The U.S. Surgeon General has released a new report highlighting health disparities related to tobacco use, according to the U.S. Department of Health and Human Services on November 19.
The report emphasizes that despite substantial progress in reducing smoking rates and secondhand smoke exposure, these improvements have not been equally experienced across all population groups.
Since 1965, smoking rates in the United States have dropped by over 70%. However, disparities in tobacco use persist due to factors such as race and ethnicity, income, education, sexual orientation and gender identity, occupation, geography, behavioral health status, and other factors.
Disparities persist in smoking prevalence and related health outcomes among specific groups, including American Indians, Alaska Natives, and individuals living in poverty.
The report highlights disparities in secondhand smoke exposure as well. Smoking and secondhand smoke still cause nearly 500,000 deaths in the United States each year, accounting for one-fifth of all deaths.
While death rates from secondhand smoke have fallen by over 50% since 2006, children, African Americans, low-income individuals, and adults with lower education levels remain disproportionately affected. These disparities have widened since 2000.
Smoking continues to be a leading cause of preventable disease and death in the U.S., with varying impacts. For instance, American Indians and Alaska Natives experience the highest rates of chronic obstructive pulmonary disease (COPD), while black males face the highest incidence and mortality rates from lung cancer.
The report identifies multiple factors driving tobacco-related disparities, including poverty, racism, discrimination, inadequate healthcare access, and targeted strategies by the tobacco industry. Additional barriers include limited access to quitting resources, insufficient tobacco prevention and control measures, and social and environmental influences.
To combat these disparities, the report calls for actions such as improving healthcare access, expanding smoke-free policies, reducing the appeal and addictiveness of tobacco products, and addressing social determinants of health. Equitable implementation of tobacco control strategies is essential to reducing smoking rates, exposure to secondhand smoke, and the overall burden of tobacco-related diseases.
"Tobacco use imposes a heavy toll on families across generations. Now is the time to accelerate our efforts to create a world in which zero lives are harmed by or lost to tobacco," said Surgeon General Dr. Vivek Murthy.
"This report offers a vision for a tobacco-free future, focused on those who bear the greatest burden, and serves as a call to action for all people to play a role in realizing that vision," Dr. Vivek Murthy said.
"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," said Xavier Becerra, HHS Secretary for Health.
"Smoking is still the leading cause of preventable death in the United States. That’s unacceptable. We will keep working until tobacco is no longer a menace to individuals and families across the nation. We will continue our efforts to improve health equity and support communities that remain the most vulnerable," Becerra said.
