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Assari S, Farhoudian A. Unequal Impact of Flavored Tobacco Across Populations: From Neuroscience to Policy. BCN 2025; 16 (6) :1003-1016
URL: http://bcn.iums.ac.ir/article-1-3332-fa.html

Flavored tobacco products engage neural reward and sensory integration pathways, increasing appeal and dependence, particularly among youth people. Although tobacco control policies such as taxation and adoption of smoke-free laws have reduced overall tobacco use, their benefits are unevenly distributed across socioeconomic and racial/ethnic groups. This study, by reviewing evidence from neuroscience, epidemiology, and public policy, aims to examine how flavored tobacco and major tobacco control strategies differentially affect population. We focus on tobacco taxation, smoke-free laws, and complementary policies, with attention to policy reach, enforcement, and structural inequities. Neuroscientific findings showed that flavor additives enhance reward and mask aversive properties of tobacco, amplifying vulnerability among targeted populations. While taxes and smoke-free laws reduce tobacco use at the population level, disadvantaged minority groups often experience weaker benefits due to uneven policy adoption, limited enforcement, targeted industry marketing, and reduced access to cessation resources. The Minorities’ Diminished Returns framework helps explain why similar policy exposure yields smaller health gains in marginalized populations. Tobacco control policies are effective but not inherently equitable. Reducing tobacco-related inequalities requires integrating flavor restrictions with uniformly applied taxation, comprehensive smoke-free protections, strong enforcement, and accessible cessation support.