Struggling with hunger and poverty, and caught in tobacco’s grip [The Philadelphia Inquirer]
By Alfred Lubrano, The Philadelphia Inquirer | |
McClatchy-Tribune Information Services |
"You smoke out of anxiety because you don't have the food you need," said Harvey, 54, who lives alone in
Harvey relies on his Newports to see him through his hard days. "In my mind, the smoking becomes a comfort as I try to create ways to get food."
In lives where people endure a dearth of nearly everything important -- food, jobs, medical care, a safe place to live -- the poor suffer an abundance of one thing:
Nicotine.
The poor are more likely to smoke than those above the poverty line.
In
The poorest of the 10 largest U.S. cities,
Ads everywhere
Lower-income neighborhoods such as
The poor smoke to manage high levels of stress and depression, Mallya said, as much a part of poverty as empty pockets.
Then, too, the poor are more likely to be exposed to nearly ubiquitous cigarette advertising at corner stores, which exacerbates smoking, Mallya said.
It's also harder for the poor to get smoking-cessation counseling and nicotine patches than others who may receive help through insurance, experts said.
Even as health insurance comes to the poor through the Affordable Care Act, smoking remains a problem: Smokers may be charged a premium of up to 50 percent, according to
'Keep you sane'
"When you're deprived, it creates enormous mental anguish," said Chilton, an expert on hunger. "One of the fastest, most convenient ways to help is a cigarette. It'll keep you sane, and keep you from hurting yourself or others."
Smoking is also a way to deal with hunger, Chilton said. Families without enough to eat are more likely to smoke than food-secure families, she said.
"Smoking treats hunger pangs," Chilton said. "Instead of having lunch, mothers will feed their children, then smoke."
That's how it works in Camden, said
"I smoke so I don't have to eat," she said. "I make sure my family eats, then I have a loosie [a cigarette sold singly for
Because smoking is costly, people ask, aren't the poor being irresponsible for mis-allocating money better spent on food?
Low-income smokers nationally spend 14 percent of household income on cigarettes, Mallya said. In
Mallya laments the fact that cigarettes in
The morality of buying cigarettes when you're poor is complicated. Most poor people want to quit smoking, surveys show. But poverty itself, combined with the overwhelming power of nicotine, make stopping hard.
"People smoke knowing is not good for them," said Leone of
Among the poor, especially low-income African Americans, menthol worsens smoking.
A flavor added to cigarettes, menthol makes the cigarette taste less harsh, which causes the smoker to take deeper, more frequent drags, Mallya said.
That, in turn, increases the harm of cigarettes.
For 50 years, menthol cigarettes were promoted in black neighborhoods; now, 90 percent of African American smokers in
"There may be something biological at work," Leone said, adding that science is studying whether race makes a difference. "But that doesn't cloud the intense effort by cigarette marketers."
In a city where black people already suffer greatly from asthma --
This is not to say all is hopeless. While still high, rates of secondhand smoke exposure in the city have decreased by nearly 7 percentage points between 2004 and 2012, health department research shows. And teen smoking is down from nearly 16 percent to over 9 percent in the same time frame, while there are slightly fewer adults lighting up these days.
Mallya attributes that to an intensive public education program and his department's efforts to help get many poor people smoking-cessation help.
But that doesn't mean the air will clean up any time soon.
As
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