Cigarette smoking more prevalent, harder to quit among rural vs. urban Americans
IMAGE: MARIA PARKER. view more
CREDIT: INDIANA UNIVERSITY
BLOOMINGTON, Ind. -- A new study by Indiana University researchers found that from 2010 to 2020, a larger proportion of rural Americans smoked cigarettes -- and their odds of quitting smoking were lower -- compared to those living in urban areas.
"Cigarette smoking prevalence is higher in rural than urban U.S. communities, and that disparity has only increased over time," said Maria Parker, an assistant professor of epidemiology and biostatistics in the IU School of Public Health-Bloomington. "We wanted to see if quit ratios might account for some of rural vs. urban area smoking disparity, beyond a higher smoking prevalence."
The study team was led by Parker and included colleagues at IU, Rutgers University and Yeshiva University. Their findings were recently published in JAMA Network Open.
Using deidentified data from the U.S. Department of Health and Human Services' 2010-20 National Survey on Drug Use, the researchers analyzed adults who had smoked at least 100 cigarettes in a lifetime, which they defined as lifetime cigarette smoking. Current smoking was defined as smoking one or more cigarettes in the past month, and former smoking as no cigarettes in the past year. Overall and annual quit ratios were estimated as proportions of former smokers among lifetime smokers.
The researchers found that of the 161,348 lifetime cigarette smokers analyzed, 33.5% were former smokers.
In 2020, current smoking prevalence was higher in rural than urban areas -- 19.2% vs 14.4% -- whereas quit ratios were similar in rural and urban areas, at 52.9% and 53.9%, respectively.
However, from 2010 to 2020, the odds of quitting smoking were 75% lower in rural areas compared to urban ones.
Over time, smoking quit ratios among both rural and urban populations increased.
"Our findings support that a persistent rural/urban disparity exists," Parker said. "Not only were smoking prevalence estimates higher in rural areas, but quit ratios were lower in rural areas than urban areas. Rural residents may face more barriers to using smoking cessation services than urban residents, or they may be in an earlier stage of motivation to quit."
Parker said that smoking intervention at the clinical setting, health system or population level might improve reach and sustainability of cessation services for rural residents. She said that leveraging existing smoking quit lines and telehealth solutions may also help rural residents by minimizing barriers to access.
Additional IU authors on the paper include researcher and biostatistician Erik S. Parker and student Emma Eggers, both of the School of Public Health-Bloomington.
JOURNAL
JAMA Network Open
ARTICLE TITLE
Trends in Rural and Urban Cigarette Smoking Quit Ratios in the US From 2010 to 2020
Cigarette smoking more prevalent – and harder to quit – among rural vs. urban Americans
Cigarette smoking is more prevalent among Americans residing in rural areas and they also have a more difficult time quitting smoking than urban residents, according to a study involving Rutgers researchers.
The study, published in JAMA Network Open, found smoking prevalence was higher in rural than urban areas – 19.2 percent versus 14.4 percent. While the number of smokers quitting in 2020 was similar in both rural and urban areas – 52.9 percent compared with 53.9 percent – the odds of quitting between 2010 and 2020 were 75 percent lower in rural areas compared with urban areas.
“Higher cigarette smoking prevalence and lower cessation in rural populations have led to higher rates of smoking-attributable cancer incidence and death in rural, compared with urban residents,” said Andrea Villanti, coauthor of the study, associate professor in the Department of Health Behavior, Society and Policy at the Rutgers School of Public Health and deputy director of the Rutgers Center for Tobacco Studies. “Tobacco cessation, therefore, is a high-impact target for cancer prevention efforts in rural populations.”
The study used data from the U.S. Department of Health and Human Services’ 2010–2020 National Survey on Drug Use to analyze adults who had smoked at least 100 cigarettes in a lifetime, which they defined as lifetime cigarette smoking. Current smoking was defined as smoking one or more cigarettes in the past month and former smoking as no cigarettes in the past year. Overall and annual quit ratios were estimated as proportions of former smokers among lifetime smokers.
The researchers found that of the 161,348 lifetime cigarette smokers analyzed, 33.5 percent were former smokers.
According to the researchers, the findings support the existence of a persistent rural/urban disparity, possibly attributed to the fact that rural residents may face more barriers to using smoking cessation services than urban residents or may be in an earlier stage of motivation to quit.
They suggest smoking intervention at the clinical setting, health system or population level might improve reach and sustainability of cessation services for rural residents. Tobacco cessation resources, including telephone quit lines and telehealth counseling could also reduce barriers to accessing tobacco treatment in rural residents.
The study team was led by Indiana University and included researchers at Yeshiva University.
JOURNAL
JAMA Network Open
METHOD OF RESEARCH
Data/statistical analysis
SUBJECT OF RESEARCH
People
ARTICLE TITLE
Trends in Rural and Urban Cigarette Smoking Quit Ratios in the US From 2010 to 2020
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