The New Demographics of Anti-Smoking Campaigns

In many places in the U.S., the population is getting older and younger at the same time. And that has big implications for public health.
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It’s a weird time to be a demographer. As always, the U.S. population is going through some pretty big changes, but one of the biggest is that the country is getting older – and getting younger. There's been lots of discussion about how America's aging Baby Boomers will affect their communities as they retire, but far less about the 27 states where the number of children has grown in the last decade.

Smoking is a great case study for how these competing demographic trends might play out at the local public policy level. Thomas Farley, New York City’s Health Commissioner, will be part of the discussion about this issue next week at CityLab, The Atlantic’s summit on municipal innovation. In the case of tobacco in particular, he says the city has a responsibility to focus on kids. “I try to carve up the population as little as I can, but there are definitely environments which we think are important to try and prevent certain health problems in kids,” he says.

“Virtually all adult smokers start as children," says Matthew Myers, another CityLab speaker and the president of the Campaign for Tobacco-Free Kids. Smoking also indirectly damages people’s health. “There’s a direct correlation between young people concerned about the health effects of smoking and those people who… engage in a variety of behaviors that otherwise impact their health. Tackling tobacco impacts perceptions about the importance of a healthy lifestyle.”

But in cities with increasingly overburdened budgets and limited resources, the dual rise of the old and the young complicates these kinds of public health campaigns. For the most part, aging regions and “younging” regions are geographically divided, but in certain places, these trends are happening simultaneously. “When you look at Las Vegas and places like that, not only are they attracting a lot of young people, but they’re also retaining a lot of aging [people] and retirees,” says William Frey, a demographer at the Brookings Institution. These cities are “in kind of a double whammy: They’ve got to deal with issues [like] the school system, daycare, and those kinds of things, in addition to whatever services you’re going to be getting with a newly aging population.”

Immigration is also playing a role in how cities approach age-related public health issues like smoking. Places like Houston and Dallas have seen huge growth in the population of Hispanic kids and teens, which Frey notes policymakers must keep in mind. “The big headline there is that any programs or resources have to deal with minority children,” he says.

In the case of smoking, though, ethnicity matters less than other factors. “Tobacco use used to vary greatly based on that kind of demographic,” says Myers, but “the greatest correlation of who smokes and who’s exposed to secondhand smoke is based on socioeconomic class.”

So how does the rise in younger populations compare to the geographic distribution of wealth in the United States?

The map below shows the states with the biggest growth in their populations of children, as of the 2010 Census. States in black and dark blue have seen the largest booms in their child populations.

The Brookings Institution

This map shows the U.S. cities with the greatest growth in young minorities.

The Brookings Institution

And here's the percent of the population living below the poverty line.

Hackers for change

There are more than a few overlaps between the two maps – in places where there are more kids, there’s also greater poverty. Which may make campaigns against tobacco use aimed at children more important than ever.

“Tobacco use is responsible for 87 percent of lung cancer deaths, 30 percent of all cancer deaths, 12 percent of heart disease deaths,” says Myers. “All of those diseases impact people in a low socioeconomic class disproportionately.”

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Emma Green is the assistant managing editor of TheAtlantic.com, where she also oversees the National Channel and writes about religion and culture.

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