Cigarette smoke has hit the record low in the United States – but progress is unbalanced, according to a new report.
Only 14% of Americans consumed a tobacco product in 2017, according to federal data.
But the numbers have just moved into the poorer communities, where smoking-related cancers are far more common than in rich areas.
It took decades to reduce the rate of smoking and the new milestone, published today in the journal JAMA Internal Medicine, is revolutionary.
However, the lead author Eric Leas said he was surprised by how different the situation is for non-whites and poor Americans.
Researchers found strong differences in smoking rates among groups, with smoking much higher among poor non-white Americans
"The degree of iniquity was surprising," a Stanford Prevention Research Center scholar said in the Los Angeles Times.
The Leas study is a data analysis of the 500 Cities project, launched in 2016 to monitor chronic diseases.
The 500 Cities project collected self-reported data on smoking, asthma, chronic obstructive pulmonary disease (COPD) and coronary heart disease (CHD).
According to Leas, it seemed like a good way to better understand how the tobacco drop was developing at the community level.
His research team collected data on the smoking of the project, taking note of each other's race and socioeconomic status (whether they live in a poor area or in a rich area).
They found strong differences between the groups, with the smoke much higher among the poor non-white Americans.
Some cities have had particularly bad divisions.
For example, smoking rates are very low among the wealthiest, white people in Washington, DC. But the poor non-white citizens of the capital also have some of the highest smoking rates.
Atlanta, Fort Lauderdale and Miami have had less clear but equally significant gaps.
Neighborhoods with higher smoking rates, of course, also have higher rates of smoking-related illnesses such as COPD, heart disease and asthma.
In fact, the areas with the highest smoking rates have 39% higher percentages than those diseases compared to areas where few people smoke.
"Industry is good at highlighting the people they think can be manipulated," said Robin Koval, CEO and president of Truth Initiative, the national public health organization that directs and funds the campaign on truth.
"Making the cheaper and more compelling cigarettes are just two of the many ways the tobacco industry exploits the hardest working communities, where you live, how much you have, or what you do should not determine how much you're worth."