Since the beginning of the opioid epidemic, advocates in our state including Community Solutions have worked tirelessly to ensure substance use disorders (SUD) and the individuals they impact receive the attention and support they deserve to recover. This includes fighting for additional mental health and addiction services funds in the state budget, supporting diversion instead of corrections for non-violent individuals whose crime stems from their addiction and advocating for improvements of multi-system youth services for at-risk youth in our state. And while the opioid epidemic has highlighted how legal and legally obtained substances can be just as deadly, and addicting, as illegal ones, it remains the case that all addiction is not treated with the same urgency and attention.
My mom, Kathy Jean, was introduced to smoking cigarettes by an older boyfriend when she was in middle school.
My mom, Kathy Jean, was introduced to smoking cigarettes by an older boyfriend when she was in middle school. They killed her shortly after her 61st birthday.
Although her family as well as her neighborhood was solidly middle class, by nature of redlining and other racially informed policy decisions of the 1950s and 1960s, it was predominately Black – meaning it was already ground zero for poor health outcomes. For over a century, Big Tobacco has aided in these outcomes as they have conspired to addict Black and low-income communities to nicotine using higher amounts of menthol flavor to help cigarettes taste less harsh and seem more appealing to new smokers and young people. This scheme included targeting tobacco advertisements at convenience stores and gas stations, often times the only retailer(s) in communities disproportionately impacted by food deserts, and aggressively marketing tobacco products in the media using elements of Black culture. Additionally, the industry knew that users of their products faced a potential cancer risk as well as other negative health outcomes including respiratory infections, emphysema, certain eye diseases and of course, addiction, and yet continued inappropriately marketing the products to children. And although this has since been admitted and litigated through The Tobacco Master Settlement Agreement (MSA) in 1998, the aftermath has been bleak for Black communities still suffering the consequences of this deliberate and intentional attack on our public health.
While my mom fell victim to the menthol movement – that is, using menthol flavoring to initiate nicotine addiction – she wasn’t the only one. Currently, nearly 9 in 10 Black youth ages 12 and older who smoke use menthol cigarettes and nearly 85 percent of all Black smokers use menthol cigarettes, compared to 30 percent of all white smokers. And while the MSA has created a mechanism for calculated investment in cessation services, the estimated number of smoke-attributable deaths and years of potential life lost among whites and Blacks indicates that the average annual smoke-attributable mortality rate is 18 percent higher for Blacks (338 per 100,000) than for whites (286 deaths per 100,000).
While smoking cessation campaigns and programs are not without merit and are incredibly important to ensuring current smokers are supported in their efforts to quit, firsthand experience tells me larger efforts to ban cigarettes in their entirety are the only way to avoid this public health crisis.
As the story goes with many other smokers: my mom, a former mental health and addiction social worker, had been trying to quit smoking cigarettes since before I was born. And although she could go several months, years even, without picking up a cigarette, one stressful workday was enough to relapse. I tried making deals with my mom – 6-year-old Hope told Kathy that if she were to quit smoking cigarettes, she would quit biting her nails. A decade later, 16-year-old-Hope bet Kathy that she could fund all holiday-related gifts and expenses if she set aside cigarette money in a jar for 3 months. She did. And it was the best, and most healthy, holiday season we’d ever had. In between this time, and up until her death, there were varying degrees of begging, fighting, pleading, gums, patches, medication, support groups and more. Nothing worked.
I decided to take matters into my own hands as a teenager when I saw the fear in her eyes as she tried to catch her breath to simply reach our third-floor apartment. I knew her days of teaching aerobics classes and taking long walks around the neighborhood while she gossiped with her sisters on the phone were long behind her. Shortly following this incident, we were introduced to oxygen tanks and words we hoped to never hear such as nebulizers, albuterol and tracheotomy.
After a few years of trading lies about whether or not she’s stopped or resumed, many trips to the emergency department for breathing treatments and many more fights, my mom succumbed to her addiction and passed away on January 1, 2020.
I am haunted by knowing how smoking leads to an early death. I can’t help but believe that there is some combination of words I left unsaid, a statistic, a hypothetical, an idea or reason I did not explore that, if expressed in the right way, at the right time, would have been enough.
Due to increased awareness and increased use and adverse effects of vaping products, several states and municipalities increased the minimum age for sale of tobacco products from 18 to 21 years old.
Since cigarettes and subsequently nicotine compared to other substances, kill much slower, requiring chronic, prolonged use to experience many of the negative effects, this substance gets much less attention than its illegal counterparts. However, due to increased awareness and increased use and adverse effects of vaping products, several states and municipalities increased the minimum age for sale of tobacco products from 18 to 21 years old before President Trump signed federal legislation to do so in September 2019.
Since the passage of this legislation, (known as Tobacco 21 or T21) there have been efforts to ban the sale of all flavored tobacco products including menthols, in states and municipalities across the country including in Cleveland. My colleague Natasha Takyi-Micah has previously written about the Northeast Ohio Black Health Coalition’s Menthol Free Communities initiative which seeks to tell the story of the negative impact of menthol cigarettes on the Black community with the goal to seek an ordinance to ban the sale outright.
I am hopeful that these efforts, and others around abolition and the prohibition of tobacco, receive the attention, funding and commitment required.
I am hopeful that these efforts, and others around abolition and the prohibition of tobacco, receive the attention, funding and commitment required to save and protect Black lives. Because while my mom never stopped smoking, she never stopped trying to quit either – and our policies should not quit on Black women like her.