The impact of the COVID-19 epidemic on smoking disparities in minority communities was addressed at a media briefing organized by the University of California, San Francisco, Smoking Cessation Leadership Center, and Robert Wood Johnson Foundation.

COVID-19 and the slowdown in efforts to eliminate smoking among minorities have been linked, according to a panel of specialists in December.

While the number of Americans who smoke has fallen significantly over the last half-century, it is still the leading cause of preventable death in this country, especially among minorities. Tobacco usage quitting rates vary widely by location and income, according to a briefing document cited by CNN.

Smoking is a social justice issue where someone is born, lives, plays, and works, and access to excellent education and health care are essential elements that have a role in smoking rates in communities and lead to high burdens of death and morbidity.”

In a briefing, Catherine Saucedo, deputy director of the Smoking Cessation Leadership Center, stated. Because of these gaps, the tobacco industry has taken advantage of historically underprivileged groups through targeted marketing and despicable tobacco industry techniques.”

At the Center for Black Health & Equity, Delmonte Jefferson, the executive director, spoke about COVID-19’s disproportionate impact on Black smokers.

This COVID-19 pandemic is more difficult for African-Americans to survive because of their deep-rooted poverty, preexisting physical ailments and concerns, less access to health care, and less stable work,” Jefferson stated at the briefing.

This is not the fault of COVID-19, but it has brought to light existing imbalances within our health care, education, traditional job and social institutions,” Jefferson asserted.

Additional factors contributing to gaps in Black communities’ health and economic well-being include a high rate of smoking among Blacks.

90% of all Black smokers use menthol, Jefferson claims. According to Jefferson, “predatory marketing” through using community athletes, performers, and donations to community events and festivals is likely to be the source of the high use of menthol goods. Black groups are being targeted because of the ease with which menthol items may be used, Jefferson added, which makes quitting more difficult.

This respiratory condition, COVID-19, which affects the lungs and makes it difficult to breathe, is coupled with the aggressive marketing of menthol cigarettes to our communities. At the same time, “the tobacco industry is predatory marketing to African American communities and other minority populations,” Jefferson stated. To put it another way, “This is a triple threat in our communities; a problem that must be addressed and something that we must be aware of.”

According to Janice Tsoh, PhD, a practicing clinical psychologist and UCSF professor of psychiatry and behavioral sciences, the current smoking prevalence among Asian Americans is 7 percent based on recent data from the National Health Interview Survey. Tsoh, on the other hand, cautioned that this figure may be skewed due to its inclusion of all Asian ethnicities and genders. Tsoh also found that the highest rates of smoking were found among Asian Americans with low command of the English language.

Tsoh stated that many changes in smoking habits have been observed as a result of the COVID-19 pandemic, including people reporting increased smoking, people reporting cessation of smoking, people reporting a decrease in the number of packs they smoke per day, and people reporting relapse after quitting smoking.

Tsoh spoke about the National Asian American and Native Hawaiian/Pacific Islander Health Response Assessment, which was conducted by the Asian and Pacific Islander American Health Forum in partnership with the CDC and asked people about their coping strategies for stress related to COVID-19; the characteristics and factors that influence their choice of smoking or vaping to cope with stress; and preexisting conditions.

According to Tsoh, Asian American and Native Hawaiian/Pacific Islander respondents identified depression and anxiety as the major reasons for smoking in the last week. Depression and anxiety among Asian Americans and Native Hawaiians/Pacific Islanders was more than twice as likely to lead them to turn to smoking or vaping as a means of coping with the pandemic. Tsoh found that people who reported having at least one mental health disorder were nearly six times more likely to report smoking or vaping.

“Among our Asian American participants, those who reported experiencing discrimination were nearly 1.5 to two times more likely to have reported using smoking and vaping to cope with stress,” Tsoh said.

Tsoh and her colleagues are currently working on an educational project that uses text messaging to deliver updated COVID-19 information on the hazards and why cigarette smokers are at a greater risk of severe COVID-19.. Individuals can also get information, links, and the phone number for a quitline through this project. As a result, Tsoh postulated that by providing this engagement in the proper languages to accommodate to language challenges, it may help reduce the amount of Asian Americans who smoke and are, consequently, at increased risk for COVID-19.

Even if Latinos as a whole are less likely to smoke than non-Latino whites, some subgroups are much more likely to smoke, Marcel A. de Dios of the University of Houston stated during a briefing on the subject. Puerto Rican American men are more likely than females to smoke, at a rate of 35% versus 32.6 percent, respectively.

It was revealed that e-cigarettes were the most often used tobacco product (23 percent) among Latino/Hispanic high school students and that Latino/Hispanic kids used e-cigarettes at higher rates than other racial/ethnic groups in the National Youth Tobacco Survey in 2019. Even while low-cost pharmacotherapies like nicotine replacement patches are available, Latino/Hispanic people are less likely to use them, says de Dios.

