African Americans and tobacco: It’s time to ‘butt’ out

“Big Tobacco” may be on the ropes again after a recent court ruling requiring that one company, Lorillard, pay out $152 million in a wrongful death suit. A Massachusetts court has ruled in favor of the family of Marie Evans eight years after she died from lung cancer. The case was strengthened by documents used in the trial that showed Lorillard purposely marketed its Newport cigarettes to African Americans such as Evans when they were teenagers.

Another document in the case, a Lorillard company memo stated, “the base of our business is the high school student.” Court testimony revealed Lorillard gave out sample packs of its menthol-flavored cigarettes to teenagers in minority enclaves such as Roxbury in Boston. That included giveaways outside of neighborhood middle schools. Lorillard is appealing the decision.

It’s not surprising that tobacco companies such as Lorillard gave away menthol cigarettes. According to a recent FDA report, menthol-flavored cigarettes can be more addictive. That’s because menthol acts as an anti-irritant and also masks tobacco’s unpleasant taste. That also makes the cigarettes more appealing to kids.

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Studies, such as one published in Addiction, have shown African Americans and young adults are the biggest menthol smokers. Studies also have shown menthol cigarettes are harder to give up than non-menthols. One study of 7,000 smokers recently published in Preventive Medicine showed that 62 percent of African Americans and 61 percent of Hispanics who attempted to quit smoking non-menthol cigarettes did so. Yet only 44 percent of African Americans and 48 percent of Hispanic menthol smokers could quit.

All that marketing – an explanation

According to study co-author, Dr. Cristine Delnevo, tobacco companies target minority populations when marketing menthols. So although minorities smoke at about the same rate as Caucasians, more smoke harder to quit menthol cigarettes. Dr. Delnevo also thinks that helps explain why minorities suffer higher rates of tobacco-related disease and death.

Big Tobacco is facing a possible FDA ban of all menthol cigarettes. Makers of menthols have been arguing against the ban. In March, the FDA’s own Tobacco Products Scientific Advisory Committee failed to make a clear recommendation on the proposed ban. One reason was the tobacco company claim that a ban could lead to a black market demand for the cigarettes.

The decision is now up to the FDA. But from a sales standpoint, tobacco companies have a lot to loose. Menthols make up a third of the U.S. Market. One study showed 40 percent of menthol smokers would quit if they were banned. The National Cancer Institute estimates that by 2020, a ban would result in 17,000 fewer premature deaths and 2.3 million fewer smokers.

As Delnevo noted, minority populations suffer higher rates of tobacco-related disease and death. A recent study may help explain some of the reasons for the “survival gap” – that mistaken attitudes on lung cancer have a negative effect on survival. Published in the journal Cancer, researchers surveyed the attitudes of 1500 African Americans and whites with lung cancer, a very deadly form of cancer. It revealed that African Americans had a “mistaken, fatalistic” belief about lung cancer that may have delayed diagnosis and treatment. The African Americans in the study tended to wait until obvious lung cancer symptoms such as pain and coughing-up blood appeared. Unfortunately, a delayed diagnosis makes it more difficult to treat lung cancer successfully.

Cancer misconceptions

The study also showed that African Americans “grossly underestimated” the seriousness of lung cancer. And after diagnosis, they were more pessimistic about survival outcomes. That may have interfered with them choosing aggressive treatment. The researchers noted the African-American community needs to be educated on the actual risks of lung cancer and the importance of early diagnosis and treatment.

Smoking and joints

It’s a well-established fact that smoking can cause lung cancer. What is not so well known is that smoking also contributes to the development of rheumatoid arthritis (RA). Now a study shows that for African Americans, that is also the case. The study, published in Arthritis & Rheumatism, compared the rates of RA among never smokers with smokers. The study showed the African Americans in the study with RA were more likely to be smokers. The rate of RA was strongly related to smoking more than 10 years.