Unfair and Unjust Practices and Conditions Harm Asian, Native Hawaiian, and Pacific Islander People and Drive Health Disparities

scared asian child hugging parent

Asian Americans have historically faced discrimination related to immigration.

Some U.S. historical policies and practices have led to mental and physical health risks and challenges, and related long-term health outcomes, for Asian, Native Hawaiian, and Pacific Islander (A/NH/PI) people. For example:

  • Discrimination and distress related to immigration laws and policies.6,10
  • Colonization of Hawaii, leading to people losing their homes, land, and cultural practices that kept people healthy and well.11,12,13,14
  • Refugee resettlement in the U.S. and lasting effects on mental health, health behaviors, and effects on people’s health and quality of life.15
  • More and different kinds of commercial tobacco* products coming into the Pacific region after large numbers of people moved in and used commercial tobacco as payment for food products, work, or other goods.16,17

There are also current reasons—like the ones explored below—that help explain why the health of A/NH/PI people is affected by commercial tobacco.

The tobacco industry targets A/NH/PI communities with marketing and advertising

Marketing plays a big role in whether people try or use commercial tobacco products. Commercial tobacco ads make smoking seem more appealing and increases the chance that someone will try smoking for the first time or start using commercial tobacco products regularly.8,18,19

Tobacco companies spend billions of dollars each year to aggressively market their products.20 They also target specific populations, including A/NH/PI populations, with commercial tobacco advertising.21

  • Tobacco companies consider Asian people a key group for marketing commercial tobacco products, since cigarette smoking is more prevalent in some Asian countries than in the U.S.18,22
  • dragon dance celebration

    Tobacco companies target cultural events, such as this Dragon Dance celebration for Lunar New Year

    Commercial tobacco ads on billboards and in stores are more common in city neighborhoods with mostly Asian residents than in other city neighborhoods.15

  • Tobacco companies promote to Asian American business owners by supporting their business groups and giving them special materials to help drive product sales.15
  • Commercial tobacco brands try to appeal to Asian people by making sure their brands are seen, giving money to community organizations, and targeting ads to this group. For example, the tobacco industry has sponsored Lunar New Year festivals and other activities related to Asia/Pacific American Heritage Month.18 The industry has also supported groups serving Asians and others, such as women’s groups, political groups, arts and culture groups, and senior citizens’ groups, with the goal of drawing in Asians and promoting their brands.23

To help protect A/NH/PI people from tobacco marketing and discourage tobacco product use, states and communities can consider limiting advertising, prohibiting price discounts, and allowing fewer stores in a neighborhood to sell commercial tobacco products.24

Tobacco companies promote flavored products – especially menthol - in neighborhoods where A/NH/PI people live.

Menthol has a minty flavor that masks the harsh taste of tobacco. Menthol makes cigarette smoke feel easier to inhale and can make it harder to quit smoking.25,26,27 Tobacco companies have aggressively marketed menthol cigarettes to A/NH/PI people for decades and continue to do so today.

  • The tobacco industry targets neighborhoods with more Asian residents, other communities of color, low-income neighborhoods, and youth with menthol advertising.28
  • In 2019, 77% of NH/PI and 41% of Asian adults who smoked reported using a menthol brand, compared to 30% of white people who smoked.29
  • In 2011, over half of Asian youth aged 12-17 who smoked reported using a menthol brand—second only to that of Black youth (72%).30
  • Filipino and Native Hawaiian/Pacific Islander adults who smoke are more likely to use menthol cigarettes than other groups of Asian adults.31

There are actions states and communities could take to reduce the availability of flavored commercial tobacco products.8,32 For example, prohibiting the sale of all flavors in tobacco products, including cigarettes, e-cigarettes, cigars, and cigarillos, could help to reduce the number of youth who use these products.33

Stress can increase commercial tobacco use, and can make health problems worse
62% of Asian American report experiencing discrimination based on ethnicity

Stress, such as that caused by financial problems, discrimination, or unsafe neighborhoods, can make someone more likely to smoke.34,35,36 Some A/NH/PI people face many types of stress:

  • Asian people who reported many instances of discrimination were more likely to smoke than Asian people who reported fewer instances of discrimination.37
  • Compared to other racial/ethnic groups, Native Hawaiians are more likely to have low-paying jobs and to have below average living conditions. Many report high levels of racism and discrimination, and that it affects their jobs, housing, and income.38
  • Southeast Asian ethnic groups have lower incomes than the average U.S. household income, according to the Southeast Asia Resource Action Center.39 Continuing financial problems are a major source of stress.

When people experience severe or long-lasting forms of stress, their bodies respond by raising stress hormones and keeping them raised. When this goes on for a long time, they may develop health problems like high blood pressure and diabetes.40,41 Smoking cigarettes also leads to disease and disability and harms nearly every organ of the body.8

*“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.
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