more dangerous and much more deadly. Tobacco companies have historically targeted their advertising campaigns toward low-income neighborhoods.[27] Unsurprisingly, researchers have also found a higher density of tobacco retailers in low-income neighborhoods, making access to these deadly products that much easier.[28]

Each of these communities has its own, unique problems associated with tobacco use, but death and disease are the common themes.

The loss of a loved one can also mean the loss of the main breadwinner, which can set families back for years. High medical costs because of smoking can also have the same effect. The fact that tobacco addiction oftentimes begins in adolescence means that recovering from these injustices becomes a never-ending cycle within these communities, making tobacco use a true social justice issue.

As members and allies of these at-risk communities, it is important to know that these injustices truly do exist and that there are ways to help combat them. Tobacco Free Florida can help in educating the public about these social justice issues so that people can empower themselves to fight back and tackle the stigmas related to tobacco use in their communities. Smoking is no longer a  choice once it becomes an addiction. An addiction that more often than not begins in adolescence.

Tobacco Free Florida has FREE tools and services designed to help ALL tobacco users quit. If you or someone you know would like to quit smoking, go to tobaccofreeflorida.com/quityourway or gives us a call at 1-877-U-CAN-NOW (1-877-822-6669).

Click the links below for more information regarding some of these at-risk populations.

[1] National Cancer Institute. The Role of the Media in Promoting and Reducing Tobacco Use. Smoking and Tobacco Control Monograph No. 19, NIH Pub. No. 07-6242, June 2008.

[2] Jha P, Ramasundarahettige C, Landsman V, et al. 21st Century Hazards of Smoking and Benefits of Cessation in the United Statesexternal icon. New England Journal of Medicine 2013;368:341–50 [accessed 2018 Feb 22].

[3] Giovino GA, Villanti AC, Mowery PD et al. Differential Trends in Cigarette Smoking in the USA: Is Menthol Slowing Progress? Tobacco Control, doi:10.1136/tobaccocontrol-2013-051159, August 30, 2013.

[4] National Cancer Institute. The Role of the Media in Promoting and Reducing Tobacco Use. Smoking and Tobacco Control Monograph No. 19, NIH Pub. No. 07-6242, June 2008.

[5] Lawrence D, Rose A, Fagan P, Moolchan ET, Gibson JT, Backinger CL. National patterns and correlates of mentholated cigarette use in the United States. Addiction. 2010; 105:13-31.

[6] U.S. Food and Drug Administration (FDA), Preliminary Scientific Evaluation of the Possible Public Health Effects of Menthol Versus Nonmenthol Cigarettes, July 2013.

[7] U.S. Department of Health and Human Services. Tobacco Use Among U.S. Racial/Ethnic Minority Groups—African Americans, American Indians and Alaska Natives, Asian Americans and Pacific Islanders, and Hispanics: A Report of the Surgeon General. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, Office on Smoking and Health, 1998 [accessed 2017 Oct 27].

[8]  Ton HT, Smart AE, Aguilar BL, et al. Menthol enhances the desensitization of human alpha3beta4 nicotinic acetylcholine receptors. Mol Pharmacol 2015;88(2):256-64 [cited 2017 Oct 27].

[9] U.S. Department of Health and Human Services. Tobacco Use Among U.S. Racial/Ethnic Minority Groups—African Americans, American Indians and Alaska Natives, Asian Americans and Pacific Islanders, and Hispanics: A Report of the Surgeon General. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, Office on Smoking and Health, 1998 [accessed 2017 Oct 27].

[10] Centers for Disease Control and Prevention. Deaths: Final Data for 2013, Table 13 [PDF–1.67 MB]. National Vital Statistics Reports. Atlanta: Centers for Disease Control and Prevention, National Center for Health Statistics, 2013 [accessed 2017 Oct 27].

