Smoking in Underserved Communities Is Nearly Double the National Rate, Study Results Show

The prevalence of smoking in underserved communities is nearly double the national average, and smoking has been linked with mental health conditions and substance use disorders (SUDs) in these communities, according to research results published online in CANCER, a peer-reviewed journal of the American Cancer Society.¹

“Our study underscores the importance of understanding the association and increased risk of mental health conditions and substance use disorders among adults from underserved communities who smoke while also addressing socioeconomic risk factors to achieve better health outcomes,” Sue Lin, PhD, of the Health and Resources and Services Administration within the US Department of Health and Human Services, said in a statement. “The study further highlights the significance of tailored smoking cessation treatments for individuals from underserved communities that will support cancer prevention care.”¹

For the study, investigators analyzed results from the 2014 Health Center Patient Survey.¹

The survey assessed the prevalence of smoking among adults in underserved communities who received primary care at federally qualified health centers.¹

The centers served families and individuals from underserved communities, including agricultural workers, those who live in public housing, and the unhoused.¹

The investigators also examined the links between smoking and co-occurring mental health conditions and SUDs.¹

Investigators found that the prevalence of smoking among adults in underserved communities was 28.1% compared with 14% in the United States as a whole.¹

Among those who smoke, 59.1% had depression, and 45.4% had anxiety.¹

Additionally, non-Hispanic Black adults who smoked were 2 times more likely to report SUD.¹

Individuals at or below the 100% poverty level also had more than 2 times the odds of having mental health conditions. Furthermore, those who were unemployed were more than 3 times more likely to have a SUD.¹

The results of the study confirmed that comorbidities and negative interdependencies of smoking, along with mental disorders and SUDs, were more prevalent across underserved populations.²

Additionally, the findings suggest that tobacco prevention and cessation programs are not effective for this population. Investigators suggested that culturally sensitive approaches tailored to these communities would be more effective to deliver treatment for mental health and SUD.²

Interventions for care and treatments for these populations should be considered as social determinants of health and not unchangeable variables, investigators said.²

Furthermore, health care professionals reported a lack of confidence, resources, time, and training as common barriers to providing counseling to individuals who are tobacco users.²

References

1. Smoking in underserved communities nearly double the US national rate. EurekAlert. News release. March 7, 2022. Accessed March 9, 2022. https://www.eurekalert.org/news-releases/944928

2. Lin SC, Gathua N, Thompson C, Sripipatana A, Makaroff L. Disparities in smoking prevalence and associations with mental health and substance use disorders in underserved communities across the United States. Cancer. 2022; doi:10.1002/cncr.34132.