• Posted November 20, 2024

Surgeon General Says U.S. Smoking Rates Have Tumbled, But Not for Everyone

Although the United States has made significant headway in curbing cigarette smoking and secondhand smoke exposure, a new report finds deep divisions remain and they run along predictable fault lines.

Disparities in tobacco use continue to persist by income and occupation, geography, education, race and ethnicity, sexual orientation and gender and mental health status, the new data from the U.S. surgeon general found.

Nearly 1 in 5 deaths nationwide -- almost 500,000 a year -- are still due to cigarette smoking and exposure to secondhand smoke.

"Tobacco use continues to decline. Americans increasingly understand tobacco products are dangerous and addictive, and many are taking advantage of available tools to help them quit. That's great news," Xavier Becerra, who heads up the U.S. Department of Human Health and Services, said in an agency news release. However, he added,"smoking is still the leading cause of preventable death in the United States. That's unacceptable."

The new report builds on one issued in 1998, summarizing new research on contributors to tobacco-related disparities.

Since 1965, smoking has declined more than 70% nationwide, according to the report. But progress owing to changes in tobacco-related policies, research and other areas has been uneven across U.S. population groups.

For example, cigarette use remains higher among adults with lower levels of education; those in blue-collar jobs; people who identify as gay, lesbian or bisexual; residents of rural areas, the Midwest or South; and those who have a mental health condition or substance use disorder.

Smoking also remains high among American Indian and Alaska Native groups, and men living in poverty are twice as likely as women to smoke.

Meanwhile, deaths owing to secondhand smoke exposure have fallen among nonsmokers by more than 50% since 2006. But exposure remains stubbornly high among Black people, kids and people with less education and lower incomes. 

And, health officials added, the "magnitude of these disparities has increased since 2000."

"Progress, in the form of improvements in tobacco-related policies, regulations, programs, research, clinical care and other areas, has not resulted in the same outcomes for everyone," said HHS Assistant Secretary for Health Dr. Rachel Levin. 

"We have not made progress unless we have all made progress," she noted in the HHS news release.

Officials said several factors contribute to tobacco-related health disparities. They include factors broadly described as "social determinants of health" -- including racism, poverty, where people live, how much they make and their access to health care. 

Exposure to tobacco ads and marketing is another factor, officials said, noting that the tobacco industry markets heavily in areas with larger populations of poor people, Black folks and Hispanic people. Flavored products, including menthol, which can make it harder to quit, are also marketed in these areas.

Habits of family, friends and coworkers are also influences -- for better or for worse, according to the report. Other contributors include smoke-free policies at home and the workplace.

The report called on policymakers to restrict sale of flavored tobacco products, set limits to make them less addictive and regulate the number of stores that sell tobacco.  

It added that strategies to reduce commercial tobacco use and exposure to secondhand smoke must be put into place equitably. Such strategies include increasing the cost of tobacco products, implementing smoke-free policies, resources to quit and anti-smoking ad campaigns.

Noting that tobacco use imposes a heavy toll across generations, Surgeon General Vivek Murthy said the new report is a call to action.

"Now is the time to accelerate our efforts to create a world in which zero lives are harmed by or lost to tobacco," he said in the HHS news release.

Yolonda Richardson, president and CEO of the Campaign for Tobacco-Free Kids, said the report underscores the need for action at all levels of government to drive down tobacco use.

"The report makes clear that the tobacco industry 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," she said in a statement. She added that it is "especially shameful" that Big Tobacco positions itself as a friend to communities that suffer most from its products and marketing.

Richardson added that the U.S. Food and Drug Administration was "absolutely right" to propose rules a year ago to ban menthol smokes, criticizing the White House for failing to put them into effect.

"We have the tools to eliminate tobacco-related death and disease and to ensure that no community is left behind," she said. "What's needed is the political will to stand up to the tobacco industry and fully utilize these lifesaving tools."

More information

There are tools and tips for people who want to quit smoking at smokefree.gov/ and at 800-QUIT-NOW.

SOURCE: U.S. Department of Health and Human Services, news release, Nov. 19, 2024