The socio-economic divide between cigarette smokers and non-smokers

Smoking reflects a deep divide in American society.

It may seem like you barely notice anyone smoking cigarettes any more — a bad habit consigned to the trash heap of history, sent there by a 1966 surgeon general's report. If you're educated and reasonably well-off — and live in suburban or urban area — you're right. The number of people who smoke has dropped considerably among the well-educated. This is great news, right? Troublingly, it's only half the story, and it's a story of privilege. According to new CDC data, the socioeconomic disparity with which America is struggling in so many ways extends to this dangerous habit: Americans of lower socioeconomic status, or SES, are still smoking, and dying in ever-more disproportionate numbers.


SES is generally measured using four criteria: education, occupation, income, and wealth. Of these, only occupation does not indicate a greater number of smokers than the general population.

The number of smokers has dropped since 1966, but more than twice the number of people without a high school diploma smoke than those with a college degree.

  • Smoking among college graduates is down 83%.
  • Smoking among people who've had some college is down 61%.
  • Smoking among people with just a high school diploma is down 52%.
  • Smoking among people without a high school diploma is down 39%.

In this graph and the one below, “Current Use" is defined as self-reported consumption of cigarettes, cigars, or smokeless tobacco in the past 30 days (at the time of survey). Data is taken from the National Survey on Drug Use and Health, 2012, and refer to adults aged 18 years and older. (CDC)

If we combine the lack of two other SES factors — income and wealth — and look at the people living below the poverty line, the numbers are also concerning, in another CDC graph:

(CDC)

Not only do more folks with low SES smoke, but they do so more heavily, according to the CDC.

  • People living in poverty smoke cigarettes for a duration of nearly twice as many years as people with a family income of three times the poverty rate.
  • People with a high school education smoke cigarettes for a duration of more than twice as many years as people with at least a bachelor's degree.
  • Blue-collar workers are more likely to start smoking cigarettes at a younger age and to smoke more heavily than white-collar workers.

Even for non-smokers, second-hand smoke continues to be a problem, especially for bartenders and wait staff, whose workplaces in poorer areas often lack smoke-free regulations. Blue-collar workers are also more regularly exposed to tobacco smoke at work than white collar workers.

What all this adds up to is that people with less education and less money are more likely to suffer, and die, from lung cancer and other smoking-related illnesses.

“It's like there's two worlds now," Debbie Seals, a volunteer for the American Lung Association, tells the Washington Post. In her hometown of Martinsville, in Virginia's Blue Ridge Mountains, cigarettes are everywhere. When she goes north to visit family in suburban Alexandria, however, they're nowhere to be seen. And as smoking disappears from the more well-off sectors of society, the urgency of the problem also disappears from view, so federal funding of smoking cessation programs is dropping. It's as if the problem is solved, except it's not.

Robin Koval, president of Truth Initiative, tells the Post, “There's this tendency now to blame the ones still smoking. The attitude is: 'You're doing it to yourself. If you were just strong enough, you'd be able to quit.' "

Tobacco companies, though, are now focusing their marketing efforts on Martinsville and communities like it. On one hand it makes sense that these companies are interested in targeting the people most likely to buy their products, but on the other, it reinforces the stark differences in smoking habits among people from different educational and economic strata.

A spokesperson for the largest tobacco company in the U.S. Altria reminded the Post of the $112 billion his and other companies have paid in settlement money to states, blaming local governments for not funneling that money back into local anti-smoking efforts. He also claims poorer communities aren't being targeted.

Truth Initiative, among others, isn't buying it: “It's not a coincidence. It's profiling," according to their ads.

The CDC is also producing ads that discourage smoking.

“Poorer people don't smoke because anything's different or wrong about them," says Koval. “Their communities are not protected like others are." Local governments, especially in the poorer areas of the southern U.S., have been lobbied hard by tobacco companies, and have been less likely to institute disincentives such as the creation of smoke-free areas and the levying of cigarette taxes.

Koval notes that making things even worse is that, “They [poorer smokers] don't have access to good health care and cessation programs. If you have a bull's eye painted on your back, it's harder to get away."

Seals, who teaches smoking-cessation classes, says there's also a deeper reason lower-SES smokers have trouble quitting. “People down here smoke because of the stress in their life. They smoke because of money problems, family problems. It's the one thing they have control over. The one thing that makes them feel better. And you want them to give that up? It's the toughest thing in the world."

