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Why tobacco is a racial justice issue

Truth Initiative has been combatting tobacco use and its many associated health disparities for more than 20 years by exposing the tobacco industry’s relentless profiling of Black Americans and vulnerable populations, calling for a nationwide ban on menthol flavored tobacco products, and helping create smoke-free communities across the country. Through this work, Truth Initiative has long recognized that racism is a public health issue.

The death and disease that tobacco products – their use still the country’s leading cause of death and preventable disease – have inflicted on minority communities are devastating. And the dangers of tobacco use are especially dire now, as the Centers for Disease Control and Prevention has named smoking a risk factor for developing severe illness from COVID-19, which is also taking a heavier toll on communities of color.

Actions and calls to declare racism as a public health crisis have been mounting in recent weeks – more than 1,000 Centers for Disease Control and Prevention employees have called on the agency to do so and many cities have passed resolutions on the matter. Here are some major reasons why racial disparities in tobacco use persist, as well as the actions and continued efforts needed to address these problems.

Menthol

It’s no accident that 81% of Black smokers use menthol cigarettes, which are easier to smoke and harder to quit. The tobacco industry strategically and aggressively targeted the community with menthol cigarettes for decades, including placing more advertising in predominantly Black neighborhoods and in publications that are popular with Black audiences, as well as appropriating culture in marketing, including sponsoring events such as jazz and hip-hop festivals.

“Today, tobacco-related diseases are still the number one cause of death in the African-American community, and that’s not a coincidence,” said former Truth Initiative Youth Activism Fellow Lincoln Mondy in his documentary “Black Lives / Black Lungs,” which explores the strategic infiltration of menthol tobacco products into the Black community. “For decades, tobacco companies have used predatory practices aimed to push their deadly product on the Black community.”

Menthol has also repeatedly been exempted from legislation on flavored tobacco products, the result of massive tobacco industry lobbying efforts. Tobacco companies have made strategic financial contributions and worked to align themselves with Black leaders and politicians, and mounted huge opposition campaigns against local policy efforts to restrict menthol tobacco products.

Truth Initiative has long called for a nationwide comprehensive ban on all menthol tobacco products and continues to conduct research and policy analysis to inform and advance these efforts. For example, a Truth Initiative review of more than 80 studies on menthol tobacco products published in BMC Public Health found more than sufficient evidence to show that menthol cigarettes appeal more to young people, are harder to quit than regular cigarettes and should be banned to protect public health. If a menthol cigarette ban had gone into effect in 2011, researchers estimate that more than 320,000 smoking-attributable deaths would be averted by 2050, almost a third of them among African-Americans.

Tobacco industry profiling

Menthol is not the only way the tobacco industry profiles minority communities. In fact, aggressively targeting groups – especially young people, Black Americans, and low-income populations – to recruit as “replacement smokers” for the more than 1,300 who die each day from tobacco use has long been central to the tobacco industry playbook.

Tobacco companies have strategically marketed to racial and ethnic communities for decades. For example, Truth Initiative researchers found that stores in predominantly Black neighborhoods in Washington, D.C. were up to ten times more likely to display tobacco ads than retailers in areas with fewer Black residents. American Indian and Alaska Natives, the group with the highest smoking rate, are also heavily targeted by tobacco companies through extensive promotions, sponsorships, and advertising campaigns. Internal tobacco industry documents have revealed the industry’s interest in Hispanic and Latino communities because they deemed the population “easy to reach” and “undermarketed.” Now, the tobacco industry is even using public health and social justice crises, which have greater impact on communities of color, to promote their products.

[Read ““In a Good Way: Indigenous Commercial Tobacco Control Practices,” co-published by Truth Initiative, which covers the role of traditional tobacco in tribal communities and shares resources for lowering commercial use.]

The truth® campaign exposes these industry tactics so that young people can make informed choices and influence others to do the same. In recent years, truth has exposed Big Tobacco’s racial targeting with campaigns and videos such as “Making Menthol Black,” “Worth More” and “Stop Profiling,” among others. Truth Initiative also focuses research efforts on tobacco company strategies and their impact, as well as the industry’s recent attempts to remake its image as a champion of public health despite these duplicitous tactics.

[Watch “Perspectives on Tobacco as a Social Justice Issue,” an installment in Truth Initiative’s regular discussion series focusing on the most important issues in tobacco control.]

Smoke-free communities

Where people live and whether those communities have smoke-free policies has a big impact on exposure to secondhand smoke, which contains more than 7,000 chemical compounds, 69 of which are known to be carcinogenic to humans or animals. The surgeon general has concluded that there is no safe level of exposure to secondhand smoke.

Lower-income communities are less likely to be protected by smoke-free laws overall and African American children and adults are more likely to be exposed to secondhand smoke than any other racial or ethnic group. Research also shows that deaths caused by secondhand smoke have a disproportionate impact on African-Americans and Hispanics.

Expanding comprehensive smoke-free policies to every community is critical. Truth Initiative has worked in recent years to make public housing smoke-free, and to include tobacco programs with Head Start initiatives and other programs that focus on health disparities. The Truth Initiative Tobacco/Vape-free College Program began by focusing on Historically Black Colleges and Universities and other minority-serving institutions and continues that focus as the program expands. Truth Initiative youth activism and leadership programs also work with young people to help give them the tools and support to create smoke-free communities where they live. Truth Initiative also supports youth-serving groups on the ground, including through programs like the Clear the Air Tennessee, which awards grants and training to help local groups raise public awareness of secondhand hand smoke and increase the number youth and young adults who are advocating for smoke-free environments in Tennessee.

This work and other efforts to address racial disparities in tobacco must continue and accelerate to fully address the public health impacts of racial injustice. Learn more about these efforts and how you can get involved.

See Truth Initiative fact sheets for more information on racial and ethnic disparities in tobacco use: