A newly released national white paper is shining a spotlight on America’s “forgotten smoker” — and its findings carry particular urgency for Kentucky, where tobacco use rates remain among the highest in the nation.
The report by PMI U.S., “The Forgotten Smoker: Modern Solutions to America’s Oldest Public Health Challenge,” emphasizes that while overall U.S. smoking rates have declined over time, millions of adults who still smoke cigarettes are increasingly overlooked by traditional public health strategies.
According to the national survey accompanying the report, nearly 8 in 10 Americans say more must be done to reduce smoking-related harm, and many adult smokers report feeling “judged, ignored, and left behind.”
That challenge is especially acute in Kentucky. Despite decades of progress nationally, 17.4% of Kentucky adults (some 600,000 individuals) still smoke — significantly higher than the U.S. average — and tobacco use remains the leading cause of preventable death in the Commonwealth, killing approximately 8,860 residents each year.
The white paper calls for a renewed focus on adult smokers through more targeted, evidence-based strategies, including improved public understanding of nicotine, expanded access to FDA-authorized alternatives, and policies that better reflect the relative risks of different products.
Specific recommendations from the report include:
• Meeting adults who smoke where they are: 52 percent of adult smokers surveyed feel discriminated against. It is time to treat cigarette smoking as a persistent public health challenge—not a moral failing—and invest in strategies that work for longtime, highly dependent adults who smoke.
• Letting the science lead: Misperceptions about nicotine and the role of combustion in smoking-related disease impede progress. Public and medical understanding of the science behind tobacco harm reduction is essential—and long overdue.
• Expanding access to FDA-authorized smoke-free alternatives: Despite recent progress, there remains a backlog of smoke-free product applications at the FDA. Adults who smoke deserve access to the science-based, smoke-free options still awaiting FDA review. Authorization of new products must coincide with the agency’s continued youth access prevention and enhanced enforcement against illicit products.
• Combating nicotine misinformation: To accelerate progress, the FDA should clearly communicate, especially to medical professionals, which products it has authorized and what the science says about their relative risk profiles, so adults who smoke can make informed choices.
• Implementing risk-based taxation: Tobacco taxes are the most regressive in the country. Tax policy should be structured to discourage use of the most harmful products (combustible cigarettes) and encourage adult smokers to switch to lower-risk alternatives. Price is a powerful lever of persuasion.
Topline findings point to a stubborn barrier: confusion about nicotine and the relative risks of combustible versus noncombustible products, as well as strong support for action:
• 52% of adults surveyed incorrectly believe nicotine directly causes cancer.
• Confirming the prevalence of misinformation in this arena, 73% mistakenly believe all tobacco and nicotine products are equally harmful to the user, while 70% believe they all pose the same risk to public health.
• 53% agree that adults who still smoke should be encouraged to switch from cigarettes to smoke-free nicotine alternatives.
• 81% say it is important for public health agencies like the FDA to provide scientifically substantiated information about the relative harms of tobacco and nicotine products.
• 63% agree that FDA reform is needed to keep pace with newer smoke-free products.
To view the full “Forgotten Smoker” white paper, please visit >> bit.ly/TheForgottenSmoker
