Chapter 4:

Marginalized Communities & Tobacco Use

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According to Truth, “tobacco use disproportionately affects many marginalized populations— including people in low-income communities1, racial and ethnic minorities, LGBT individuals2, and those with mental illness— who have a long and documented history of being targeted by the tobacco industry.”3,4,5,6 

1. Lee, J. G. L., Henriksen, L., Rose, S. W., Moreland-Russell, S., & Ribisl, K. M. (2015). A Systematic Review of Neighborhood Disparities in Point-of-Sale Tobacco Marketing. American Journal of Public Health, 105(9), e8-18. https://doi.org/10.2105/AJPH.2015.302777

2. Hinds, J. T., Loukas, A., & Perry, C. L. (2019). Explaining Sexual Minority Young Adult Cigarette Smoking Disparities. Psychology of Addictive Behaviors : Journal of the Society of Psychologists in Addictive Behaviors, 33(4), 371–381. https://doi.org/10.1037/adb0000465

3. Centers for Disease Control and Prevention (CDC). (2015). Best Practices User Guide: Health Equity in Tobacco Prevention and Control. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health.

4. Smoking Cessation Leadership Center (SCLC). (2015, December 8). Achieving Health Equity in Tobacco Control. Smoking Cessation Leadership Center. Retrieved from https://smokingcessationleadership.ucsf.edu/factsheets/achieving-health-equity-tobacco-control

5. Creamer, M. R., Wang, T. W., Babb, S., Cullen, K. A., Day, H., Willis, G., Jamal, A., & Neff, L. (2019). Tobacco Product Use and Cessation Indicators Among Adults—United States, 2018. Morbidity and Mortality Weekly Report, 68(45), 1013–1019. https://doi.org/10.15585/mmwr.mm6845a2

6. Centers for Disease Control and Prevention (CDC). (n.d.) Behavioral Risk Factor Surveillance System Survey Data [BRFSS]. Atlanta, Georgia: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention.

Low-income Communities

More than 25% of people living below the poverty line smoke1, which is 2x more than people who live above the poverty line. Additionally, 35-45% of children living below the poverty line live with a smoker.2

In contrast to white-collar workers, blue-collar workers are more likely to start smoking earlier in life and in larger quantities. They are also more likely to suffer from tobacco related illnesses.3,4

Individuals living below the poverty line attempt to quit smoking at the same rate as individuals living above the poverty line, but are less successful.5

1. Jamal, A., King, B. A., Neff, L. J., Whitmill, J., Babb, S. D., & Graffunder, C. M. (2016). Current Cigarette Smoking Among Adults - United States, 2005-2015. MMWR. Morbidity and mortality weekly report, 65(44), 1205–1211. https://doi-org.ezproxy.lib.utexas.edu/10.15585/mmwr.mm6544a2

2. Health Resources and Services Administration, Maternal and Child Health Bureau. (2007). The National Survey of Children’s Health: The Child’s Family. https://mchb.hrsa.gov/nsch/07rural/moreinfo/pdf/nsch07family.pdf

3. Arheart, K. L., Lee, D. J., Dietz, N. A., Wilkinson, J. D., Clark, J. D., LeBlanc, W. G., Serdar, B., & Fleming, L. E. (2008). Declining trends in serum cotinine levels in US worker groups: The power of policy. Journal of Occupational and Environmental Medicine, 50(1), 57–63. https://doi.org/10.1097/JOM.0b013e318158a486

4. Su, C., Syamlal, G., Tamers, S., Li J., & Luckhaupt, S.E. (2019). Workplace Secondhand Tobacco Smoke Exposure Among U.S. Nonsmoking Workers. MMWR. Morbidity and Mortality Weekly Report, 68. https://doi.org/10.15585/mmwr.mm6827a2

5. U. S. Department of Health and Human Services. (2014). The Health Consequences of Smoking—50 Years of Progress. Centers for Disease Control and Prevention. National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health.

Low Income Communities

People who live in low-income communities:

Have a higher exposure to secondhand smoke1

Receive less information about the risks of smoking/using tobacco products than those who don’t live in low-income communities2 

Have a higher exposure to tobacco retailers and are often targets of tobacco marketing3

 

Approximately 75% of homeless adults use tobacco.

