Ken AlltuckerUSA TODAY
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Adult and youth smoking rates this decade have dipped to the lowest levels on record. Despite this progress, the nation's top doctor is warning about stubborn disparities that remain among the 36 million adults and 760,000 kids who smoke.
U.S. Surgeon General Vivek Murthy released a report Tuesday saying that cigarette smoking is more common among American Indian and Alaska Native people than other racial and ethnic groups. People living in poverty are more than twice as likely to smoke than those who earn non-poverty wages. Black people, lower-income populations and people with less education are more likely to be exposed to secondhand smoke.
Because cigarette smoking and secondhand smoke kill nearly half a million people each year nationwide, Murthy said an accelerated effort is needed to limit disparities in smoking rates and reduce secondhand smoke.
"What's at stake are the lives of our kids and adults across America," Murthy told USA TODAY. "Tobacco is the leading cause of preventable death in the country − 490,000 lives we lose every year to tobacco-related disease. Despite all the progress we've made, that remains the truth today."
Imperative: Nicotine limits, menthol ban
The report called for limiting the nicotine in cigarettes and other tobacco products to "minimally addictive or nonaddictive levels." Such a move could prevent more than 33 million people from starting to smoke and prevent 8 million deaths by 2100, it said.
The report also calls for banning menthol cigarettes and flavored cigars. It says menthol products "increase the likelihood of tobacco initiation, addiction, and sustained use" and are "disproportionately used by Black people, Native Hawaiian and Pacific Islander people, women and people who identify as lesbian, gay, or bisexual."
The Biden administration stalled an effort to finalize a Food and Drug Administration rule to ban menthol cigarettes. The ban was supported by tobacco control groups who want to reduce smoking deaths. The tobacco industry and groups that get funding from it opposed the ban.
The surgeon general's report cited 2023 research that projected a nationwide ban on the sale and marketing of menthol cigarettes would prevent up to 654,000 deaths in the next four decades.
Murthy said the report reiterates a call to finalize the federal menthol ban and limit nicotine in tobacco products.
"These are the kinds of measures that can dramatically accelerate our movement toward the tobacco endgame, which is a nation where we do not lose lives or incur disease due to tobacco," he said.
Tobacco-control advocates said the failure to finalize the federal menthol ban could harm efforts to curb smoking for years to come.
"It is deeply distressing that President Biden did not finalize the menthol cigarette and flavored cigar rules last year when the rules were ready to go," said Erika Sward, assistant vice president of nationwide advocacy for the American Lung Association. "Biden's decision to punt this will have widespread repercussions for decades to come."
Yolonda C. Richardson, president and CEO of the Campaign for Tobacco-Free Kids, said despite progress, "large and unacceptable disparities" persist in tobacco use.
Richardson said the tobacco industry’s targeted marketing is a "major driver of these disparities, especially the industry’s decades-long targeting of Black and other communities with menthol cigarettes and other flavored products."
"It is shameful that at the same time, the industry has targeted and greatly harmed these communities, it has sought to buy influence in these communities and fought policies like a ban on menthol cigarettes that would reduce smoking, save lives and advance health equity," Richardson said.
Health care access, smoke-free housing and workplaces
The report said factors influencing smoking disparities at times go beyond regulating the tobacco industry. Unequal access to health care accelerates disparities, the report said. Disparities could be addressed through quality education and smoke-free housing and workplaces.
Other policies that could reduce tobacco use include increasing the price of tobacco, passing smoke-free air laws, offering public health education and providing resources for people who want to quit smoking. These programs are available by phone at 1-800-QUIT-NOW or www.smokefree.gov, the report said.
The Centers for Disease Control and Prevention and tobacco settlements have helped fund public education campaigns about the harms of tobacco, but, the report said the tobacco industry's deep-pocketed marketing has continued to target new and existing customers. The tobacco industry spends $8.5 billion each year on tobacco-related advertising and promotion, it said.
That represents about $12 in tobacco industry marketing for each $1 spent by tobacco control groups, according to the report.