According to de Dios, cultural predisposition, quitting without pharmacological aid, a lack of understanding about the effectiveness and use of drugs, and misconceptions about the risks of smoking while on the patch are all reasons for underuse or nonuse.

Latinos, according to de Dios, “tend not to adhere to the product” when they use pharmacotherapy. Latinos face more than only nicotine replacement treatment or Chantix or Wellbutrin or other pharmacotherapies when it comes to medicine adherence issues.” When it comes to chronic illnesses like diabetes, hypertension, HIV, and mental health issues, Latinos have a worse adherence rate than other ethnic/racial groups. Health and well-being in the Latino community is hindered by a lack of adherence.”

Tobacco use is expected to fall slightly during the COVID-19 pandemic in 2021, according to preliminary data from the CDC’s National Health Interview Survey (NHIS) conducted in 2019–2021. According to de Dios, electronic nicotine delivery system use decreased in 2020 but increased again in 2021.

The CDC launched 1-800-QUIT-NOW in 2012 as part of a national media effort to persuade people to stop smoking. Approximately 700,000 to 900,000 quitline calls were received each year as a result of the campaign, according to de Dios. There was a 27% decrease in phone calls to state quitlines in 2020 as opposed to 2019.

According to de Dios, “what we are seeing is less people are trying to quit” during the pandemic.

The pandemic’s influence on the Latino population goes beyond smoking. COVID-19 had a significant impact on the lives of many Latinos, including a high percentage of family members and close friends who were hospitalized or died, and lower rates of vaccination among Latinos than those of their white counterparts. 70 percent of people in the United States who received at least one dose of the vaccination had their race/ethnicity identified as white, 19 percent Hispanic, 10 percent black, and 6 percent Asian as of Nov. 30, 2021, according to the CDC.

When it comes to vaccine uptake, “those same concerns related to hesitancy, fears, side effects like you see with [smoking] pharmacotherapies among Latinos, I believe are also driving some of the differences and disparities we are seeing with COVID-19 vaccination,” de Dios said.

According to Patricia Nez Henderson, MD, MPH, a member of the Dine Navajo tribe and leading authority on tobacco management in American Indian communities, American Indians and Alaska Natives have one of the highest rates of smoking in the country. Tobacco use has risen from 34 percent to 49.9 percent among American Indian and Alaska Native women during the past two decades. Smoking cessation is also more difficult for this demographic, but Nez Henderson found that 70% of smokers say they want to quit, 41% have tried to quit, and only 5% have succeeded.

Tobacco-related damages were “more severe” for Indigenous peoples who had been through colonization even before COVID-19, according to Nez Henderson.

For example, the Northern Plains tribes and Alaska Natives smoke at higher rates, whereas the Southwest tribes smoke at lower rates, according to Henderson. Nez Henderson, an epidemiologist at the Southwest Center for Disease Control and Prevention, says that the number of young people and youth in the region who smoke is on the rise.

Native American health and socioeconomic disparities were brought to light by the flu epidemic, Nez Henderson said. In addition, there is a dearth of water, a lack of energy, and an inadequate health care system.” Providing culturally relevant smoking cessation services to these groups is hampered by these problems. Quitlines, for example, have been a huge success. We know what works and what helps other groups quit. When more than 30 percent of a tribe does not have access to electricity, how can a community advertise a service that requires energy?

Nez Henderson believes that a wide range of lobbying initiatives are needed to raise awareness of the need for smoking cessation programs in Indigenous communities at the federal, state, tribal, and local levels..

COVID-19 has created a unique opportunity for tribal nations to address high smoking rates through commercial tobacco policy and control, according to Nez Henderson.

Fewer than ten tribal casinos offered smoke-free environments prior to the COVID-19 outbreak. Many tribes’ health activists had more to say on the need of reopening casinos with smoke-free practices during the pandemic. According to Nez Hernandez, there are already over 144 tribal casinos that have reopened smoke-free.

A complete commercial tobacco-free policy, signed into law by Navajo Nation President Jonathan Nez on Nov. 6, 2021, prohibits the use of commercial tobacco products in all public and workplace locations, such as casinos, parks, rodeos and powwow grounds.

We must take care of this absolutely preventable cause of illness.” As a result of this, “significant health benefits for our communities and better-informed policies and programs aimed at eliminating the harms of commercial tobacco,” Nez Henderson said. As a constructive start toward decolonizing, these initiatives must be carefully implemented so that they do not continue to disenfranchise our people or Indigenous people or prohibit the usage of an understanding ceremonial tobacco in our communities. “