1. Baggett, T. P., Rigotti, N. A., & Campbell, E. G. (2016). Cost of Smoking among Homeless Adults. New England Journal of Medicine, 374(7), 697–698. https://doi.org/10.1056/NEJMc1508556

25%   50%   75%   100%

True or False.
There are higher rates of smoking in individuals with a low socio-economic status.

  Correct

  Wrong

More than 25% of people living below the poverty line smoke, which is 2x more than people who live above the poverty line.

1. Jamal, A., King, B. A., Neff, L. J., Whitmill, J., Babb, S. D., & Graffunder, C. M. (2016). Current Cigarette Smoking Among Adults - United States, 2005-2015. MMWR. Morbidity and mortality weekly report, 65(44), 1205–1211. https://doi-org.ezproxy.lib.utexas.edu/10.15585/mmwr.mm6544a2

Racial & Ethnic Minorities

% of Adults ≥18 Years Who Reported Cigarette Use Every Day or Some Days1

Matchbook 22.6% full of matches

22.6%
American Indian/Alaska Native,
Non-Hispanic

Matchbook 19.1% full of matches

19.1%
Multirace,
Non-Hispanic

Matchbook 15% full of matches

15%
White,
Non-Hispanic

Matchbook 14.6% full of matches

14.6%
Black,
Non-Hispanic

Matchbook 9.8% full of matches

9.8%
Hispanic

Matchbook 7.1% full of matches

7.1%
Asian,
Non-Hispanic

1. Centers for Disease Control and Prevention (CDC). (n.d.) Behavioral Risk Factor Surveillance System Survey Data [BRFSS]. Atlanta, Georgia: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention.

 

 

 
African Americans

African Americans disproportionately:

  • Use menthol cigarettes (almost 90% of African American smokers)1
  • Use cigars (traditional, cigarillos, little cigars)2
  • Develop tobacco-related cancer relative to all other racial/ethnic groups3
  • Die from tobacco-related diseases/causes4,5
  • Are exposed to secondhand smoke relative to all other racial/ethnic groups4,5
  • Die from secondhand smoke exposure4,5

 

Smoking is a significant cause of:

lungs with smoke in them

Cancer

Brain with target on it

Stroke

drawing of a smoking heart

Heart Disease

All of which are the 3 leading causes of death for African Americans6

 

 

African Americans have the highest prevalence rates of tobacco-related cancer than all other racial and ethnic groups. In both African American men and women, lung cancer is the second most common cancer.7,8

 

More than 72,000 African Americans are diagnosed with cancer caused by/related to tobacco every year, and more than 39,000 of these people, die every year.7,8

1. Giovino, G. A., Villanti, A. C., Mowery, P. D., Sevilimedu, V., Niaura, R. S., Vallone, D. M., & Abrams, D. B. (2015). Differential trends in cigarette smoking in the USA: Is menthol slowing progress? Tobacco Control, 24(1), 28–37. https://doi.org/10.1136/tobaccocontrol-2013-051159

2. Messer, K., White, M. M., Strong, D. R., Wang, B., Shi, Y., Conway, K. P., & Pierce, J. P. (2015). Trends in Use of Little Cigars or Cigarillos and Cigarettes among U.S. Smokers, 2002–2011. Nicotine & Tobacco Research, 17(5), 515–523. https://doi.org/10.1093/ntr/ntu179

3. American Cancer Society. (2019). Cancer Facts & Figures for African Americans 2019-2021.https://www.cancer.org/content/dam/cancer-org/research/cancer-facts-and-statistics/cancer-facts-and-figures-for-african-americans/cancer-facts-and-figures-for-african-americans-2019-2021.pdf

4. Max, W., Sung, H.-Y., & Shi, Y. (2012). Deaths from secondhand smoke exposure in the United States: Economic implications. American Journal of Public Health, 102(11), 2173–2180. https://doi.org/10.2105/AJPH.2012.300805

5. Homa, D. M., Neff, L. J., King, B. A., Caraballo, R. S., Bunnell, R. E., Babb, S. D., Garrett, B. E., Sosnoff, C. S., Wang, L., & Centers for Disease Control and Prevention (CDC). (2015). Vital signs: Disparities in nonsmokers’ exposure to secondhand smoke--United States, 1999-2012. MMWR. Morbidity and Mortality Weekly Report, 64(4), 103–108.

