Despite smoking fewer cigarettes per day on average, African Americans in the United States report disproportionately higher rates of smoking-related diseases. African American men, in particular, are affected by bronchus and lung cancer at an incidence of 85.4% per 100,000 individuals versus 74.3% among white men.
The Centers for Disease Control and Prevention (CDC) also reports that African American smokers initiate tobacco use at a later age in life. However, this demographic is still more likely than any other racial or ethnic group to die from smoking-related diseases.
Given that African Americans in the U.S. experience health disparities related to smoking, it is important to look beyond data. The data shows the necessity to instead examine the roots and impact of tobacco use on the health and quality of life of African Americans. Attention needs to also extend to discussing strategies that reduce the health risks and burdens caused by tobacco use.
Looking into Tobacco and Health Inequities
The smoking-related health inequities faced by African American people can partly be attributed to unjust practices by tobacco companies. Tobacco companies carry a long history of targeting African American communities with aggressive marketing and promotions for menthol cigarettes. This has been done through advertising more heavily in stores where many of the customers were African Americans. In terms of marketing messages, menthol cigarettes were promoted to African American youth as a cool, hip, and healthy product.
A research study published in the Tobacco Control journal also analyzes the African American population’s disproportionately high use of menthol cigarettes by looking at national health surveys since the 1980s. The study revealed that menthol cigarettes were responsible for 1.5 million new smokers. The harm that they have caused to African Americans’ health outcomes was also quantified in terms of 157,000 premature deaths and 1.5 million life-years lost over a period of nearly four decades.
The racial disparities in tobacco-related health outcomes can also be linked to the economic, social, and cultural factors that affect how African Americans access and utilize healthcare services. As covered in a previous article by Upscale Magazine on mental health in the Black community, only a third of Black Americans receive mental health treatment due to access barriers — financial constraints, familial and social environment, and the lack of culturally competent healthcare workers.
These barriers are similar to what African American smokers face when trying to find cessation and treatment services. On top of their limited incomes and health insurance coverage, the CDC notes that only 56% of Black adults who smoke receive clinical advice to quit. This racial bias against the African American population leads to mistrust of the medical community, making it less likely for adult smokers to quit, seek treatment, and prevent tobacco-related cancer mortality.
Reducing the Health Risks and Burden
A ban on menthol cigarettes can help reduce mortality rates and life years lost due to smoking. But improving health outcomes for the African American population also relies on their receptiveness to evidence-based cessation treatment. A clinical trial on quit medication published in JAMA Network found that among African American smokers, varenicline added to cessation counseling can by 15.7%. This presents a higher likelihood than those who only received placebo treatment (6.5%).
However, there needs to be increased effort on the government’s part to increase coverage for prescription quit medication by all types of insurance, most importantly for low-income Medicaid enrollees who are Black.
Nicotine Replacement Therapy
When Black adult smokers cannot visit a physician and get a prescription for quit medication, over-the-counter nicotine replacement therapy (NRT) becomes the next viable option. To reduce tobacco intake without worsening one’s health, nicotine pouches provide fast-acting and direct nicotine absorption.
While the pouches originate from Sweden, nicotine pouch brand ZYN has met the high demand in the U.S. market by being accessible in offline stores and online via Prilla.com. The pouches are designed to deal with nicotine cravings and withdrawal symptoms, with tobacco-free properties that ensure safe and discreet use without emitting any smoke, stain, or odor. The delivery format of pouches can be combined with the fixed and steady dose of transdermal nicotine patches for an increased likelihood of success. The most popular nicotine patch brand is Nicorette, which launched its patch in 1996. Since then the company has also released a line of lozenges to help more smokers quit.
Culturally Specific Quit-Smoking Apps
Lastly, the rise of mobile technologies can be tailored to the specific contexts of African American adult smokers. For instance, data from the Pew Research Center states that Black people are about 11% more likely to access health information using their phones, making quit-smoking apps an alternative route to traditional and in-person cessation counseling.
The iCanQuit app was proven to be successful in helping Black adults who smoke to quit and remain abstinent for 12 months. This success and engagement can be attributed to a virtual coach that is available 24/7, as well as the approach of acceptance and commitment therapy (ACT), which helps smokers become aware of their triggers and let the urge pass without acting on it.
In essence, it helps to recognize the contexts and needs of African American adult smokers first before designing strategies to help them quit smoking and seek treatment. Whether the cessation strategy is pharmacological or psychological, it must be evidence-based and relevant in order to improve quit rates and overall health outcomes.