Right now our country is echoing with protests about the unjust killing of unarmed black people and the general devaluing of black lives. While these severe violent episodes are horrifying and need to be addressed in a systemic fashion, we also have to look at all the ways that the black community suffers disproportionately in this country. In my ICU and clinic everyday, I see members of our black community sickened and dying from tobacco. I see the generational effects of tobacco, with children being addicted and struggling lifelong to break free later in life. The tobacco industry has targeted the black community since the days of the African slave trade. Black children and children of color are exposed to more tobacco advertising than white children. There are many forces in the world that contribute to early death in communities of color. Tobacco is one of them.
On today’s podcast, I talk with Cyreena Boston Ashby who is an expert on the policy side of saving lives and ensuring equity in health outcomes. In 2008, at the age of 27 (the age Breonna Taylor would have been today if she had not been shot in her own home), she ran for the Oregon House of Representatives understanding the importance of policymakers in determining health outcomes. She was the youngest candidate, the only woman or person of color in the race, and though she did not win, she certainly made her mark, gathering endorsements from community based groups and EMILY’s List. In addition to much of her other work, she was the first director of the Portland African American Leadership Forum. She was also the chief executive officer of the Oregon Public Health Institute, where she advocated for the importance of tobacco control for community health. We had a great discussion today, and I hope you listen.
Some notes on our discussion– Cyreena provides a very helpful perspective as a black woman growing up in Oregon and the mother of two young children. She reflected on her development from young activist to a professional working on health equity issues and dismantling the white supremacy tied up in the tobacco industry.
We explored the history of tobacco as a commodity, from the history of exploitation of Native Americans with the capture and commodification of tobacco by white colonizers to tobacco as a driver of the African slave trade and the exploitation by tobacco corporations of anchor organizations in the black community.
She also reflects on different lenses on public health, from a clinical scientific standpoint as well as the importance of adding in a bottom-up approach to what is facing communities, which is a newer way to round out our historical understanding of public health. We doctors learn a lot about telling people to quit smoking and the “admonishment model,” and Cyreena talked a lot about work breaking out of that mold with rooting tobacco cessation at the community and family level by leveraging community health workers as licensed health professionals in the State of Oregon as a game-changing intervention.
She expressed concern about when tobacco taxes are used to fund things outside helping the people being taxed as a larger facet of the problem of Oregon’s general tax structure, with high income tax, low business taxes, high property taxes and no sales tax. We have to be very careful about crafting taxes and tobacco policy and ensure inclusivity of stakeholders.
“The tobacco industry as it’s evolved over the years… became a platform for the advertising industry….As tobacco companies became aware of the addictive nature of tobacco (which they hid from the public)… Tobacco and cigarette and advertising companies were in lockstep with each other … marketing to specific communities that they knew they could get addicted.”
Newport and Kool targeted black communities and developed strong relationships with store owners, offering services in exchange for marketing of their cigarette brands on awnings, advertising at registers, etc. She recalls the unrestricted grants made by tobacco companies to black organizations and the corrupting influence those could have.
Cyreena and I talked for a long time, and I felt like I could go on for much longer. Some things we had to cut out for time for the podcast, but I hope to use for a future podcast:
- We talked about international consumption as tobacco companies know to target overseas in countries without strong public health culture. Cyreena shared her experience from living in China and travels in Asia
- We talked about how white-based corporations make a profit off black and brown bodies overseas
- We covered analogies to sugar beverage industries that she has encountered in her work
- She also shared her family history of tobacco and personal experience with parents who smoked at different levels and exposure of advertising
Please listen and share your thoughts. More importantly, share this podcast episode, since it is vital that we actually learn history that is so often hidden from us.
TLDR = Don't light things on fire and breathe them in your lungs!
(And don't trust corporations profiting on putting smoke in your lungs!)
References this page:
Too much sad personal experience and endless lectures… Also the following are helpful primers.
Campaign for Tobacco Free Kids– fact sheet and references on marketing to black community
Cost-benefit analysis of tobacco taxes in Mexico: most recent update, similar studies in tobacco control literature previously as well
Washington Post article- more general information on history of menthol, source of ad images above