6. Kochanek, K. D., Murphy, S.L., Xu, J., & Tejada-Vera, B. (2016). Deaths: Final Data for 2014. https://www.cdc.gov/nchs/data/nvsr/nvsr65/nvsr65_04.pdf

7. Smoking Cessation Leadership Center (SCLC). (2017, Sept 11). Race/Ethnicity. Smoking Cessation Leadership Center. Retrieved from  https://smokingcessationleadership.ucsf.edu/printpdf/195456

8. Henley, S. J., Thomas, C. C., Sharapova, S. R., Momin, B., Massetti, G. M., Winn, D. M., Armour, B. S., & Richardson, L. C. (2016). Vital Signs: Disparities in Tobacco-Related Cancer Incidence and Mortality — United States, 2004–2013. MMWR. Morbidity and Mortality Weekly Report, 65(44), 1212–1218. https://doi.org/10.15585/mmwr.mm6544a3

 
American Indians & Alaska Natives

Of all the racial and ethnic groups in the U.S., American Indians and Alaska Natives have the highest prevalence of tobacco use.1

It is important to note that when talking about tobacco use in this section, we are referring to commercial use and not cultural use, as “some American Indians use tobacco for ceremonial, religious, or medicinal purposes.”2

Compared to the 13.7% of U.S. adults who smoke cigarettes, 22.6% of American Indian and Alaska Native adults smoke.1 American Indian and Alaska Native adult smokers are also less likely to report the desire to quit smoking compared to other ethnic groups.3

Tobacco use is associated with:

drawing of a smoking heart

Heart Disease

lungs with smoke in them

Cancer

Heart disease is the primary cause of death and cancer is the second leading cause of death among American Indians and Alaska Natives.4

In 2016, more than 3,300 American Indians and Alaska Natives died of heart disease and more than 3,200 died of cancer.4

Additionally, 18% of American Indian deaths are due to cancer.4

1. Wang, T. W., Gentzke, A. S., Creamer, M. R., Cullen, K. A., Holder-Hayes, E., Sawdey, M. D., Anic, G. M., Portnoy, D. B., Hu, S., Homa, D. M., Jamal, A., & Neff, L. J. (2019). Tobacco Product Use and Associated Factors Among Middle and High School Students—United States, 2019. Morbidity and Mortality Weekly Report. Surveillance Summaries (Washington, D.C.: 2002), 68(12), 1–22. https://doi.org/10.15585/mmwr.ss6812a1

2. Odani, S. (2017). Prevalence and Disparities in Tobacco Product Use Among American Indians/Alaska Natives—United States, 2010–2015. MMWR. Morbidity and Mortality Weekly Report, 66. https://doi.org/10.15585/mmwr.mm6650a2

3. Babb, S., Malarcher, A., Schauer, G., Asman, K., & Jamal, A. (2017). Quitting Smoking Among Adults—United States, 2000-2015. MMWR. Morbidity and Mortality Weekly Report, 65(52), 1457–1464. https://doi.org/10.15585/mmwr.mm6552a1

4. Center for Disease Control and Prevention. (2018). National Vital Statistics Reports. Retrieved from https://www.cdc.gov/nchs/products/nvsr.htm

 
Asian Americans

Asian Americans (far east or southeast Asia, or Indian subcontinent) have the lowest smoking rates when compared to other racial and ethnic groups. However, there is variability in tobacco use rates within Asian American subgroups. The differences between the subgroups may be caused by differences in socioeconomic status, exposure to tobacco advertising, and attitudes toward tobacco use.1

 

% of Asian American Adult Smokers from 2010-2013:2

Match burnt 20%

20%
Korean American Adults

Match burnt 16.3%

16.3%
Vietnamese Adults

Match burnt 7.6%

7.6%
Chinese Adults

Match burnt 7.6%

7.6%
Asian Indian Adults

 

Smoking is a significant cause of:

lungs with smoke in them

Cancer

Brain with target on it

Stroke

drawing of a smoking heart

Heart Disease

Cancer, stroke, and heart disease are the 3 leading causes of death among Asian Americans and Pacific Islanders.3

 

Moreover, the leading cause of cancer death in this population is lung and bronchus cancer.3

