Hookah, Cigarillos May Be Raising Lung Cancer Rates for Fulton’s Black Men
MSM's Dr. Eric Flenaugh says research suggests the demographic may be more susceptible to negative effects of smoking than their counterparts.
By Chauncey Alcorn, Capital B Atlanta
The popularity of hookah lounges, cigar bars, and recreational marijuana may be contributing to higher rates of lung cancer among Black men living in Fulton County, according to recent research outlined by the county’s Board of Health.
Panelists at the Fulton County Board of Health’s “State of Healthcare for African Americans” town hall on Monday, February 10, said that a higher rate of lung cancer exists among Black men in the region, despite smoking rates often being equal to or lower than that of other racial groups.
“There’s something about African Americans that [is] making them more susceptible to the bad effects of tobacco smoke,” Fulton-DeKalb Hospital Authority board trustee Alicia M. Ivey told attendees at the event, which took place at Fulton’s South Services Center in College Park.
Dr. Eric L. Flenaugh, a pulmonary medicine expert with Ƶ and Grady Memorial Hospital, cited research indicating the rate of lung cancer among African American men in Fulton County (74 per 100,000) is about 10 points higher than it is for white men (64 per 100,000), even though both demographics smoke at roughly the same rates (23% versus 25%, respectively).
Flenaugh says Native American men who live in the county smoke at much higher rates (44%) than Black men but are less likely to get lung cancer.
“It’s not just race when we talk about health disparities,” Flenaugh said. “It’s an imbalance between people’s health and what they know about their health and what they do with their health and the health care that’s available to them or what they seek out.”
The city of Atlanta banned smoking at most public venues in 2020 to help curb growing local respiratory health disparities. But it’s allowed in establishments that promote smoking as a form of entertainment, such as hookah lounges and cigar bars, which have become more ubiquitous in Fulton County in recent years.
The Atlanta metro area had the 67th worst level of ozone pollution in the nation last year, according to an American Lung Association report released in April that said Fulton — a majority-Black county — was the worst offender in the region for cancer-causing air particle pollution.
Dr. Lynn Paxton, health director for the Fulton Health District, said the disparities in lung cancer rates among Black Fulton County residents could possibly be attributed to the popularity of products that rival cigarettes in adverse health effects, including hookah, Black and Mild cigarillos, and other cigars.
One Black and Mild has the same nicotine content as about 12.5 cigarettes, according to Flenaugh, who said smoking one full-sized cigar is the same as an entire pack of cigarettes, if not more.
Still, Paxton noted that there’s not enough data yet to say conclusively whether hookah use is more likely to cause lung cancer than other tobacco products.
Higher rates of smoking marijuana may also be a problem, according to Flenaugh.
Research shows Black men smoke marijuana at higher rates than other demographic groups. Some Americans believe smoking marijuana is healthier than cigarettes, but Flenaugh noted research showing heavy marijuana users — those who smoke weed 50 times or more throughout their lives — are twice as likely to develop lung cancer.
“I have patients that do that in a week,” Flenaugh said. “It’s starting to become more acceptable. We want to legalize marijuana, but we have got to realize the impact it has, especially for those populations that are more susceptible to the bad effects of smoking.”
Panelists noted that lack of healthcare access in southern Fulton County, where most Black residents live, may also contribute to higher rates of cancer diagnosis due to lower insurance rates, lack of healthcare service centers, and fewer overall cancer screenings in local Black communities.
Quitting smoking, exercising, avoiding venues where secondhand smoke is prevalent, and increasing healthcare access via full Medicaid expansion were some of the proposed policy solutions.