Tobacco use

Graphic of the week

SmokingByIncome_Standalone
Analysis included in HPIO’s policy brief, Health Impacts of Tobacco Use in Ohio, found that while overall smoking rates have declined over the past three decades, this has not been the case for people with low incomes. As a result, low-income communities experience a much greater impact of tobacco use than communities with higher incomes. In 1995, Ohioans with very low incomes (less than $15,000 a year) were 36% more likely than those with higher incomes ($50,000 or more a year) to smoke cigarettes. By 2020, this gap had increased to 107%, as illustrated in the graphic above.


DeWine vetoes law prohibiting local tobacco bans

Ohio Gov. Mike DeWine vetoed legislation Thursday that would’ve preempted local bans on flavored tobacco (Source: “Ohio Gov. DeWine vetoes tobacco measure that would prohibit local bans,” Ohio Capital Journal, Jan. 6).

“This measure is not — is not in the public interest,” DeWine said of HB 513.

Because a new General Assembly has begun, DeWine’s office contends lawmakers can’t initiate a veto override.

Speaking Thursday, DeWine acknowledged the merit of uniform statewide policy. “The easiest way to do that, it seems to me, is to have a statewide ban of flavored cigarettes and flavored vaping,” DeWine said.

State health director Dr. Bruce Vanderhoff noted Ohio’s rates of tobacco use are higher than national averages, and tobacco remains the leading preventable cause of death in the state. According to Vanderhoff, deaths attributable to tobacco use top 20,000 a year. And treating tobacco-related illness isn’t cheap. According to the Health Policy Institute of Ohio, he said, health care costs tied to cigarettes are about $6.8 billion a year.


Canadian study links menthol bans with higher tobacco quit rates

As Columbus contemplates becoming the first city in Ohio to ban the sale of menthol cigarettes, data is starting to come in from areas that have implemented similar bans.

A new Canadian study has found that a ban on menthol has led to increased rates of quitting the use of tobacco products (Source: “Researchers find bans on menthol cigarettes sales can lead to higher tobacco quit rates,” WOSU Public Media, Nov. 14).

Menthol is a chemical tobacco companies began adding to cigarettes broadly in the 1950s, used to mask the harshness of cigarettes in efforts to expand the base of smokers.

The research found cigarette sales decreased by 11% and Canadians who smoked menthol cigarettes quit smoking at a rate of 22%, compared to 15% of non-menthol smokers. In Canada about 5% of smokers used menthols before the ban. But in the U.S., as many as 40% of smokers use menthols, and most Black smokers use menthol cigarettes, meaning a U.S. ban could lead to even greater increases in quitting.


CDC: Teen vaping rising again after pandemic drop

The latest government study on teen vaping suggests there’s been little progress in keeping e-cigarettes out of the hands of high school students (Source: “New survey suggests little progress against U.S. teen vaping,” Associated Press, Oct. 7).
 
The new data from the Centers for Disease Control and Prevention seems to show more teens are vaping, with 14% saying they had done so recently, according to survey results released Thursday. In last year’s survey, about 11% said they had vaped recently.
 
But experts cautioned that a change in the survey makes it difficult to compare the two: This year, a much higher percentage of participants took the survey in schools, and vaping tends to be reported more in schools than in homes.
 
Despite its persistence, vaping appears to be less popular than it was: In 2019, 28% of high schoolers said they had recently vaped.


Graphic of the week

AlcoholTobaccoTrend_HighSchool_Standalone

Analysis from HPIO late last year found that the most notable change in tobacco use in recent years has been the shift away from combustible cigarettes and toward e-cigarettes among teens and young adults (see graphic above). By 2019, only 4.9% of Ohio high school students reported that they had smoked a cigarette in the past 30 days, while e-cigarettes surpassed alcohol and became the most commonly used drug among teens. Similarly, the percent of 18-24-year-olds reporting e-cigarette use jumped 77% from 2016 to 2020, making this the group of adults with the highest rate of e-cigarette use in 2020 (19%).

Learn more in HPIO’s fact sheet, Tobacco, Alcohol and Health Series: Health Impacts of Excessive Alcohol Use in Ohio.

 


Study: Smoking rates double in underserved communities

Patients in underserved communities smoke at a rate double that of the general U.S. population, according to a new study (Source: “Smoking rate in underserved communities double that of general population, study says,” Medical Economics, March 7).
 
