Chris Hansen, ACS CAN President

ACS CAN President Lisa Lacasse shares her views on the impact of advocacy on the cancer fight.


Advancing Health Equity: Tobacco Control as a Racial and Social Justice Issue

October 2, 2020

Today’s blog is one of a series of posts highlighting how ACS CAN is examining, prioritizing and pursuing policy interventions that ensure everyone has an equal opportunity to prevent, find, treat and survive cancer. I look forward to also sharing the voices and perspectives of volunteers, colleagues and partners who are leading the work to address longstanding disparities in cancer care and outcomes. Achieving health equity in communities nationwide is a cornerstone of our mission.

Tobacco use remains the leading cause of preventable death in the U.S., a fact that though shared widely is often surprising and sobering to people in our country. While tobacco-related cancer incidence and mortality have significantly declined, it remains an area of public health in which disparities by socioeconomic status, race/ethnicity, gender, sexual orientation and geographic location persist to this day, largely perpetuated by the deliberate, relentless targeting of addictive products to certain communities by the tobacco industry. Flavored tobacco products are weaponized by Big Tobacco to target youth, low-income communities, LGBTQ+ communities and communities of color. These populations now bear an undue burden of death and disease caused by tobacco use.

This isn’t a novel tactic. The industry has spent decades – and billions of dollars – aggressively marketing menthol-flavored tobacco products in order to hook and addict youth, low-income communities, LGBTQ+ communities and communities of color. Menthol in cigarettes increases smoking initiation, undercuts attempts to quit and leads to greater addiction than nonmenthol cigarettes. The tobacco companies are well aware of the addictive nature of these products and deliberately use them to target youth, low-income communities, LGBTQ+ communities and communities of color.

Big Tobacco’s strategy worked. Black people consistently report the highest prevalence of menthol cigarette use. More than half of youth age 12 to 17 who smoke use menthol cigarettes compared to one-third of older adult smokers. 2018 data from the National Health Interview Survey found that among 18 to 25-year-olds who smoke,  59 percent who identify as lesbian or gay report using menthol cigarettes compared to 46 percent of those who smoke and identify as heterosexual. These health disparities are the very real result of both the relentless tactics of the industry and the lack of comprehensive action by federal, state and local policymakers. It’s crystal clear to me that tobacco use is as much a racial and social justice issue as it is a public health concern.

Public policy change can and must serve as a central avenue for shielding against and reversing longstanding inequalities – but only when done comprehensively and with the well-being of people of color, people who are low-income, and LQBTQ+ populations in mind. This summer the Chicago city council passed an ordinance to end the sale of flavored e-cigarettes. Taken at face value, this policy may appear a positive step in addressing the epidemic of tobacco use occurring in our country. In reality it represents an enormous missed opportunity to promote health equity in a city where too often which neighborhood you live in determines your ability to lead a healthy life. By allowing exemptions for menthol cigarettes, flavored cigars, hookah and smokeless tobacco, the ordinance directly fails to protect children in predominantly Black, Latinx and LGBTQ+ communities who we know are being targeted with these dangerous products.

ACS CAN staunchly supports policies that end the sale of all flavored tobacco products, including menthol cigarettes. Leaving these products on the market prevents us from being one step closer to achieving health equity.