Nearly 20 million viewers of the 2018 GRAMMY Awards watched Dr. Jennifer Pearson explain how the tobacco industry continues to sell products that kill 1,300 Americans every day: by targeting lower-income communities and enhancing the addictiveness of cigarettes.

“The tobacco industry is targeting low-income Americans — people who are having a hard time — and selling a product that kills one-half of long-term smokers who use it as directed,” says the University of Nevada, Reno, School of Community Health Science professor who appears in “Worth More,” the newest campaign from truth®.

We spoke with Pearson about why spreading this information about the tobacco industry is so important.

Q: In the video, you quote a tobacco industry document that describes a target customer as someone who has “nothing to look forward to.” How else can you describe the way tobacco companies have gone after people who are struggling?

A: We know from tobacco industry documents, which were released as part of lawsuits against the industry, that companies certainly targeted low-income people — specifically people down on their luck. They positioned cigarettes as the one good thing in their lives. It’s really condescending and elitist.

The tobacco industry documents are damning but, to me, do not reflect the true injustice of what is going on. You need to look at the epidemiological data, which shows the incredible concentration of smoking among people with the lowest incomes and the lowest education levels.

The evidence is in their actions. Lower-income communities have more places to buy tobacco, more tobacco advertising and lower cigarette prices. It’s not surprising that smoking is so concentrated among these groups — 72 percent of smokers are from lower-income communities.

Q: You also highlight how tobacco companies intentionally modified tobacco to be more addictive, including by engineering tobacco crops to contain twice the amount of nicotine. What else did they do to manipulate the product?

A: The cigarette is an amazingly engineered product that is made to be addictive.

Companies genetically modified the tobacco, or extracted nicotine from leftover tobacco and sprayed it back on the tobacco leaf to increase the nicotine yield in each stick. Many companies also add ammonia to the cigarettes to facilitate the delivery of nicotine from your lungs into your blood. It’s like free-basing nicotine.

Tobacco companies engineered tobacco crops to contain twice the amount of nicotine

We also know that they add all kinds of flavoring. For example, not only menthol cigarettes contain the mint flavor menthol. Nearly all cigarettes have some degree of menthol in them. You can’t always taste it, but the menthol is in there to facilitate inhalation and to inhibit your cough response. That allows you to take a deeper inhalation, which gives you a deeper dose to facilitate addiction or maintain addiction.

Q: Many people think that the tobacco epidemic is over and that the misdeeds of the industry, such as lying about the harmfulness of cigarettes, are all in the past. What is your response to that?

A: They’ve gotten smarter. Companies that sell in the U.S. have learned to toe the regulatory and legal line.

For example, tobacco companies used to label cigarettes “light” or “low-tar,” even though they were no safer than other cigarettes. They can no longer claim that certain tobacco products are less harmful without the Food and Drug Administration allowing the claim. But look at the brand Natural American Spirit. I have done a lot of research on this product, including studies with Truth Initiative®. It’s the only major cigarette brand that makes the claims “natural,” “organic” and “additive-free,” and the majority of its smokers believe the brand is less harmful. They are still clearly misrepresenting the harms of their products. They are toeing the letter of the law, but not the spirit of the law.

So many people still smoke that it remains the leading cause of preventable death and disease in the country. It just may not be as obvious to everyone anymore, especially leaders of the country, because it’s been largely pushed to a corner of society. It’s a social justice issue. We are allowing the tobacco industry to just continue to stomp on this group of people.

Creating a tobacco-free generation is possible. We have to raise awareness and put a ton of pressure on the tobacco industry and the policymakers to make regulations stronger so that tobacco companies get away with less and less.

Get more information on the truth “Worth More” campaign, which also features Imagine Dragons lead vocalist Dan Reynolds and country star Jon Pardi.

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