[11] Heron, M. Deaths: Leading Causes for 2010 [PDF–5.08 MB]. National Vital Statistics Reports, 2013;62(6) [accessed 2017 Oct 27].

[12] Schoenborn CA, Adams PF, Peregoy JA. Health Behaviors of Adults: United States, 2008–2010 [PDF–3.21 MB]. National Center for Health Statistics. Vital Health Stat 10(257) [accessed 2017 Oct 27].

[13] American Lung Association. Too Many Cases, Too Many Deaths: Lung Cancer in African Americans [PDF–1.68 MB]. Washington, D.C.: American Lung Association, 2010 [accessed 2017 Oct 27].

[14] U.S. Department of Health and Human Services. The Health Consequences of Smoking. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2004 [accessed 2017 Oct 27].

[15] Buchting FO, Emory KT, Scout, Kim Y, Fagan P, Vera LE, Emery S. Transgender Use of Cigarettes, Cigars, and E-cigarettes in a National Studyexternal icon. American Journal of Preventive Medicine 2017;53(1):e1-e7 [accessed 2018 Jun 1].

[16] Centers for Disease Control and Prevention. Current Cigarette Smoking Among Adults—United States, 2016.Morbidity and Mortality Weekly Report 2018;67(2):53-9

[17] King BA, Dube SR, Tyan M.  Current Tobacco Use Among Adults in the United States. Findings from the National Adult Tobacco Survey. American Journal of Public Health 2012;102(11):e93-e100.

[18] American Lung Association. The LGBT Community: A Priority Population for Tobacco Control. Greenwood Village (CO): American Lung Association, Smokefree Communities Project.

[19] Margolies L. The Same, Only Scarier—The LGBT Cancer Experienceexternal icon. American Cancer Society, 2015.

[20] Fallin A, Goodin AJ, King BA. Menthol Cigarette Smoking among Lesbian, Gay, Bisexual, and Transgender Adults. American Journal of Preventive Medicine, 2015;48(1):93-7.

[21] Centers for Disease Control and Prevention. Best Practices User Guide: Health Equity in Tobacco Prevention and Control. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2015.

[22] Burns EK, Deaton EA, Levinson AH. Rates and Reasons: Disparities in Low Intentions to Use a State Smoking Cessation Quitlineexternal icon. American Journal of Health Promotion, 2011; 25, No. sp5:S59-65 [accessed 2018 Jun 1].

[23] U.S. Department of Health and Human Services. The Health Consequences of Smoking—50 Years of Progress: A Report of the Surgeon General. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2014 [accessed 2016 Jun 13].

[24] Substance Abuse and Mental Health Services Administration. Results from the 2016 National Survey on Drug Use and Health: Detailed Tables. pdf icon[PDF–56.2 KB]external icon Rockville, MD: Substance Abuse and Mental Health Services Administration, Center for Behavioral Health Statistics and Quality, 2014 [accessed 2018 Jul 12].

[25] Siahpush M, Singh GH, Jones PR, Timsina LR. Racial/Ethnic and Socioeconomic Variations in Duration of Smoking: Results from 2003, 2006 and 2007 Tobacco Use Supplement of the Current Population Surveyexternal icon. Journal of Public Health 2009;32(2):210-8 [accessed 2018 Jun 13].

[26] Campaign for Tobacco-Free Kids. Tobacco and Socioeconomic Status pdf icon[PDF–56.2 KB]external icon. Washington, D.C.: Campaign for Tobacco-Free Kids, 2015 [accessed 2018 Jun 13].

[27] U.S. Department of Health and Human Services. The Health Consequences of Smoking—50 Years of Progress: A Report of the Surgeon General. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2014 [accessed 2016 Jun 13].

[28] Yu D, Peterson NA, Sheffer MA, Reid RJ, Schneider JE. Tobacco Outlet Density and Demographics: Analysing the Relationships with a Spatial Regression Approach. Public Health, 2010;124(7):412–6 [cited 2018 Jun 13].

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