Disparities in Smoking are Complicated and Consequential. What to Do about Them?

As a fundamental matter of social justice, Americans worry about health disparities experienced by racial/ethnic minorities, the poor, and other minority groups. Typically concerns focus on inequalities in access to high-quality health care and on often large differences in health outcomes. Ironically, with the exception of the tobacco control community (indeed, probably only a subset of it), Americans express little concern about disparities in smoking prevalence and cessation among groups differentiated by race/ethnicity, socioeconomic status, mental health, or sexual orientation. Why is this ironic? Because the health consequences attributable to differences in smoking rates likely account for a significant proportion of disparities in important health outcomes, like life expectancy.