1. Center for Disease Control and Prevention. (2017). Asian Americans, Pacific Islanders, Native Hawaiians and Tobacco Use. https://www.cdc.gov/tobacco/disparities/asian-americans/index.htm

2. Martell, B.N., Garrett, BE, Caraballo, RS. (2016). Disparities in Adult Cigarette Smoking — United States, 2002–2005 and 2010–2013. MMWR Morb Mortal Wkly Rep. 65:753–758. http://dx.doi.org/10.15585/mmwr.mm6530a1

3. Siegel, R. L., Miller, K. D., & Jemal, A. (2016). Cancer statistics, 2016. CA: A Cancer Journal for Clinicians, 66(1), 7–30. https://doi.org/10.3322/caac.21332

 
Individuals of Hispanic & Latino Descent

Compared to the 13.7% of U.S. adults who smoke cigarettes, almost 1 in 10 Hispanic/Latinx adults smoke, which is lower than the national average.1

 

There is variability in tobacco use rates within Hispanic/Latinx subgroups. Dominican, Central, and South American adults have the lowest smoking rates, and Puerto Rican adults have the highest. Additionally, there is a higher prevalence of smoking among Hispanic/Latinx adults born in the U.S. and Hispanic/Latina women have reported lower smoking rates than men among all subgroups.2,3

Tobacco use is associated with:

 

lungs with smoke in them

Cancer

drawing of a smoking heart

Heart Disease

Cancer and cardiovascular disease are the 2 leading causes of death among Hispanic/Latinx Americans.4

Compared to white smokers, Hispanic/Latinx smokers are less likely to receive cessation advice from health professionals.1

More than 43,000 Hispanic/Latinx Americans are diagnosed with cancer caused by/related to tobacco every year, and more than 18,000 of these result in death.5

1. Creamer, M. R., Wang, T. W., Babb, S., Cullen, K. A., Day, H., Willis, G., Jamal, A., & Neff, L. (2019). Tobacco Product Use and Cessation Indicators Among Adults—United States, 2018. Morbidity and Mortality Weekly Report, 68(45), 1013–1019. https://doi.org/10.15585/mmwr.mm6845a2

2. Felicitas-Perkins, J. Q., Sakuma, K.-L. K., Blanco, L., Fagan, P., Pérez-Stable, E. J., Bostean, G., Xie, B., & Trinidad, D. R. (2018). Smoking Among Hispanic/Latino Nationality Groups and Whites, Comparisons Between California and the United States. Nicotine & Tobacco Research, 20(9), 1085–1094. https://doi.org/10.1093/ntr/ntx191

3. Kaplan, R. C., Bangdiwala, S. I., Barnhart, J. M., Castañeda, S. F., Gellman, M. D., Lee, D. J., Pérez-Stable, E. J., Talavera, G. A., Youngblood, M. E., & Giachello, A. L. (2014). Smoking among U.S. Hispanic/Latino adults: The Hispanic community health study/study of Latinos. American Journal of Preventive Medicine, 46(5), 496–506.https://doi.org/10.1016/j.amepre.2014.01.014

4. Heron M. (2019). Deaths: Leading Causes for 2017. Hyattsville, MD: National Center for Health Statistics. https://stacks.cdc.gov/view/cdc/79488

5. Henley, S. J., Thomas, C. C., Sharapova, S. R., Momin, B., Massetti, G. M., Winn, D. M., Armour, B. S., & Richardson, L. C. (2016). Vital Signs: Disparities in Tobacco-Related Cancer Incidence and Mortality — United States, 2004–2013. MMWR. Morbidity and Mortality Weekly Report, 65(44), 1212–1218. https://doi.org/10.15585/mmwr.mm6544a3

“Tobacco use disproportionately affects many racial and ethnic minorities because of where they live”1

Click on the windows to learn more.

