Racialized Geography, Corporate Activity, and Health Disparities: Tobacco Industry Targeting of Inner Cities

Abstract

Industry has played a complex role in the rise of tobacco-related diseases in the United States. The tobacco industry's activities, including targeted marketing, are arguably among the most powerful corporate influences on health and health policy. We analyzed over 400 internal tobacco industry documents to explore how, during the past several decades, the industry targeted inner cities populated predominantly by low-income African American residents with highly concentrated menthol cigarette marketing. We study how major tobacco companies competed against one another in menthol wars fought within these urban cores. Little previous work has analyzed the way in which the inner city's complex geography of race, class, and place shaped the avenues used by tobacco corporations to increase tobacco use in low-income, predominantly African American urban cores in the 1970s-1990s. Our analysis shows how the industry's activities contributed to the racialized geography of today's tobacco-related health disparities.

The Global Laboratory of Tobacco Control: Research to Advance Tobacco Cessation in LMICs

“…Within LMICs, lower income is usually (though not always) associated with increased tobacco use prevalence as well (WHO, 2014). Studies from HICs show that tobacco companies have targeted low-income and minority populations (Iglesias-Rios & Parascandola, 2013;Yerger, Przewoznik, & Malone, 2007); tobacco retailers and retail advertising are more highly concentrated in low-income neighbourhoods (Hillier et al, 2015;Rodriguez, Carlos, Adachi-Mejia, Berke, & Sargent, 2013;Schneider & Gruber, 2013); and low socioeconomic status (SES) and the presence of tobacco retailers are negatively associated with smoking cessation (Cano & Wetter, 2014;Cantrell et al, 2015). Development of low-cost cessation interventions to assist underserved populations in LMICs may also have relevance for HICs.…”

Letter by Lempert et al Regarding Article, “Menthol and Nonmenthol Cigarette Smoking: All-Cause Deaths, Cardiovascular Disease Deaths, and Other Causes of Death Among Blacks and Whites”

“…Although menthol per se was not associated with higher cardiovascular disease risk, tobacco companies have targeted black communities effectively with specialized marketing to promote menthol cigarettes, which contributes to tobacco-related disparities. 2 In 2011 the Food and Drug Administration's Tobacco Products Scientific Advisory Committee concluded that "removal of menthol cigarettes from the marketplace would benefit public health in the United States," 3 and a 2012 study found that 44% of black menthol smokers said they would try to quit smoking if menthol were banned. 4 In May 2016, the Food and Drug Administration published its "deeming rule" extending its jurisdiction over cigarettes and smokeless tobacco to all tobacco products.…”

The case for banning cigarettes

“…Support with cessation, including nicotine replacement therapy (NRT), counselling and medical advice, may also be more accessible for those from better-off groups. Further, the tobacco industry has specifically targeted disadvantaged populations, for example by placing its advertising disproportionately in low-income and ethnic minority neighbourhoods21 22 and devising marketing strategies with particular appeal to the homeless and those with mental health problems 23. These factors may help explain differences in cessation rates: studies suggest that across social groups smokers make similar numbers of cessation attempts but those in better-off groups are more likely to succeed 24.…”