Tobacco-Related Disparities in Specific Populations

Research

"Willful misconduct": How the U.S. government prevented tobacco- disabled veterans from obtaining disability pensions
A new descriptive case study published in the American Journal of Public Health describes how the U.S. government, the tobacco industry, and veterans’ organizations took positions that ultimately prevented veterans who began using tobacco while in service from getting disability pensions for their tobacco-related illnesses. Researchers analyzed tobacco industry, Veterans Affairs (VA), and Congressional documents to examine attempts by veterans to access disability pensions for tobacco-related illnesses. These records demonstrate that Congress and the VA labeled smoking as “willful misconduct,” contradicting the federal position in lawsuits against the tobacco industries, while Veterans’ groups supported the pensions even though they previously called smoking a “right.” The tobacco industry did not firmly select a position, fearing liability either way. Because smoking has been viewed as a personal choice, veterans have received few disability pensions for tobacco-related illnesses. The authors argue that the government should fairly compensate veterans and change military policies to discourage tobacco use. Read the abstract of the study here.

A population-based study of sexual orientation identity and gender differences in adult health
In a recent study, researchers used data from the 2001-2008 Massachusetts Behavioral Risk Factor Surveillance surveys (BRFSS) to assess leading health indicators based on sexual orientation identity and gender. The population-based data showed that compared to heterosexuals, sexual minorities were more likely to report smoking. The odds of smoking among lesbian, gay, and bisexual men and women were more than double the odds of smoking among heterosexuals. Click here to view the abstract of the study in the American Journal of Public Health.

Sensitivity to cigarette prices among individuals with alcohol, drug, or mental disorders
A study published in the American Journal of Public Health indicates that a 10% increase in cigarette prices is associated with an 18.2% decrease in smoking among people with alcohol, drug, or mental disorders. The results show that cigarette prices had a significant negative effect on smoking participation among binge drinkers and those with substance abuse or mental disorders. While the cross-sectional study design does not allow causal inference, these findings suggest that increasing cigarette prices through taxes could be an effective way to reduce smoking in this population. Click here to read a summary of the findings, or click here to read the study abstract.

Changes in cigarette smoking, purchase patterns, and cessation-related behaviors among low-income smokers in New York State from 2002 to 2005
A new study shows that while state and local tobacco control policies and programs are reaching low-income New York smokers, tobacco industry price promotions may be counteracting their successes. Low-income adult smokers from Erie County, New York were interviewed in 2002 and again in 2005 regarding their smoking, cessation, and purchase behaviors; awareness and use of the state Quitline; and the use of tobacco industry promotions. The data show that over the course of three years, 13.5% of participants quit smoking, and among those still smoking, the average daily cigarette consumption dropped. There were increases in the proportions of smokers who reported attempting to use medication to stop smoking (26.6% to 51.9%), awareness of the state Quitline (32.5% to 73.0%), and having called the Quitline (4.25% to 11.0%). There was also an increase in the use of coupons distributed by the tobacco industry, from 41.1% in 2002 to 59.3% in 2005, suggesting that these programs might be offsetting the efforts of tobacco control policies and programs. Click here to read the abstract of the study, published in the Journal of Public Health Management and Practice.

Tobacco outlet density and demographics: Analyzing the relationships with a spatial regression approach
A new study shows that tobacco outlet density is higher in New Jersey census tracts where there are more minority groups and more people of lower socioeconomic status. Researchers used tobacco retail license records from 2004 and 2000 census data to determine tobacco outlet density and demographic characteristics in 1,938 residential census tracts of New Jersey. The results indicate that the demographic factors significantly associated with tobacco outlet distribution were the percentage of Hispanics, percentage of African Americans, and lower median household income. These findings support similar findings in past studies, and the use of spatial effects in the analysis allowed for less biased and more reliable results than in past studies. Click here to read the abstract of the study, published in Public Health.

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Reports

Expert panel makes recommendations on addressing tobacco in homeless populations
On October 21, 2009 the Break Free Alliance gathered over twenty researchers, policy makers, tobacco control administrators and service providers to develop targeted recommendations on tobacco policy and programming initiatives to reduce tobacco use among homeless persons. Policy recommendations, prioritized state, local and social service-based cessation interventions as well as research priorities are highlighted in a comprehensive report of the panel’s findings. Critical factors for achieving success, challenges and solutions are also identified for each topic area (policy and cessation interventions) and remaining research questions outlined. Click here for a copy of the report, or click here to learn more about Break Free Alliance.

American Lung Association highlights health disparity in new report on tobacco prevalence in lesbian, gay, bisexual and transgender (LGBT) community
The American Lung Association’s latest health disparity report, Smoking Out a Deadly Threat: Tobacco Use in the LGBT Community, examines the trend of higher tobacco use among the lesbian, gay, bisexual and transgender (LGBT) community and the need for additional research specific to this community. The report recommends that state and local tobacco control programs work to make prevention and cessation programs, materials and staff culturally competent and inclusive of the LGBT community. Organizations representing LGBTs are encouraged to advocate for policies to promote tobacco prevention and cessation programs and seek alternative funding streams to avoid tobacco industry sponsorship. This report is the second in a series of reports from ALA on health disparities in specific populations. Click here to download a press release announcing the report, or click here to access the full report.

WHO publication: Equity, Social Determinants, and Public Health Programs
The World Health Organization recently published this book as a follow-up to the September 2008 report of the Commission on Social Determinants of Health, which argued that improving the health of populations, in genuine and lasting ways, ultimately depends on understanding the causes of these inequities and addressing them. This new publication is a collection of analyses of the social determinants of health that impact specific health conditions and promising interventions to improve health equity. This book aims to translate knowledge into concrete, workable actions in order to enable health programs and policies to tackle the leading causes of ill-health at their roots, even when these causes lie beyond the direct control of the health sector. Throughout the volume, an effort is made to identify entry points within existing health programs for interventions that address the upstream causes of poor health. Click here to access this new publication.

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