Cigarette smoking has declined but population disparities among populations are cause for concern

It is terrific news that the results of the National Health Interview Survey, released today by the U.S. Centers for Disease Control and Prevention (CDC), show smoking is on the decline among 18- to 24-year olds in the U.S., with a more than 45 percent drop between 2005 and 2015 and a significant year on year decline of 3.7 percentage points; a dramatic 22 percent decline in a single year.  These highly encouraging results in part reflect the unprecendented power of having three complementary national public education programs including Truth Initiative’s truth, CDC’s Tips and FDA’s Real Cost in the market at the same time.

However, the data also quite starkly highlight the growing disparity in our population in terms of who are the tobacco industry’s best customers. Smoking is increasingly a function of who you are, where you live, your income and your sexual preference. The report underscores that smoking disproportionately affects individuals who live below poverty level, LGBT persons, the uninsured or Medicaid insured, those suffering from a disability or mental illness, and individuals living in areas with weak clean air laws and low taxes – predominantly the Midwest and South. For example, South Carolina has no smoking restrictions and is 45^th in the country for its cigarettes tax of 57 cents per pack.

Many of the differences in smoking rates can be attributed to specific targeting by the tobacco industry. For instance, tobacco companies target the LGBT community by sponsoring events, bar promotions, and advertisements. Researchers have also found a higher density of tobacco retailers in low-income neighborhoods.

Public education campaigns targeted to youth and young adults, like truth, are doing their part. But for public education to fulfill its potential to prevent teen tobacco use, we need lawmakers at all levels to act on clean air indoor policies, excise taxes and price minimums, flavored tobacco bans and proposals to raise the minimum age of sale of tobacco products to 21.