People With Low Socioeconomic Status Experience a Health Burden From Commercial Tobacco

At a glance

  • People with lower income have higher incidence of commercial tobacco-related diseases than people with higher levels of income.
  • People with annual family incomes of less than $12,500 have higher lung cancer incidence than those with family incomes of $50,000 or more.
Woman leaning back on a pickup truck's tailgate.

The burden of commercial tobacco

Commercial tobacco gets in the way of achieving health equity for people with low socioeconomic status (SES), including those with low income.A1 Currently, people with low SES suffer from health problems related to commercial tobacco product use and the burden is not shared evenly across all populations. For example:

  • People with lower income have higher incidence of commercial tobacco-related diseases than people with higher levels of income.2
  • Current tobacco product use prevalence is higher among adults who were uninsured (27.3%), enrolled in Medicaid (28.6%), or had some other public insurance (21.3%) compared to adults with private insurance (16.4%) or Medicare only (12.5%).3
  • Cigarette smoking causes about 80% to 90% of lung cancer deaths in the United States and people experiencing extreme poverty have higher lung cancer risk than those in higher SES groups.4 People with annual family incomes of less than $12,500 have higher lung cancer incidence than those with family incomes of $50,000 or more.5
  • People with low SES are more likely to be diagnosed with diabetes.6 The risk of developing type 2 diabetes is 30 to 40% higher for people who smoke cigarettes than for people who don't.7
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Content Source:
National Center for Chronic Disease Prevention and Health Promotion; Office on Smoking and Health
  1. "Commercial tobacco" means harmful products that are made and sold by tobacco companies. It does not include "traditional tobacco" used by Indigenous groups for religious or ceremonial purposes.
  1. USA.gov. Government benefits. Accessed March 21, 2022. https://www.usa.gov/benefits
  2. Campaign for Tobacco-Free Kids. Tobacco and socioeconomic status; 2021.
  3. Cornelius ME, Loretan CG, Wang TW, Jamal A, Homa DM. Tobacco Product Use Among Adults — United States, 2020. MMWR Morb Mortal Wkly Rep. 2022;71(11):397–405.
  4. Singh GK, Williams SD, Siahpush M, Mulhollen A. Socioeconomic, rural-urban, and racial inequalities in US cancer mortality: part I-all cancers and lung cancer and part II-colorectal, prostate, breast, and cervical cancers. J Cancer Epidemiol. 2011;2011:107497.
  5. Siahpush M, Singh GK, Jones PR, Timsina LR. Racial/ethnic and socioeconomic variations in duration of smoking: results from 2003, 2006 and 2007 Tobacco Use Supplement of the Current Population Survey. J Public Health (Oxf). 2009;32(2):210–218.
  6. Sheets L, Petroski GF, Jaddoo J, et al. The effect of neighborhood disadvantage on diabetes prevalence. AMIA Annu Symp Proc. 2017;2017:1547–1553.
  7. U.S. Dept of Health and Human Services. The Health Consequences of Smoking—50 Years of Progress: A Report of the Surgeon General. U.S. Dept of Health and Human Services; 2014. Accessed March 21, 2022. https://www.ncbi.nlm.nih.gov/books/NBK179276/