Tobacco use has been found to be one of the primary drivers of cancer-related health disparities because its use disproportionately impacts people based on race, ethnicity, sexual orientation, gender identity, disability status, mental health, income level, education level, and geographic location. Achieving health equity relies heavily on eliminating tobacco use. ACS CAN is pursuing fact-based tobacco control policies at the local, state and federal levels that aim to reduce disparities and improve health outcomes for everyone.
Big Tobacco Targets the Black Community
While overall smoking rates have declined in recent years, smoking rates remain higher among specific subpopulations, including African Americans. These differences are in large part due to the tobacco industry’s targeted marketing through advertising, price discounting and other strategies.[i] Every year the tobacco industry spends $9.1 billion in the United States marketing their deadly and addictive products.[ii]
Tobacco Use in the Black Community
Cigar Use Puts Health at Risk
Black Americans, both adults and youth, are more likely to use cigars than their peers. iii, iv Regular cigar smoking increases the risk of cancers of the lung, oral cavity, larynx, and esophagus.xv
In 2020, 19.4% of Black adults reported using a tobacco product including 14.4% who reported using cigarettes.[iii] In 2022, 11.5% of Black middle and high school students used a tobacco product.[iv] Even though Black people tend to smoke fewer cigarettes daily and start smoking cigarettes at an older age, they are more likely to die from smoking-related diseases than white people.[v] In the African American community, tobacco use continues to be a major risk factor for the three leading causes of death – heart disease, cancer, and stroke.
Aggressive Marketing of Menthol to Black Communities
“The tobacco industry has aggressively marketed menthol products to young people and African Americans, especially in urban communities.” -The Centers for Disease Control and Prevention
Large disparities exist in who is smoking menthol cigarettes by race and ethnicity with nearly 83.1% of African Americans who smoke, 48.0% of Hispanics who smoke, 41.5% of Asians who smoke, and 31.6% of whites who smoke using menthol cigarettes.[vi]
These disparities in the use of menthol cigarettes, which are easier to start and harder to quit, are no accident.[vii],[viii] Tobacco companies disproportionately market menthol products in African American neighborhoods, magazines popular with African Americans, and events that are aimed for African Americans.[ix] The industry has also provided more shelf space for menthol products located in the community’s neighborhood stores.[x]
Tobacco Industry Targeting of Black Communities
The tobacco industry targets Black communities through advertising, price promotions, retail, and point-of-sale advertising.[xi] Some of the marketing tactics Big Tobacco has utilized to target African Americans include:
- Placing large amounts of ads in publications to expose members of the community to more cigarette advertisements.[xii]
- Significantly lower prices for tobacco products in neighborhoods with higher proportions of African Americans.[xiii]
- Making contributions to Historically Black Colleges and Universities (HBCUs), elected officials, civic and community organizations, and scholarship programs, along with supporting and sponsoring cultural events such as music concerts and festivals.[xiv]
Additionally, studies have found greater tobacco retailer density nationwide in census tracts with a higher proportion of African American residents.[xv] The more tobacco retailers, the more exposure to tobacco marketing individuals face. In fact, retail marketing, including in-store advertising, product displays, and discounts accounts for a large portion of the tobacco industry’s marketing budget. In 2020 Big Tobacco spent 97% of their total cigarette and smokeless tobacco advertising and promotion budgets on strategies that facilitated retail sales, such as price discounts, point-of-sale advertising, coupons, and payments to ensure prime retail space.[xvi]
Big Tobacco’s Deceptive and Targeted Marketing Costs Lives
Big Tobacco’s deceptive marketing practices, the current low tobacco prices they have fought for, and their use of flavored tobacco products continue to addict people to tobacco and keep them addicted, for causing populations at higher risk of being targeted by Big Tobacco to shoulder a disproportionate share of the real cost of tobacco use. Smoking harms nearly every organ in the body and remains the number one cause of preventable death.[xvii] Smoking is the single largest contributing risk factor to cancer in the United States, increasing the risk of at least 12 cancers, and causing approximately 30% of cancer deaths.[xviii]
[i] The Truth Initiative, Campaign for Tobacco-Free Kids, American Heart Association and American Stroke Association, American Cancer Society Cancer Action Network, American Lung Association, Americans for Nonsmokers’ Rights, and Robert Wood Johnson Foundation. A report entitled Broken Promises to Our Children: A State-By-State Look at the 1998 State Tobacco Settlement 19 Years Later. December, 2017.Available on-line at: https://www.tobaccofreekids.org/what-we-do/us/statereport.
