While the habit of smoking has declined significantly among the general public within the last decade, the rates are still relatively high among three groups of people: Native Americans, the LGBT community (lesbian, gay, bisexual, and transgender) and people with mental illness.
“We’re making great strides, but it’s evident that there are large groups of people who continue to struggle with tobacco and the chronic diseases associated with it,” said Amy Lukowski, Psy.D., clinical director of Health Initiatives at National Jewish Health in Denver. “We need to find ways to better reach and serve those vulnerable demographic groups that are disproportionately impacted by tobacco.”
About 17.8 percent of adults now smoke in the United States, according to a recent study by the Centers for Disease Control and Prevention. That’s the lowest percentage since 1965 (the first year of smoking statistics), when more than 42 percent of adults smoked.
“As an academic medical center devoted for decades to eliminating tobacco use and its associated disease states, we feel the imperative to better identify and understand the unique factors related to tobacco use in these groups and develop protocols that are specifically tailored to their needs,” said Lukowski. “This is a high priority for us.”
More than 26 percent of Native Americans are smokers, the highest rate of any ethnic group and significantly higher than the national average. What makes the issue particularly sensitive is that tobacco has been an integral part of Native American culture. It holds a sacred place in their history and is still used in spiritual ceremonies and traditional practice.
Until now, effective smoking cessation programs designed specifically for Native Americans across multiple tribes in different geographic locations did not exist. QuitLogix at National Jewish Health became the first quitline in the United States to hire Native coaches.
Prior to launching their American Indian Commercial Tobacco Program (AICTP), Lukowski said that researchers had met with dozens of previous and potential participants of quitline services in various regions.
“We needed to better understand the best ways to address commercial tobacco from community members themselves, while still honoring traditional tobacco practices,” she said.
Quitline experts are also working to better help counsel those with mental illness, who smoke at a rate of 36 percent, more than twice the national average. They are also working closely with people in the LGBT community, a population that is up to 200 percent more likely than others to be addicted to cigarettes.
“Those high rates of tobacco use in these populations are no accident,” said Lukowski. “Tobacco companies have identified and targeted these groups as being populations more vulnerable to nicotine addiction and are shrewdly advertising directly to them.”
One particular ad aimed at the LGBT community reads, Whenever someone yells ‘Dude, that’s so gay,’ we’ll be there. “That’s an ad for a tobacco company,” said Lukowski. “As absurd as it may sound, it works. Tobacco companies are reaching young members of the LGBT community, in particular, to convince them that they actually empathize with them and support them, all while selling them deadly products,” said Lukowski.
Other ads are aimed at appealing to Native Americans with their use of traditional colors and imagery. Some cigarette companies claim to use pure tobacco, insinuating that it’s much like the tobacco grown, dried, cut, and used in ceremonies. Tobacco companies also offer commercial products directly to tribes and, in some cases, it’s been suggested that they may give tribal leaders commission for products that are sold.
“Unfortunately, their efforts are often effective, and once members of these particular groups become consumers, it does not take long to develop a physical addiction to the nicotine found in these tobacco products,” said Lukowski. “If we’re going to help members of these populations quit smoking, we need to show the same level of interest in these groups as tobacco companies do.”
Source: National Jewish Health