A Cepeda-Benito1, N J Doogan2, R Redner3, M E Roberts2, A N Kurti4, A C Villanti5, A A Lopez6, A J Quisenberry2, C A Stanton7, D E Gaalema4, D R Keith5, M A Parker5, S T Higgins4. 1. University of Vermont Center of Tobacco Regulatory Science, University of Vermont, United States; Department of Psychological Science, University of Vermont, United States. Electronic address: acepeda@uvm.edu. 2. Center of Excellence in Regulatory Tobacco Science, College of Public Health, The Ohio State University, United States. 3. University of Vermont Center of Tobacco Regulatory Science, University of Vermont, United States; Rehabilitation Institute, Southern Illinois University, United States. 4. University of Vermont Center of Tobacco Regulatory Science, University of Vermont, United States; Department of Psychological Science, University of Vermont, United States; Department of Psychiatry, University of Vermont, United States. 5. University of Vermont Center of Tobacco Regulatory Science, University of Vermont, United States; Department of Psychiatry, University of Vermont, United States. 6. University of Vermont Center of Tobacco Regulatory Science, University of Vermont, United States. 7. Westat, Center for Evaluation and Coordination of Training and Research (CECTR) in Tobacco Regulatory Science, Department of Oncology, Georgetown University Medical Center, United States; Department of Oncology, Georgetown University Medical Center / Cancer Prevention and Control Program, Lombardi Comprehensive Cancer Center, United States.
Abstract
BACKGROUND: Smoking prevalence is declining at a slower rate in rural than urban settings in the United States (U.S.), and known predictors of smoking do not readily account for this trend difference. Given that socioeconomic and psychosocial determinants of health disparities accumulate in rural settings and that life-course disadvantages are often greater in women than men, we examined whether smoking trends are different for rural and urban men and women. METHOD: We used yearly cross-sectional data (n = 303,311) from the U.S. National Survey on Drug Use and Health (NSDUH) from 2007 through 2014 to compare cigarette smoking trends in men and women across rural and urban areas. Current smoking status was modelled using logistic regression controlling for confounding risk factors. RESULTS: Regression derived graphs predicting unadjusted prevalence estimates and 95% confidence bands revealed that whereas the smoking trends of rural men, urban men, and urban women significantly declined from 2007 to 2014, the trend for rural women was flat. Controlling for demographic, socioeconomic and psychosocial predictors of smoking did not explain rural women's significantly different trend from those of the other three groups. CONCLUSION: Rural women lag behind rural men, urban men and urban women in decreasing smoking, a health disparity finding that supports the need for tobacco control and regulatory policies and interventions that are more effective in reducing smoking among rural women.
BACKGROUND: Smoking prevalence is declining at a slower rate in rural than urban settings in the United States (U.S.), and known predictors of smoking do not readily account for this trend difference. Given that socioeconomic and psychosocial determinants of health disparities accumulate in rural settings and that life-course disadvantages are often greater in women than men, we examined whether smoking trends are different for rural and urban men and women. METHOD: We used yearly cross-sectional data (n = 303,311) from the U.S. National Survey on Drug Use and Health (NSDUH) from 2007 through 2014 to compare cigarette smoking trends in men and women across rural and urban areas. Current smoking status was modelled using logistic regression controlling for confounding risk factors. RESULTS: Regression derived graphs predicting unadjusted prevalence estimates and 95% confidence bands revealed that whereas the smoking trends of rural men, urban men, and urban women significantly declined from 2007 to 2014, the trend for rural women was flat. Controlling for demographic, socioeconomic and psychosocial predictors of smoking did not explain rural women's significantly different trend from those of the other three groups. CONCLUSION: Rural women lag behind rural men, urban men and urban women in decreasing smoking, a health disparity finding that supports the need for tobacco control and regulatory policies and interventions that are more effective in reducing smoking among rural women.
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