Similar to other health disparities, tobacco-related disparities are, in part, caused and perpetuated by the unequal distribution of the social determinants of health including income and educational attainment.

Many groups including military personnel, people with mental illness, racial/ethnic groups, lesbian, gay, bisexual, and transgender communities and those with disabilities are more likely to use tobacco, struggle with quitting or be exposed to secondhand smoke while having less access to available cessation resources. As a result, they’re more likely to suffer from preventable tobacco-related disease, disability and death.

In 2002, The National Conference on Tobacco and Health Disparities characterized tobacco-related health disparities as differences in patterns, prevention and treatment of tobacco use; the risk, incidence, morbidity, mortality and burden of tobacco-related illness; and related differences in community capacity and infrastructure, access to resources and secondhand smoke exposure. Since the tobacco industry spends $24 million every day to market and promote its products within the US, it has succeeded in targeting those groups who have the fewest resources, the least amount of social support and the least access to cessation services.

To help eliminate these tobacco-related disparities, tobacco control interventions must include evaluation components to assess the impact among those groups who are most at risk to optimize their effectiveness at both the population and community levels.