[ii] U.S. Federal Trade Commission (FTC), Cigarette Report for 2020, 2021 https://www.ftc.gov/system/files/documents/reports/federal-trade-commiss... [data for top 5 manufacturers only].; FTC, Smokeless Tobacco Report for 2020, 2021, https://www.ftc.gov/system/files/documents/reports/federal-trade-commiss... [Data for top 5 manufacturers only]. FTC, E-Cigarette Report for 2019 – 2020, 2022. https://www.ftc.gov/system/files/ftc_gov/pdf/E-Cigarette%20Report%202019...
[iii] Cornelius ME, Loretan CG, Wang TW, Jamal A, Homa DM. Tobacco Product Use Among Adults — United States, 2020. MMWR Morb Mortal Wkly Rep 2022;71:397–405. DOI: http://dx.doi.org/10.15585/mmwr.mm7111a1
[iv] Park-Lee E, Ren C, Cooper M, Cornelius M, Jamal A, Cullen KA. Tobacco Product Use Among Middle and High School Students — United States, 2022. MMWR Morb Mortal Wkly Rep 2022;71:1429–1435. DOI: http://dx.doi.org/10.15585/mmwr.mm7145a1.
[vii] Food and Drug Administration. Preliminary Scientific Evaluation of the Possible Public Health Effects of Menthol Versus Nonmenthol Cigarettes; 2013.
[viii] Tobacco Products Scientific Advisory Committee. Menthol Cigarettes and Public Health: Review of the Scientific Evidence and Recommendations. Rockville, MD: US Department of Health and Human Services, Food and Drug Administration; 2011.
[ix] U.S. National Cancer Institute. A Socioecological Approach to Addressing Tobacco-Related Health Disparities. National Cancer Institute Tobacco Control Monograph 22. NIH Publication No. 17-CA-8035A. Bethesda, MD: U.S. Department of Health and Human Services, National Institutes of Health, National Cancer Institute; 2017
[x] Centers for Disease Control and Prevention (CDC). African Americans and Tobacco Use. https://www.cdc.gov/tobacco/disparities/african-americans/index.htm.
[xi] Centers for Disease Control and Prevention (CDC). African Americans and Tobacco Use. https://www.cdc.gov/tobacco/disparities/african-americans/index.htm.
[xii] Centers for Disease Control and Prevention (CDC). African Americans and Tobacco Use. https://www.cdc.gov/tobacco/disparities/african-americans/index.htm.
[xiii] Resnick, EA, et al., Cigarette Pricing Differs by U.S. Neighborhoods—A BTG Research Brief. Chicago, IL: Bridging the Gap Program, Health Policy Center, Institute for Health Resarch and Policy, University of Illinois at Chicago, 2012, www.bridgingthegapresearch.org.
[xiv] Yerger, V.B. & Malone, R.E. “African American leadership groups: smoking with the enemy,” Tobacco Control, 11: 335-345, 2002
[xv] Campaign for Tobacco-Free Kids. Tobacco Company Marketing to African Americans. https://www.tobaccofreekids.org/assets/factsheets/0208.pdf
[xvi] U.S. Federal Trade Commission (FTC), Cigarette Report for 2020, 2021 https://www.ftc.gov/system/files/documents/reports/federal-trade-commiss... [data for top 5 manufacturers only].; FTC, Smokeless Tobacco Report for 2020, 2021, https://www.ftc.gov/system/files/documents/reports/federal-trade-commiss... [Data for top 5 manufacturers only].
[xvii] Centers for Disease Control and Prevention (CDC). Health Effects of Cigarette Smoking. Updated October 29, 2021. https://www.cdc.gov/tobacco/data_statistics/fact_sheets/health_effects/e...