Recommendations to advance equity in tobacco control

Abstract

Reducing racial and socioeconomic inequities in smoking has been declared a priority for tobacco control in the USA for several decades. Yet despite the rhetoric, these inequities persist and some have actually worsened over time. Although tobacco companies have targeted racially and ethnically diverse and lower-income tobacco users, which substantially contributes to these disparities, less attention has been given to the role of individuals and organisations within the tobacco control movement who have allowed progress in eliminating disparities to stagnate. We examine the failure of tobacco control professionals to ensure the widespread adoption of equity-focused tobacco control strategies. Review of major US tobacco control reports found that the focus on equity often stops after describing inequities in tobacco use. We suggest ways to advance equity in tobacco control in the USA. These recommendations fall across five categories: surveillance, interventions, funding, accountability and addressing root causes. Policy interventions that will have a pro-equity impact on smoking and related disease should be prioritised. Funding should be designated to tobacco control activities focused on eliminating racial and socioeconomic inequities in smoking, and tobacco control programmes should be held accountable for meeting equity-related goals.

Tobacco endgame measures and their adaptation in selected European countries: A narrative review synthesis

“…Disappointedly, practical actions related to vulnerable groups were uncommon, as only a few countries planned measures to reduce tobacco use, especially among these groups. Pro-equity measures should be emphasized when planning, adopting, and implementing future tobacco control measures to account for different population groups, especially those most vulnerable 54 . Smoking cessation measures were given strong emphasis in country strategies, but incorporating cessation measures in specific endgame measures was lacking.…”

Commercial tobacco endgame themes in the Australian media from 2000 to 2021

“…6 While demand-reduction policies denormalise smoking and exert downwards pressure on smoking prevalence, they are associated with stigma for people who smoke 8 and inequitable outcomes. 9 Commercial tobacco endgame (endgame) policies focus on the structural determinants of smoking and include: phasing out retail sale of tobacco; banning the sale of tobacco to everyone born after a set year (smoke-free generation/tobacco-free generation (TFG) policies); requiring adults to obtain a consumer licence to purchase tobacco; regulating the contents of tobacco products to reduce their addictiveness by mandating a very low nicotine content (VLNC) standard, 10 11 and banning features…”