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Health Plans

The Complexities of Tobacco Use Disparities

August 16, 2023
By Pivot
colorful bar chart showing disparities in tobacco use across populations

Explore the profound impact of tobacco use across different populations, examining disparities based on race, education level, geography, and sexual orientation. Discover how targeted marketing and systemic factors contribute to these disparities and learn about the collective efforts needed to address the issue

Tobacco is not a new problem; its use has a long-standing history that spans thousands of years, and the introduction of cigarettes over a century ago only further exacerbated the issue. However, delving into this history reveals the complexity of tobacco's impact, as different populations have been affected in distinct ways. Demographics play significant roles in shaping tobacco use patterns.

Disparities in Tobacco Use

Analyzing the impact of tobacco across different demographics unveils compelling facts that shed light on the nuances of this issue. 

horizontal bar chart showing disparities in tobacco use across different populations
Graph of tobacco use across different populations


Research has shown that certain racial and ethnic groups face higher rates of tobacco use compared to others, due to specific targeting by Big Tobacco. 

African Americans, for example, have historically experienced targeted marketing efforts, with a specific focus on mental cigarettes, by the tobacco industry, leading to disproportionately high smoking rates within their communities. 


Geographic location also plays a crucial role in tobacco use disparities. Rural areas, for instance, have shown higher smoking rates compared to urban areas. This can be attributed to a range of factors, including price reductions for cigarettes, limited access to healthcare facilities, fewer smoking cessation programs, and cultural norms that perpetuate tobacco use, that are exploited in advertising. 

Sexual Orientation

Additionally, the LGBTQ+ community has faced specific challenges related to tobacco use, with higher rates observed compared to the general population. After the black community protested against Big Tobacco, they turned their attention to the LGBTQ+ community with campaigns focused on stopping smoking bans, promoting alternative lifestyles, and at Pride festivals. In addition, stressors such as discrimination and social stigma have contributed to this disparity.

Disability Status

People with disabilities may face unique challenges, including social isolation and stress. Big Tobacco capitalizes on these vulnerabilities by positioning smoking as a way to manage emotional difficulties. Brands often depict smoking as a way to relax or fit in socially.


Tobacco companies have a long history of targeting young people to create future customers. Studies reveal that a majority of adult smokers started smoking before the age of 18. As traditional cigarette use declines among the youth, e-cigarette use and smokeless tobacco remain a concern. Big Tobacco has employed various strategies to appeal to young audiences, including using cartoon mascots, advertising in magazines with teenage readerships, sponsoring youth-centric events, and employing social media influencers to bypass advertising restrictions.

Education and Income

Similarly, individuals with lower levels of education or who fall within the lower income bracket have been more vulnerable to tobacco addiction, often due to limited access to accurate information, resources, and cessation programs. These individuals also represent the part of society already struggling with paying rent, having food on the table, and being impacted more by the struggles of childcare - costs they have to weigh against buying cigarettes and paying for doctor appointments.

The Source of the Disparities

Understanding the reasons behind these disparities requires acknowledging the efforts of the tobacco industry to target specific populations through their marketing strategies. For centuries, tobacco companies have exploited legal loopholes and advertising platforms to create addiction, particularly in communities that may experience higher levels of stress. By leveraging these vulnerabilities, they have perpetuated the cycle of tobacco use and addiction, further deepening the disparities among different groups.

Addressing the Problem

In order to address the tobacco epidemic and reshape the future landscape, collaborative efforts from various stakeholders are imperative. It is crucial to ensure that proper care and support are provided to all individuals using tobacco products. Public health campaigns and organizations have taken steps to raise awareness about the disproportionate impact of smoking on disadvantaged communities. By removing the personal stigma associated with nicotine use and framing smoking as a social justice issue, these initiatives strive to create meaningful change. However, it is important to acknowledge that powerful interests are working to ensure addiction remains a prevalent problem, making it necessary for continued advocacy and activism.

Despite the existence of these initiatives, it is crucial to acknowledge that disadvantaged populations still lack effective smoking cessation programs tailored to their urgent needs. 

Tobacco Cessation Programs Can Help

This gap in tobacco use across populations highlights the need for dedicated programs such as Pivot Breathe

By providing accessible and tailored support, Pivot aims to bridge the gap and ensure that all individuals, regardless of their background, receive the necessary resources to quit smoking and lead healthier lives. Pivot Breathe is committed to helping each individual succeed in their journey toward overcoming tobacco addiction. 

The longstanding issue of tobacco use is far from simple, as different populations have been impacted in varying ways. Disparities based on race, education level, geographic location, and sexual orientation highlight the need for targeted interventions and support. By addressing the systemic targeting of vulnerable communities by the tobacco industry and working collectively to provide comprehensive care, we can strive for a future where tobacco addiction becomes a thing of the past.

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Learn more about disparities across populations

This white paper includes even more information that can help educate and support your organization in your DEI efforts.

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