Mood changes
Nicotine is also advertised as good for "nerves", irritability, and stress. Again, ads have moved from explicit claims ("Never gets on your nerves") to implicit claims ("Slow down. Pleasure up"). Although nicotine products temporarily relieve nicotine withdrawal symptoms, an addiction causes worse stress and mood, due to mild withdrawal symptoms between hits. Nicotine addicts need the nicotine to temporarily feel normal.[31][32] Nicotine addiction seems to worsen mental health problems,[31] but industry marketing has claimed that nicotine is both less harmful and therapeutic for people with mental illness, and is a form of "self-medication". Marketing has also claimed that quitting will worsen rather than improve mental health symptoms. These claims have been criticized by independent researchers as inaccurate.[33]
It is thought that nicotine withdrawal is worse for those who are already stressed or depressed, making quitting more difficult.[31][32] About 40% of the cigarettes sold in the U.S. are smoked by people with mental health issues.[34] Smoking rates in the U.S. military were also high, and over a third started smoking after entering the military; deployment was also a risk factor.[35] Disabled people are more likely to smoke; smoking causes disability, but the stress of disability might also cause smoking.[36]
According to the CDC Tobacco Product Use Among Adults 2015 report, people who are American Indian/Alaska Native, non-Hispanic, less-educated (0–12 years education; no diploma, or General Educational Development), lower-income (annual household income less than $35,000), the uninsured, and those under serious psychological distress have the highest reported percentage of any tobacco product use.[37]
Poorer people also smoke more. When marketing cigarettes to the developing world, tobacco companies associate their product with an affluent Western lifestyle.[39] However, in the developed world, smoking has almost vanished among the affluent. Smoking rates among the American poor are much higher than among the rich, with rates of over 40% for those with the equivalent of a US high school diploma.[40] These differences have been attributed to both lack of healthcare and to selective marketing to socio-economic, racial, and sexual minorities.[40][41] The tobacco industry targeted young rural men by creating advertisements with images of cowboys, hunters, and race car drivers. Teens in rural areas are less likely to be exposed to anti-tobacco messages in the media. Low-income and predominantly minority neighborhoods often have more tobacco retailers and more tobacco advertising than other neighborhoods.[42]
The tobacco industry focuses marketing towards vulnerable groups, contributing to the large disparity in smoking and health problems.[43] The tobacco industry has marketed heavily to African Americans,[38] sexual minorities,[44][45] and even the homeless and the mentally ill.[46] In 1995, Project SCUM, which targeted sexual and racial minorities and homeless people in San Francisco, was planned by R. J. Reynolds Tobacco Company (a British American Tobacco subsidiary).[47][48]
Tobacco companies have often been progressive in their hiring policies, employing women and people of colour when this was controversial. They also donate some of their profits to a variety of organizations that help people in need.[49][38]
