Marketing to the marginalized: Tobacco industry targeting of the homeless, mentally ill, and injection drug users

Objectives. Describe the tobacco industry's relationships with and influence on homeless, mentally ill, and injection drug using smokers, and organizations providing services to them. Methods. We analyze internal tobacco industry documents and journal articles. Results. The tobacco industry has marketed cigarettes to the homeless, seriously mentally ill, and recovering injection drug users, part of its "downscale" market, and has developed relationships with homeless shelters, treatment centers, and advocacy groups for these populations, gaining positive media coverage and political support. Discussion. Tobacco control advocates and public health organizations should consider how to target programs to marginalized individuals. Education of service providers about tobacco industry efforts to cultivate this market may help in reducing smoking in these populations.