A growing geographic disparity: Rural and urban cigarette smoking trends in the United States. Prev Med 2017 Nov;104:79-85
Date
03/21/2017Pubmed ID
28315761Pubmed Central ID
PMC5600673DOI
10.1016/j.ypmed.2017.03.011Scopus ID
2-s2.0-85017472503 (requires institutional sign-in at Scopus site) 167 CitationsAbstract
Rural areas of the United States have a higher smoking prevalence than urban areas. However, no recent studies have rigorously examined potential changes in this disparity over time or whether the disparity can be explained by demographic or psychosocial characteristics associated with smoking. The present study used yearly cross sectional data from the National Survey on Drug Use and Health from 2007 through 2014 to examine cigarette smoking trends in rural versus urban areas of the United States. The analytic sample included 303,311 respondents. Two regression models were built to examine (a) unadjusted rural and urban trends in prevalence of current smoking and (b) whether differences remained after adjusting for demographic and psychosocial characteristics. Results of the unadjusted model showed disparate and diverging cigarette use trends during the 8-year time period. The adjusted model also showed diverging trends, initially with no or small differences that became more pronounced across the 8-year period. We conclude that differences reported in earlier studies may be explained by differences in rural versus urban demographic and psychosocial risk factors, while more recent and growing disparities appear to be related to other factors. These emergent differences may be attributable to policy-level tobacco control and regulatory factors that disproportionately benefit urban areas such as enforcement of regulations around the sale and marketing of tobacco products and treatment availability. Strong federal policies and targeted or tailored interventions may be important to expanding tobacco control and regulatory benefits to vulnerable populations including rural Americans.
Author List
Doogan NJ, Roberts ME, Wewers ME, Stanton CA, Keith DR, Gaalema DE, Kurti AN, Redner R, Cepeda-Benito A, Bunn JY, Lopez AA, Higgins STAuthor
Alexa Anderson PhD Associate Professor in the Nursing department at University of Wisconsin - MilwaukeeMESH terms used to index this publication - Major topics in bold
AdolescentAdult
Aged
Cross-Sectional Studies
Female
Health Status Disparities
Health Surveys
Humans
Male
Marketing
Middle Aged
Prevalence
Risk Factors
Rural Population
Smoking
Socioeconomic Factors
Tobacco Products
United States
Urban Population