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Homo sapiens have been on earth for 200,000 years — give or take a few ten-thousand-year stretches. Much of that time is shrouded in the fog of prehistory. What we do know has been pieced together by deciphering the fossil record through the principles of evolutionary theory. Yet new discoveries contain the potential to refashion that knowledge and lead scientists to new, previously unconsidered conclusions.

A set of 8-million-year-old teeth may have done just that. Researchers recently inspected the upper and lower jaw of an ancient European ape. Their conclusions suggest that humanity's forebearers may have arisen in Europe before migrating to Africa, potentially upending a scientific consensus that has stood since Darwin's day.

Rethinking humanity's origin story

The frontispiece of Thomas Huxley's Evidence as to Man's Place in Nature (1863) sketched by natural history artist Benjamin Waterhouse Hawkins. (Photo: Wikimedia Commons)

As reported in New Scientist, the 8- to 9-million-year-old hominin jaw bones were found at Nikiti, northern Greece, in the '90s. Scientists originally pegged the chompers as belonging to a member of Ouranopithecus, an genus of extinct Eurasian ape.

David Begun, an anthropologist at the University of Toronto, and his team recently reexamined the jaw bones. They argue that the original identification was incorrect. Based on the fossil's hominin-like canines and premolar roots, they identify that the ape belongs to a previously unknown proto-hominin.

The researchers hypothesize that these proto-hominins were the evolutionary ancestors of another European great ape Graecopithecus, which the same team tentatively identified as an early hominin in 2017. Graecopithecus lived in south-east Europe 7.2 million years ago. If the premise is correct, these hominins would have migrated to Africa 7 million years ago, after undergoing much of their evolutionary development in Europe.

Begun points out that south-east Europe was once occupied by the ancestors of animals like the giraffe and rhino, too. "It's widely agreed that this was the found fauna of most of what we see in Africa today," he told New Scientists. "If the antelopes and giraffes could get into Africa 7 million years ago, why not the apes?"

He recently outlined this idea at a conference of the American Association of Physical Anthropologists.

It's worth noting that Begun has made similar hypotheses before. Writing for the Journal of Human Evolution in 2002, Begun and Elmar Heizmann of the Natural history Museum of Stuttgart discussed a great ape fossil found in Germany that they argued could be the ancestor (broadly speaking) of all living great apes and humans.

"Found in Germany 20 years ago, this specimen is about 16.5 million years old, some 1.5 million years older than similar species from East Africa," Begun said in a statement then. "It suggests that the great ape and human lineage first appeared in Eurasia and not Africa."

Migrating out of Africa

In the Descent of Man, Charles Darwin proposed that hominins descended out of Africa. Considering the relatively few fossils available at the time, it is a testament to Darwin's astuteness that his hypothesis remains the leading theory.

Since Darwin's time, we have unearthed many more fossils and discovered new evidence in genetics. As such, our African-origin story has undergone many updates and revisions since 1871. Today, it has splintered into two theories: the "out of Africa" theory and the "multi-regional" theory.

The out of Africa theory suggests that the cradle of all humanity was Africa. Homo sapiens evolved exclusively and recently on that continent. At some point in prehistory, our ancestors migrated from Africa to Eurasia and replaced other subspecies of the genus Homo, such as Neanderthals. This is the dominant theory among scientists, and current evidence seems to support it best — though, say that in some circles and be prepared for a late-night debate that goes well past last call.

The multi-regional theory suggests that humans evolved in parallel across various regions. According to this model, the hominins Homo erectus left Africa to settle across Eurasia and (maybe) Australia. These disparate populations eventually evolved into modern humans thanks to a helping dollop of gene flow.

Of course, there are the broad strokes of very nuanced models, and we're leaving a lot of discussion out. There is, for example, a debate as to whether African Homo erectus fossils should be considered alongside Asian ones or should be labeled as a different subspecies, Homo ergaster.

Proponents of the out-of-Africa model aren't sure whether non-African humans descended from a single migration out of Africa or at least two major waves of migration followed by a lot of interbreeding.

Did we head east or south of Eden?

Not all anthropologists agree with Begun and his team's conclusions. As noted by New Scientist, it is possible that the Nikiti ape is not related to hominins at all. It may have evolved similar features independently, developing teeth to eat similar foods or chew in a similar manner as early hominins.

Ultimately, Nikiti ape alone doesn't offer enough evidence to upend the out of Africa model, which is supported by a more robust fossil record and DNA evidence. But additional evidence may be uncovered to lend further credence to Begun's hypothesis or lead us to yet unconsidered ideas about humanity's evolution.