Tobacco use in the African American community

Although African Americans smoke at lower or similar rates compared with other racial and ethnic groups, they are disproportionately affected by tobacco use in several ways. For example, African Americans have higher death rates from tobacco-related causes and are more likely to be exposed to secondhand smoke.

The tobacco industry has targeted African Americans and strategically marketed its products to appeal to the community for decades, including placing more advertising in predominantly black neighborhoods and in publications that are popular with black audiences. The most striking example is menthol cigarettes, which are easier to smoke and harder to quit. Today, nearly 90% of all African American smokers use menthol cigarettes, and more than 39,000 African Americans die from tobacco-related cancers each year. Experts believe that racial differences in smoking habits, socioeconomic factors and the metabolism of tobacco carcinogens may all play a role.

PATTERNS OF USE IN THE U.S.

CIGARETTES

Youth

• According to the 2019 National Youth Tobacco Survey, the current cigarette smoking rate was 4% among African American high school students compared with 5.8% of all high schoolers.
• The current cigarette smoking rate among African American middle schoolers was 1.8% compared with 2.3% of all middle schoolers.

Young Adults and Adults

• According to the 2018 National Health Interview Survey (NHIS), among adults ages 18 and above, 14.6% of African Americans are current smokers, compared with 15% of whites and 9.8% of Hispanics.

MENTHOL CIGARETTES

Menthol is a chemical compound extracted from peppermint or corn mint plants, or created synthetically. It reduces the harshness of cigarette smoke due to its characteristic cooling effects on the mouth and throat. It also suppresses the coughing reflex, which makes inhaling smoke from cigarettes more tolerable. For more information, see the Truth Initiative® fact sheet on menthol tobacco products.

• Nearly 9 in 10 (88.5%) African American smokers ages 12 and older use menthol cigarettes.
• African American youth who smoke menthol cigarettes have greater nicotine dependence and a greater desire to smoke than nonusers,6 and therefore have a harder time quitting.
• In 2014, among middle and high school students, 70.5% of African American smokers used menthol cigarettes, compared with 52.3% of Hispanic smokers and 51.4% of white smokers.
• Data from nationally representative samples show that the youngest age groups use menthol at the highest rates.
  • From 2008 to 2010, 94.8% of African American teenage smokers aged 12-17 smoked menthol cigarettes, compared with 93.9% of smokers aged 18-25, 91.6% of smokers aged 26-34, 89.9% of smokers aged 34-49 and 80.9% of smokers aged 50 and over.
• Despite starting to smoke later and smoking fewer packs per day, African American menthol smokers successfully quit smoking at a lower rate than non-menthol smoking African Americans.
  • Research shows that if menthol cigarettes were banned nationally, 44.5% of African American menthol smokers would try to quit.

LITTLE CIGARS, CIGARILLOS AND CIGARS

African Americans have the highest rate of cigar use. Cigars include a variety of products, including traditional large cigars, longer and slimmer versions of large cigars called cigarillos, and little cigars, which are like cigarillos, but generally have a filter like cigarettes.

Youth

• African American middle and high school students have the highest rates of cigar use compared to other races.
• Among African American high school students, cigars were the most common tobacco product used after e-cigarettes, at 12.2% in 2019.
• Among African American middle school students, 3.8% were current users of cigars in 2019.
• Cigars, particularly little cigars and cigarillos, come in a variety of flavors. As is the case with flavored cigarettes, such flavors may appeal to youth and young people.

Young Adults and Adults

• In a study that used data from 18- to 34-year-olds, African Americans were shown to have greater odds of currently using little cigars and cigarillos.
• According to the 2018 NHIS, 4.9% of African Americans aged 18 and over used cigars, cigarillos and filtered little cigars “every day” or “some days.”

E-CIGARETTES

E-cigarette use among young people has skyrocketed in recent years, jumping 135% among high schoolers between 2017 and 2019 alone.

Youth

• In 2019, 17.7% of African American high school students and 8.6% of African American middle school students currently used e-cigarettes. These rates are lower than the general population rates of 27.5% for high school students and 10.5% for middle school students.

Young Adults and Adults

• In 2017, 10.3% of African American adults had ever tried an e-cigarette.
• In 2017, current e-cigarette use was highest among white adults (3.3%), compared with African American (2.2%), Hispanic/Latino American (1.8%) and Asian American (0.9%) adults.

SECONDHAND SMOKE

African American children and adults are more likely to be exposed to secondhand smoke than any other racial or ethnic group. The surgeon general has concluded that there is no safe level of exposure to secondhand smoke.

• African American nonsmokers generally have higher cotinine levels (an indicator of recent exposure to tobacco smoke) than nonsmokers of other races and ethnicities.
• Deaths caused by secondhand smoke exposure have a disproportionate impact on African Americans and Hispanic/Latino Americans.

INDUSTRY TARGETING

• Evidence from tobacco industry documents shows that tobacco companies have a long history of specifically targeting African Americans with menthol cigarette advertising and promotions and making large financial contributions to African American groups and political leaders.
  • A 2013 study found that African American children were three times more likely to recognize advertisements for Newport brand menthol cigarettes than other children.
  • A review of menthol marketing found more advertising in publications and venues that target African American audiences.
  • A 2014 study found that Newport print advertising in 2012 and 2013 “focused on themes of sociability and sexuality, and were placed in magazines targeting African Americans and younger consumers.”
  • A 2011 review concluded that Ebony magazine was almost 10 times more likely than People magazine to contain an advertisement for menthol cigarettes.
  • A study found that, as a high school’s African American student population increased, the likelihood of Newport promotions went up and the cost of Newport packs went down.
  • In November 2015, Mother Jones published a thorough exploration of the strategic partnerships tobacco companies made in African American communities and the possibility that those partnerships prevented stronger regulation of menthol products.
• Several studies have found a greater number of tobacco advertisements and a larger presence of tobacco advertising in African American neighborhoods.
  • Researchers in Washington, D.C. found that stores in predominantly black neighborhoods were up to 10 times more likely to display tobacco ads inside and outside than retailers in areas with fewer black residents.
  • Other studies have shown that predominantly black communities across the country have more advertising and cheaper prices for menthol cigarettes.
  • Studies have found that little cigars and cigarillos are more available, cheaper and highly advertised in African American neighborhoods.
• Tobacco companies have used experiential marketing — the tactic of encouraging consumers to experience or interact with a brand at recreational venues and events, such as concerts, bars or nightclubs — to specifically target certain populations, including African Americans.

HEALTH EFFECTS

• Smoking is a major cause of heart disease, cancer and stroke, which are the three leading causes of deaths for African Americans in the U.S.
• Smoking is responsible for about 30% of all cancer deaths. Lung cancer is the second most common cancer in both African American men and women. African Americans have the highest rates of tobacco-related cancer of all racial and ethnic groups, and are more likely to die because of the disease. In 2019, 25,390 new cases of lung cancer are estimated to occur among African Americans.
• More than 72,000 African Americans are diagnosed with a tobacco-related cancer each year.