Surgeon General Reports Major Disparities in Smoking Rates Across Ethnicity, Income, and Sexual Orientation

Vicki Bonomo

Surgeon General Reports Major Disparities in Smoking Rates Across Ethnicity, Income, and Sexual Orientation

Despite the progress achieved by the US population in reducing cigarette smoking, the measure of that improvement has not been equal for all populations, according to a new Surgeon General report.

The survey, issued Tuesday morning, discovered that gaps in tobacco use continue based on race and ethnicity, sexual orientation and gender identity, income level, education level, occupation, geography, and mental health status, among other factors.

Furthermore, the survey concluded that cigarette smoking and secondhand smoke exposure cause approximately half a million deaths nationwide each year, accounting for nearly one in every five deaths.

“Tobacco usage has taken a terrible toll on families for decades. Surgeon General Vivek Murthy said in a statement that now is the moment to step up our efforts to build a society where no lives are injured or lost as a result of tobacco use. “This report offers a vision for a tobacco-free future, focused on those who bear the greatest burden, and serves as a call to action for all people to play a role in realizing that vision.”

Cigarette smoking has fallen considerably in the United States since the 1960s, when the Surgeon General issued a report in 1964 stating that smoking causes lung cancer and is likely to cause heart disease. Anti-smoking campaigns followed, as did increased public knowledge of the dangers of smoking, as well as stronger government prohibitions on tobacco usage.

According to the new data, 42.4% of persons aged 18 and older reported being current cigarette smokers in 1965, compared to 11.5% by 2021.

However, in 2020, the most recent year for which complete data is available, 27.1% of American Indian and Alaska Native persons identified as current cigarette smokers. This is more than double the 13.3% of white participants and nearly double the 14.4% of Black Americans who admitted to being current smokers, according to the survey.

Furthermore, the survey indicated that Americans living in poverty smoked more than twice as much as those who did not live in poverty. In 2020, 20.2% of people earning less than $35,000 per year reported being current cigarette smokers, compared to 6.2% of those earning $100,000 or more.

Smoking was also more prevalent among Americans who identified as homosexual, lesbian, or bisexual. According to the survey, 16.3% of LGB individuals reported being current cigarette smokers, compared to 12.5% of heterosexual persons between 2019 and 2021.

When comparing rates among high school students at the same period, 10.4% of LGB teenagers reported current cigarette usage, more than doubling the 5.3% reported by heterosexual teens.

“While there is much to celebrate, progress has not been equally distributed across all populations or communities,” Adm. Rachel L. Levine, assistant secretary for health at the Department of Health and Human Services, stated. “Progress in tobacco-related legislation, regulations, initiatives, research, clinical care, and other areas has not resulted in equal outcomes for everybody. We haven’t made any progress till everyone has.”

To address such inequities, the Surgeon General’s Office advocated numerous actions, including increasing equitable access to health care, creating a maximum nicotine yield to minimize cigarette addictiveness, and implementing further laws to reduce secondhand smoke exposure.

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