We’ve come a long way in reducing tobacco use, but we can save millions of lives and advance health equity by doing even more.
Although smoking rates have dropped by more than half over the past 50-plus years, tobacco use remains the number one cause of preventable deaths in the United States.
And not everyone has benefited equally from reduced rates in smoking—there are deep disparities in tobacco use and quit rates, depending on where people live, how much money they make, and the color of their skin.
Tobacco products disproportionately harm people with lower incomes and less education; people with mental illness and substance use disorders; people who identify as lesbian, gay, bisexual, and/or transgender (LGBT); and racial and ethnic minorities.
What’s causing these inequities? Part of it is marketing. Tobacco control efforts have not focused on closing racial, ethnic and socio-economic gaps. In fact, we know that the tobacco industry targets certain populations—women, people who are black or Latino, andmembers of the LGBT community—with higher levels of marketing, exposing them to more tobacco product ads.
In addition, people in many of these groups are less likely to have health insurance—and, as a result, less likely to have access to smoking cessation products and services.
Tobacco’s enormous toll on our society underscores why it’s so important to reduce its use in order to build a Culture of Health.
We have a unique opportunity now, as the federal Food and Drug Administration (FDA) considers making new rules on limiting nicotine in tobacco, further restricting flavored tobacco products, and exempting premium cigars from its authority to regulate tobacco. Here’s what RWJF recommends:
Reduce Nicotine to Non-Addictive Levels
Nicotine is what makes tobacco products addictive—and it’s a key factor in whether kids who try tobacco become regular smokers. Limiting nicotine to non-addictive levels in all combusted tobacco products can prevent kids from becoming addicted and help more smokers quit. This action might lower smoking rates across all groups and could be particularly beneficial for those with lower quit rates, including marginalized populations.
Further Restrict Flavored Tobacco Products
Although the Tobacco Control Act bans the sale of most flavored cigarettes, menthol cigarettes are still sold throughout most of the country and e-cigarettes and cigars are sold in flavors like cherry, vanilla, chocolate, and clove that appeal to young people. FDA has found that menthol cigarettes lead to increased smoking among young people, greater addiction, and reduced success in quitting smoking. They are also disproportionately used by and marketed to African-Americans, who are more likely than whites to die from a tobacco-related disease.
Continue FDA Oversight of Premium Cigars
There is no reason for FDA to loosen its regulation of cigars. They pose a significant public health risk since they are addictive, toxic, and both youth and adults smoke them. Tobacco is the only consumer product that leads to disease and death when used as intended.
To move the needle in reducing tobacco-related disparities, RWJF will fund projects that support communities in 13 Southern and Midwestern states to strengthen capacity to advocate for stronger local and regional tobacco-related policies. Review the closed call for proposals.
About the Author
Matthew Pierce joined the Robert Wood Johnson Foundation in 2015. He works in the areas of public health law and tobacco control. Pierce is interested in finding more equitable ways to promote health and well-being.