1. Truth Initiative. (2017, February 03). Tobacco is a Social Justice Issue: Racial and Ethnic Minorities. Truth Initiative. https://truthinitiative.org/research-resources/targeted-communities/tobacco-social-justice-issue-racial-and-ethnic-minorities

2. Henriksen, L., Schleicher, N. C., Dauphinee, A. L., & Fortmann, S. P. (2012). Targeted advertising, promotion, and price for menthol cigarettes in California high school neighborhoods. Nicotine & Tobacco Research: Official Journal of the Society for Research on Nicotine and Tobacco, 14(1), 116–121. https://doi.org/10.1093/ntr/ntr122

3. Resnick, E.A., Jackson, K.L., Barker, D.C., & Chaloupka, F.J. (2012) Cigarette Pricing Differs by U.S. Neighborhoods – A BTG Research Brief. Chicago, IL: Bridging the Gap Program, Health Policy Center, Institute for Health Research and Policy, University of Illinois at Chicago. http://www.bridgingthegapresearch.org/_asset/d49910/btg_tobacco_brief_FINAL_011113.pdf

4. U.S. Department of Health and Human Services. (1998). Tobacco Use Among U.S. Racial/ Ethnic Minortiy Groups – African Americans, American Indians and Alaska Natives, Asian Americans and Pacific Islanders, and Hispanics: A report of the Surgeon General.https://www.cdc.gov/tobacco/data_statistics/sgr/1998/complete_report/pdfs/complete_report.pdf

5. Lee, J. G. L., Henriksen, L., Rose, S. W., Moreland-Russell, S., & Ribisl, K. M. (2015). A Systematic Review of Neighborhood Disparities in Point-of-Sale Tobacco Marketing. American Journal of Public Health, 105(9), e8-18. https://doi.org/10.2105/AJPH.2015.302777

6. U. S. Department of Health and Human Services. (2014). The Health Consequences of Smoking—50 Years of Progress. Centers for Disease Control and Prevention. National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health.

7. Zinser, M. C., Pampel, F. C., & Flores, E. (2011). Distinct Beliefs, Attitudes, and Experiences of Latino Smokers: Relevance for Cessation Interventions. American Journal of Health Promotion : AJHP, 25(5 Suppl), eS1-e15. https://doi.org/10.4278/ajhp.100616-QUAN-200

8. Trinidad, D. R., Xie, B., Fagan, P., Pulvers, K., Romero, D. R., Blanco, L., & Sakuma, K.-L. K. (2015). Disparities in the Population Distribution of African American and Non-Hispanic White Smokers Along the Quitting Continuum. Health Education & Behavior : The Official Publication of the Society for Public Health Education, 42(6), 742–751. https://doi.org/10.1177/1090198115577376

9. Fakunle, D. O., Curriero, F. C., Leaf, P. J., Furr-Holden, D. M., & Thorpe, R. J. (2019). Black, white, or green? The effects of racial composition and socioeconomic status on neighborhood-level tobacco outlet density. Ethnicity & Health, 0(0), 1–16. https://doi.org/10.1080/13557858.2019.1620178

 

Minority smoker in the window

Menthol cigarettes, which are easier to smoke and harder to quit, are heavily marketed to black communities.2

Menthol smoker in the window

Predominately black neighborhoods tend to have lower prices for menthol cigarettes.3

Young asian man in the window

Urban Asian American communities have more tobacco advertising and fewer health warnings than white neighborhoods.4

Young hispanic woman in the window

Retailers in Hispanic neighborhoods are more liekly to sell tobacco products to underage individuals.5

Another hispanic woman in the window

Racial and ethnic minorities typically have less access to cessation services.6,7,8

Young black woman in the window

Stores in black neighborhoods were significantly more likely to have tobacco advertisements inside and outside than stores in neighborhoods with fewer black people.9

Which population has the highest rates of tobacco use?

  Correct

  Wrong

Of all the racial and ethnic groups in the U.S., American Indians and Alaska Natives have the highest prevalence of tobacco use. Compared to the 13.7% of U.S. adults who smoke cigarettes, 22.6% of American Indian and Alaska Native adults smoke.

1. Odani, S. (2017). Prevalence and Disparities in Tobacco Product Use Among American Indians/Alaska Natives—United States, 2010–2015. MMWR. Morbidity and Mortality Weekly Report, 66. https://doi.org/10.15585/mmwr.mm6650a2

Sexual and gender minority (SGM) populations experience stress related to social stigma & discriminatory treatment. Additionally,  individuals who identify as transgender are especially vulnerable to tobacco use because of high rates of substance abuse, depression, HIV infection, and social and employment discrimination.

1. Centers for Disease Control and Prevention. Current Cigarette Smoking Among Adults—United States, 2005–2013. Morbidity and Mortality Weekly Report 2014;63(47):1108-12 [accessed 2018 Jun 1].

