Tobacco-Related Health Inequities are a Social Justice Issue

Rutgers Institute for Nicotine & Tobacco Studies experts contribute to Surgeon General's new report "Eliminating Tobacco-Related Disease and Death: Addressing Disparities"

The 2024 Surgeon General's Reportestimates that each year, more than 490,000 deaths are attributable to cigarette smoking and exposure to secondhand tobacco smoke in the United States.

"With one in five U.S. deaths attributable to tobacco and persistent disparities in tobacco use and exposure to secondhand smoke, this report underscores the tremendous impact of commercial tobacco in the U.S. and the disproportionate burden placed on some people and communities," said Andrea Villanti, the deputy director of the Rutgers Institute for Nicotine & Tobacco Studies, professor in the Rutgers School of Public Health and a senior scientific editor on the report. "Our findings elevate tobacco-related health disparities as social justice issue - not just a health or economic issue."

Our findings elevate tobacco-related health disparities as social justice issue - not just a health or economic issue.

Andrea Villanti

Deputy Director, Rutgers Institute for Nicotine & Tobacco Studies, Professor, Rutgers School of Public Health

Key findings in the report highlight the persistence of disparities in tobacco use by race and ethnicity, level of income, level of education, gender identity, type of occupation, geography and behavioral health status. The report notes that addressing disparities requires reflection on the complex history of the commercialization of tobacco and both past and present-day experiences of racism, discrimination, and targeted marketing by the tobacco industry.

The report calls for social and structural interventions to reduce inequities in the use of tobacco products and the influence of commercial tobacco companies, as well as complementary approaches to reduce the appeal, affordability, accessibility and addictiveness of tobacco products; eliminate exposure to secondhand tobacco smoke; conduct high-impact prevention and cessation media campaigns; and promote barrier-free access to cessation support - all with broad reach to disparate populations. Equitable implementation of programs and policies will be needed to decrease disparities in tobacco use and tobacco-related disease and death.

The report recommends further efforts to assess structural and social determinants of health, increase the representation of disparate populations in research, and improve understanding of intervention impacts - including programs and policies - on tobacco-related health inequities.

"Our work on this report spanned the COVID-19 pandemic and social movements that have brought the importance of health equity to the fore in our public health research and practice," Villanti said. "This report is a clarion call for greater research and action to improve tobacco-related health equity."

Faculty in the Institute for Nicotine & Tobacco Studies are engaged in tobacco-related health equity research across a number of projects, including studies on disinformationand potential reactions to FDA's proposed menthol cigarette and flavored cigar bans in Black/African American young adults and adults and Hispanic young adults.

Cristine Delnevo, director of the Rutgers Institute for Nicotine & Tobacco Studies and Distinguished Professor at the Rutgers School of Public Health, served as a reviewer of the report. Allison Glasser, a postdoctoral fellow at Rutgers Institute for Nicotine and Tobacco Studies, was a contributing author and Ollie Ganz, assistant professor in the Rutgers School of Public Health, and Melanie LaVake, research teaching specialist at the Rutgers Institute for Nicotine & Tobacco Studies, were contributors to the report.