Why it Matters
- Current tobacco use among adults who are African American is 14.6% for cigarettes and 4.9% for cigars, for a total of 19.5%.1
- Although people who are African American usually smoke fewer cigarettes and start smoking cigarettes at an older age, they are more likely to die from smoking-related diseases than people who are white.2
- Seventy-four percent of people who smoke and are African American want to quit. However, they are typically less successful than people of other ethnic groups. This may be due to a number of reasons:
- Most smokers who are African American choose menthol cigarettes, which are more difficult to quit
- There are very few cessation resources developed with audiences of people who are African American in mind
- Research is unclear about the unique ways in which nicotine addiction affects people of African descent
- People who are African American use cessation treatment and services less often3
- Nearly 85% of people who smoke and who are Black smoke menthol cigarettes, compared to just 29% of people who smoke and who are white.4
- Research that modeled what would happen if the U.S. adopted a nationwide ban on menthol tobacco products found that the policy would save more than 600,000 lives, including nearly a quarter million lives of people who are Black.5
- Children and adults who are African American are more likely to be exposed to secondhand smoke than any other racial or ethnic group.6
- Youth and young adults who are African American have significantly lower prevalence of cigarette smoking than those that are Hispanic or White.7
- During 2014-2017, current tobacco use (of any kind) among middle and high school students who are Black was 11.5%. Cigars were the most commonly used product by students who are Black (6.7%), whereas e-cigarettes were the most common for people of all other racial/ethnic groups. Unlike people of most other racial/ethnic groups there was no significant difference among types of tobacco used between males and females.8
What We Know About What Works
- There is expanding literature to support the use of church-based health promotion programs among people who are African American to address cancer prevention and control behaviors.
- In one example, focusing on lung cancer, Voorhees and colleagues implemented a smoking cessation program in 22 urban Baltimore churches, comparing an intensive, culturally specific intervention with a minimal self-help intervention. Those who received the intensive intervention were significantly more likely to progress through the stages of change, including action (quitting smoking) and maintenance.9
- Health Communications Research Laboratory (funded by the National Cancer Institute) researchers conducted original studies with over 30,000 participants (largely women who are African American) to learn how to improve the reach and effectiveness of health information for populations who have low incomes or are people of color. They synthesized the findings to offer evidence-supported ideas to expand insurance coverage. Several of these
recommendations may be translated to tobacco cessation:
- Identify potential partners that are non-health programs, systems and services that reach large numbers of individuals and families that have low-incomes
- Learn where people go in the daily course of their lives and go there, establish a presence and make it easy for people to engage
- Motivate enrollment in programs by emphasizing the priority group’s (people who are African American) progress—not problems or deficiencies
- Use the personal stories of members of the priority population (people who are African American)
- Develop strategies that reach individuals with low incomes through family and social networks
- Link positive aspects of cessation to valued life activities of people who are African American, their cultures, and other sources of happiness and pride
- Equip community-based organizations that use mobile and other outreach activities to deliver the intervention10
What’s Relevant in Pennsylvania
- In 2018, the rate of smoking in Pennsylvania among adults who are Black, non-Hispanic was 24% compared to 16% among adults who are white, non-Hispanic.11
- In Pennsylvania, almost 60% of all adults who currently smoke attempted to quit in the previous 12 months. A higher proportion of people who smoke and who are Black non-Hispanic have quit smoking for a day or more in the past 12 months as compared to people who smoke and who are white, non-Hispanic.12
- SmokeFree Philly includes video testimonials from Pennsylvanians several who are African American.
- SmokeFree Philly also has a link to an op-ed on the impact of menthol cigarettes on communities of people who are Black. It also links to Black Lives/Black Lungs, a 15-minute short film investigating the tobacco industry’s successful infiltration into communities of people who are Black.
What Other States Are Doing
- Tobacco Free Florida has a page dedicated to the History of Tobacco Impacting African-American Communities that also provides information on resources available in Florida.
- Multnomah County, Oregon has a Racial and Ethnic Approaches to Community Health (REACH) program which held focus groups on cessation and created a campaign funded by a three-year CDC grant. Videos are available on YouTube
References and Resources
- Pathways to Freedom: Leading the Way to a Smoke Free Community is a free resource from the National African American Tobacco Prevention Network (NAATPN) designed to assist individuals and community leaders in their efforts to become smoke free, and end smoking-related diseases and death among people who are African American.
• This documentary-style video is a theoretically based smoking cessation program specifically prioritizing communities of people who are African American.
• Its development was supported by grants awarded to the University of Miami from the National Cancer Institute and the American Cancer Society.13
• CDC’s TIPS campaign includes stories of people who are African Americans suffering from smoking-related diseases and disabilities.
• The American Lung Association has resources that Address Tobacco Cessation in Black Communities.
- African American/Black
- Asian American / Native Hawaiian / Pacific Islander
- Behavioral Health Population
- Chronic Conditions/ Diseases
- Hispanic / Latinx
- People Experiencing Homelessness
- Justice Involved Individuals
- LGBTQA / Sexual Gender Minority (SGM)
- Low Income Individuals
- People in the Military or Veterans
- Older Tobacco Users
- People with Disabilities (PWD)
- Pregnant Women
- Rural Geographic Areas / Amish and Mennonite
- Smokeless Tobacco Products
- Youth and Young Adult Nicotine Consumption and Tobacco Use
- “African Americans and Tobacco Use.” Centers for Disease Control and Prevention. November 18, 2019. https://www.cdc.gov/tobacco/disparities/ african-americans/index.htm.
- “Tobacco.” National African American Tobacco Prevention Network. 2016. https://www.naatpn.org/tobacco.
- Lincoln Mondy. “Opinion: As The Vaping Industry Fights The Government, Remember Big Tobacco’s Menthol Playbook,” BuzzFeed News. https://www.buzzfeednews.com/article/lmondy/vaping-and-big-tobaccos-mentholplaybook.
- Sweetland J. Framing Tobacco as a Social Justice Issue. Presented to theCalifornia Tobacco Control Program, January 10, 2020.
- Satomi Odani et al., “Racial/Ethnic Disparities in Tobacco Product Use Among Middle and High School Students – United States,” 2014.2017. MMWR Morb Mortal Wkly Rep 2018;67:952-957. https://www.cdc.gov/mmwr/volumes/67/wr/mm6734a3.htm
- Marlyn Allicock et al., “Tailoring Health Interventions: An Approach for Working with African American Churches to Reduce Cancer Health
Disparities,” Handbook of African American Health: Social and Behavioral Interventions. 2011. https://doi.org/10.1007/978-1-4419-9616-9_16.
- Matthew Kreuter et al., “What can Health Communication Science Offer for ACA Implementation? Five Evidence-Informed Strategies for Expanding Medicaid Enrollment,” The Milbank Quarterly. November 1, 2014. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3955377/.
- “2018 Behavioral Health Risks of Pennsylvania Adults.” Pennsylvania Department of Health. https://www.health.pa.gov/topics/HealthStatistics/BehavioralStatistics/BehavioralRiskPAAdults/Documents/State%20
- “Pathways to Freedom.” National African American Tobacco Prevention Network https://www.naatpn.org/pathways.
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