Drawing of Pride Parade

 

% of Adults ≥18 Years Who Reported Cigarette Use Every Day or Some Days

drawing of a cig with 13.5% left

13.5%
Heterosexual

drawing of a cig with 20.6% left

20.6%
Lesbian/Gay/Bisexual

Sexual Orientation

1. Creamer, M. R., Wang, T. W., Babb, S., Cullen, K. A., Day, H., Willis, G., Jamal, A., & Neff, L. (2019). Tobacco Product Use and Cessation Indicators Among Adults—United States, 2018. Morbidity and Mortality Weekly Report, 68(45), 1013–1019. https://doi.org/10.15585/mmwr.mm6845a2

SGM Facts

20.6% of LGB adults1 and 35.5% of transgender adults smoke cigarettes.2

LGBT individuals are less likely to have health insurance than straight individuals & 5x more likely to never intend to call a smoking cessation hotline.3

GBT men have similar exposure to tobacco cessation advertising as straight individuals, but are 20% less likely than straight men to be aware of smoking quitlines.4

LGBT adults smoke at rates almost 2.5x higher than heterosexual adults, are significantly more likely to smoke menthol cigarettes5, & have a higher prevalence of smoking other types of tobacco.6

Bisexual women are up to 3.5x more likely to smoke & have a higher nicotine dependence than hetero-sexual women.7

1. Centers for Disease Control and Prevention. (2016). Current Cigarette Smoking Among Adults- United States, 2005-2015. Morbidity and Mortalilty Weekly Report. 65(44):1205-1211.

2. Buchting, F. O., Emory, K. T., Scout, null, Kim, Y., Fagan, P., Vera, L. E., & Emery, S. (2017). Transgender Use of Cigarettes, Cigars, and E-Cigarettes in a National Study. American Journal of Preventive Medicine, 53(1), e1–e7. https://doi.org/10.1016/j.amepre.2016.11.022

3. Fallin, A., Goodin, A., Lee, Y. O., & Bennett, K. (2015). Smoking characteristics among lesbian, gay, and bisexual adults. Preventive Medicine, 74, 123–130. https://doi.org/10.1016/j.ypmed.2014.11.026

4. Centers for Disease Control and Prevention (CDC). (2015). Best Practices User Guide: Health Equity in Tobacco Prevention and Control. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health.

5. Fallin, A., Goodin, A. J., & King, B. A. (2015). Menthol Cigarette Smoking among Lesbian, Gay, Bisexual, and Transgender Adults. American Journal of Preventive Medicine, 48(1), 93–97. https://doi.org/10.1016/j.amepre.2014.07.044

6. Lee, J. G. L., Griffin, G. K., & Melvin, C. L. (2009). Tobacco use among sexual minorities in the USA, 1987 to May 2007: A systematic review. Tobacco Control, 18(4), 275–282. https://doi.org/10.1136/tc.2008.028241

7. Fallin, A., Goodin, A., Lee, Y. O., & Bennett, K. (2015). Smoking characteristics among lesbian, gay, and bisexual adults. Preventive Medicine, 74, 123–130. https://doi.org/10.1016/j.ypmed.2014.11.026

True or False.
In the U.S, smoking rates are higher among
heterosexual/straight adults, than in LGBT adults.

  Correct

  Wrong

LGBT adults smoke at rates almost 2.5x higher than heterosexual adults.

1. Fallin, A., Goodin, A. J., & King, B. A. (2015). Menthol Cigarette Smoking among Lesbian, Gay, Bisexual, and Transgender Adults. American Journal of Preventive Medicine, 48(1), 93–97. https://doi.org/10.1016/j.amepre.2014.07.044

Mental Health

Examples of mental health conditions include, but are not limited to: anxiety, depression, ADD/ADHD, and substance use disorders.

