New research calls for a health equity lens in the regulation of commercial tobacco products

Dana Mowls Carroll, assistant professor at the University of Minnesota School of Public Health, co-authored a recent commentary in Preventive Medicine on how tobacco trade policies contribute to inequities, including unequal burden and unfairness of tobacco-related illnesses and deaths among racialized populations.

The researchers explained that policies permit the continued sale of menthol cigarettes — particularly through targeted marketing — that increase the risk of commercial tobacco use among Black or African American (B/AA) and Native American adults. At the same time, policies banning e-cigarette flavors to prevent young people from starting to vape have received considerable attention. These policies disproportionately benefit white youth, whose e-cigarette use is higher than B/AA youth. While preventing e-cigarette use among young people is essential, the level of support, urgency and publicity for banning e-cigarette flavors exceeds that of banning menthol cigarettes. that reinforces inequalities in how regulation benefits various groups.

The authors argue that equitable opportunities for healthy living can no longer be afterthoughts or secondary goals for policy makers, and call for a health equity lens in the regulation of commercial tobacco products and provide individual recommendations. and systems that put health equity at the forefront of regulation. and research.

Their recommendations include:

  • The Food and Drug Administration – which regulates commercial tobacco products nationally – should directly address health equity while evaluating regulations and prioritizing research that examines how regulations, or lack thereof, can increase or reduce commercial tobacco-related health inequalities experienced by B/AA and Native American groups.
  • Community engagement is essential and public health professionals must be prepared to do it well. This approach can be used to authentically engage with populations most at risk of tobacco-related disease and ensure their voice and wisdom are prioritized in policy development and implementation.
  • More B/AA and Native American tobacco regulatory science researchers should be mentored, recruited, and supported in their training.
  • This work must begin with understanding the roots of inequalities. All scholars should educate themselves on the cultural and historical contexts in which their academic and community institutions exist and their impacts on B/AA and Indigenous communities.

“Striving to achieve the highest possible level of health for all means we must learn about the real roots of inequalities, particularly racism, and identify public health approaches and policies that are anti-racist,” Carroll said. “I am interested in how the populations that bear the heaviest tobacco-related burdens benefit to a lesser extent from, or may even be harmed by, the implementation or absence of tobacco-related policies compared to the socially privileged populations.

This research was supported by the National Institute on Drug Abuse of the National Institutes of Health (NIH), the National Institute on Minority Health and Health Disparities of the NIH and the Center for Tobacco Products of the United States Food and Drug Administration.

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