CHICAGO — The rate of cigarette smoking by youth in Chicago is down to 3.9%, a historic low, yet vaping is on the rise and racial disparities in tobacco use have widened, according to a report released today by the Chicago Department of Public Health (CDPH). If combustible and vapor products are combined, 16.6% of high school students in Chicago use some form of tobacco—a 12% increase since 2017.
“Our city has long been a leader in the fight to end tobacco addition thanks to its tough policies,” said Mayor Lori E. Lightfoot, the most recent example being City Council passage last week of an ordinance banning the sale of flavored vaping products in the city. “But a lot more must be done to protect our youth from the tobacco industry and to promote initiatives pushing for greater health equity.”
Chicago is faring better than the country as a whole when it comes to youth tobacco use. The city’s youth smoking rate of 3.9% is lower than the Illinois (4.7%) and U.S. levels (6.0%). Meanwhile, even though the youth vaping rate is up to 12.4%—an 88% increase over the last two years—it’s still lower than the averages for Illinois (19.9%) and the nation (32.7%).
Still, not all youth in Chicago are faring equally. Cigarette use by young Black males has risen 32% in the past two years even as all other demographics see declines. Moreover, the vaping rate for Black youth more than quadrupled in the last two years, by far the highest increase across racial and ethnic groups.
“We have come a long way. Twenty years ago, 1 in 4 teens in Chicago smoked cigarettes. Today, that number is down to 1 in 25,” said CDPH Commissioner Allison Arwady, M.D. “The fact that Chicago’s rates are lower than the state and nation is a testament to the tough policies we have in place. Yet the growing vaping epidemic is unacceptable, as are the increasing inequities in tobacco use. To advance health and equity, we must keep going.”
Chicago has an almost nine-year life expectancy gap between Black and White residents, and tobacco-related diseases are responsible for nearly two years of that gap. In fact, Black Chicagoans are dying at higher rates from COVID-19 due in part to underlying health conditions caused by tobacco use and other factors, according to health officials.
“COVID-19 makes addressing tobacco use across the life course all the more urgent,” said Rev. Horace Smith, MD, Pastor of Apostolic Faith Church on the South Side and a pediatric oncologist at Lurie Children’s Hospital. “We know that people with compromised pulmonary function and immune deficiencies are among the most vulnerable to the effects of COVID-19. We can’t afford to lose another generation to addiction.”
The report also showed high rates of tobacco use among lesbian, gay and bisexual (LGB) youth. In 2019, LGB high school students used tobacco at rates up to 5.6 times higher than heterosexual students, depending on the product. These disparities were even more pronounced among Black LGB students, with rates up to 7 times higher than heterosexual students of any race—a figure that includes a 49% increase in cigar use since 2017.
“That the tobacco industry targets Black youth is no surprise to any Black American,” said Phoenix Matthews, PhD, an anti-tobacco activist and Associate Dean of Equity & Inclusion of the College of Nursing at the University of Illinois at Chicago. “For generations, the industry has targeted African Africans with menthol cigarettes, making it the leading product in this demographic. Now Black youth are getting hooked on e-cigarettes, too. We have to get even tougher on an industry that has taken so much from us.”
Chicago was one of the first cities in the nation to add e-cigarettes to its Clean Indoor Air Ordinance, the first big city to impose a vaping tax, and the first jurisdiction anywhere to include menthol in a flavored tobacco sales ban, which covers stores within 500 feet of high schools. Numerous other jurisdictions have now passed flavored tobacco bans that include menthol, most recently California. Research shows that menthol cigarettes—most common among African Americans—are more addictive and harder to quit than other tobacco products.
Chicago residents also have the highest cigarette tax burden in the country, a ban on redeeming tobacco coupons and a minimum purchasing age of 21 that went into effect years ago. The City has recently filed a number of lawsuits against vape product manufacturers and retailers for deceptive marketing and illegal sales to kids.
“Flavored tobacco products are available at gas stations and other stores across the city. A pack of strawberry cigarillos costs just $1.99,” said Shana Crews, Illinois Government Relations Director for the American Cancer Society’s Cancer Action Network. “When you’re routinely exposed in every neighborhood shop to addictive products that can be bought with pocket change and tastes like a dessert, kids will find a way to use them.”
The underlying data from CDPH’s report comes from the Centers for Disease Control & Prevention’s Youth Risk Behavior Survey, conducted every two years in public schools. The use rates cover those who have used a tobacco product in the last 30 days.