Mental Health

40% of the cigarettes smoked in the US are by people with mental health conditions.1

1 in 3 adults with mental health conditions smoke, while 1 in 5 adults without mental health conditions smoke.1

Individuals with mental health conditions live about 5 years less than others.2,3 The top causes of death are heart disease, cancer, and lung disease, which are all tied to tobacco.4

1. Centers for Disease Control and Prevention. (2013, February 8). Vital Signs: Current Cigarette Smoking Among Adults Aged ≥18 Years with Mental Illness — United States, 2009–2011. https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6205a2.htm?s_cid=mm6205a2_w

2. Latoo, J., Mistry, M., & Dunne, F. J. (2013). Physical morbidity and mortality in people with mental illness | British Journal of Medical Practitioners. https://www.bjmp.org/content/physical-morbidity-and-mortality-people-mental-illness

3. Plana-Ripoll, O., Pedersen, C. B., Agerbo, E., Holtz, Y., Erlangsen, A., Canudas-Romo, V., Andersen, P. K., Charlson, F. J., Christensen, M. K., Erskine, H. E., Ferrari, A. J., Iburg, K. M., Momen, N., Mortensen, P. B., Nordentoft, M., Santomauro, D. F., Scott, J. G., Whiteford, H. A., Weye, N., … Laursen, T. M. (2019). A comprehensive analysis of mortality-related health metrics associated with mental disorders: A nationwide, register-based cohort study. The Lancet,394(10211), 1827–1835. https://doi.org/10.1016/S0140-6736(19)32316-5

4. Centers for Disease Control and Prevention (CDC). (2020). People with Mental Health Conditions. Atlanta: Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention.

Adults who experience serious psychological distress are more likely to be current smokers than adults who haven't.

% of Adults ≥18 Years Who Reported Cigarette Use Every Day or Some Days

drawing of a cig with 31.6% left

31.6%
YES

drawing of a cig with 13.3% left

13%
NO

Serious Psychological Distress

 

1. Creamer, M. R., Wang, T. W., Babb, S., Cullen, K. A., Day, H., Willis, G., Jamal, A., & Neff, L. (2019). Tobacco Product Use and Cessation Indicators Among Adults—United States, 2018. Morbidity and Mortality Weekly Report, 68(45), 1013–1019. https://doi.org/10.15585/mmwr.mm6845a2

Fewer than half of U.S. mental health and substance abuse treatment facilities offer evidence-based tobacco cessation treatments.

1. University of Colorado Denver. (2009, January). Smoking cessation for persons with mental illness: A toolkit for mental health providers. Denver, Colorado: Department of Psychiatry, Behavioral Health and Wellness Program.

Mental Health

 

People with mental illnesses are at a higher risk for cigarette use and nicotine addiction & are less likely to stop smoking than those without mental illness. They are also more likely to lack access to cessation resources, health Insurance, and health care and have low incomes and stressful living conditions. 

 

 

1. Centers for Disease Control and Prevention. (2013, February 8). Vital Signs: Current Cigarette Smoking Among Adults Aged ≥18 Years with Mental Illness — United States, 2009–2011. https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6205a2.htm?s_cid=mm6205a2_w

2. Centers for Disease Control and Prevention. Vital Signs Fact Sheet: Adult Smoking Focusing on People With Mental Illness, February 2013. National Center for Chronic Disease and Health Promotion, Office on Smoking and Health, 2013 [accessed 2018 Jun 18].

On average, individuals with mental health conditions live ____ years less than individuals without mental health conditions.

  Correct

  Wrong

Individuals with mental health conditions live about 5 years less than others.1,2 The top causes of death among adults with mental health conditions are heart disease, cancer, and lung disease, which are all tied to tobacco.3

1. Latoo, J., Mistry, M., & Dunne, F. J. (2013). Physical morbidity and mortality in people with mental illness | British Journal of Medical Practitioners. https://www.bjmp.org/content/physical-morbidity-and-mortality-people-mental-illness

2. Plana-Ripoll, O., Pedersen, C. B., Agerbo, E., Holtz, Y., Erlangsen, A., Canudas-Romo, V., Andersen, P. K., Charlson, F. J., Christensen, M. K., Erskine, H. E., Ferrari, A. J., Iburg, K. M., Momen, N., Mortensen, P. B., Nordentoft, M., Santomauro, D. F., Scott, J. G., Whiteford, H. A., Weye, N., … Laursen, T. M. (2019). A comprehensive analysis of mortality-related health metrics associated with mental disorders: A nationwide, register-based cohort study. The Lancet,394(10211), 1827–1835. https://doi.org/10.1016/S0140-6736(19)32316-5

3. Centers for Disease Control and Prevention (CDC). (2020). People with Mental Health Conditions. Atlanta: Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention.

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