The American Cancer Society study, which was published in the journal Cancer, found that the prevalence of smoking among adults served at federally qualified health centers was 28.1%, compared to 14% reported for the general U.S. population.
 
Among other major findings in the study are that Black adults who smoked had more than two times the odds of reporting substance use disorders.
 
“Our study underscores the importance of understanding the association and increased risk of mental health conditions and substance use disorders among adults from underserved communities who smoke while also addressing socioeconomic risk factors to achieve better health outcomes,” said study author Dr. Sue C. Lin of the Health Resources and Services Administration within the U.S. Department of Health and Human Services. “The study further highlights the significance of tailored smoking cessation treatments for individuals from underserved communities that will support cancer prevention care.”


Cigarettes sales up last year for first time in two decades

For the first time in two decades, cigarette sales increased last year during the COVID-19 pandemic, as tobacco companies also beefed up spending to promote their products (Source: “Cigarette sales went up last year for the first time in 20 years,” National Public Radio, Oct. 27).

The Federal Trade Commission, in its annual Cigarette Report, said that manufacturers sold 203.7 billion cigarettes in 2020, up from 202.9 billion in 2019 — an increase of 0.4%.

The cigarette companies, the report said, increased advertising and promotion to $7.84 billion in 2020 from $7.624 billion the previous year, concentrating the bulk of their spending in "price discounts paid to cigarette retailers in order to reduce the price of cigarettes to customers," the FTC said.


FDA approves e-cigarette product for first time

Federal health regulators Tuesday for the first time authorized the legal marketing of an electronic cigarette, saying the product from RJ Reynolds could help addicted adult smokers (Source: “FDA authorizes an e-cigarette for first time, citing benefit for smokers,” The Hill, Oct. 12).

The Food and Drug Administration said the company's refillable Vuse Solo closed device and tobacco-flavored e-liquid pods could benefit addicted adult smokers who switch by reducing their exposure to harmful chemicals.

The first-of-its-kind authorization comes amid an effort by the FDA to regulate the massive vaping industry and determine which products are allowed to stay on the market. 

It signals the agency may look more favorably on tobacco-flavored products than the fruity ones that are most popular among teenagers, even though some feature extremely high nicotine content.


Study: Americans with lower incomes more likely to have respiratory illnesses

Despite improvements in air quality and other advances, Americans with low incomes more often have asthma, lung disease and related illnesses, a new study has found (Source: “Poor Americans More Likely to Have Respiratory Problems, Study Finds,” New York Times, May 28).

In recent decades, air quality has improved in the United States, smoking rates have plummeted and government safety regulations have reduced exposure to workplace pollutants. But rich and poor Americans have not benefited equally, scientists reported in a paper on Friday.

While wealthier Americans have quit smoking in droves, tobacco use remains frequent among the poor. Asthma has become more prevalent among all children, but it has increased more drastically in low-income communities. And Americans with lower incomes continue to have more chronic lung disease than the wealthy.

The analysis, which was published in JAMA Internal Medicine, included data from national health surveys conducted by the Centers for Disease Control and Prevention periodically from 1959 to 2018. The study did not examine disparities in respiratory health by race or ethnicity, though it assessed both income-based and education-based differences in lung health.

Before the 1980s, smoking rates did not vary much by income, and they only slightly varied by education level: 62% of the wealthiest adults and 56% of the poorest were either current or former smokers. But that has changed drastically. By the survey period 2017-18, current and former smoking rates among the wealthiest dropped by nearly half to 34% — while rates among the poorest inched up to 57.9%.


Ban on menthol cigarettes, long marketed to Black Americans, gains momentum

Banning menthol cigarettes appears to be gaining political momentum at the federal, state and local levels (Source: “Menthol Cigarettes Kill Many Black People. A Ban May Finally Be Near.,” New York Times, March 22).

Black smokers smoke less but die of heart attacks, strokes and other causes linked to tobacco use at higher rates than white smokers do, according to the Centers for Disease Control and Prevention. And 85% of Black smokers use Newport, Kool and other menthol brands that are aggressively marketed to Black Americans and are easier to become addicted to and harder to quit than plain tobacco, according to the Food and Drug Administration (FDA).

There is also now growing momentum in Congress to enact a ban. In states and municipalities across the country, Black public health activists have been organizing support and getting new laws passed at the state and local level. Public opposition among white parents to all flavored e-cigarettes, including menthol, has brought new resources to the issue. And the FDA is under a court order to respond to a citizens’ petition to ban menthol by April 29.