Research Brief

Only 1 in 4 rural US smokers attempted to quit during a one year period

White hand holding a lit cigarette
Credit: iStock

While overall smoking rates among U.S. adults are declining, many communities remain disproportionately burdened by commercial tobacco use and the associated negative health consequences. Smoking prevalence among rural adults stood at 19.2% in 2020, compared to 14.4% for their urban counterparts. Previous research also shows rural people start smoking at younger ages and smoke more heavily than non-rural residents.

Given these disparities, it is pressing to identify strategies that help people quit smoking. A new study from the University of Minnesota School of Public Health (SPH) addresses this need by examining the factors associated with attempts to quit smoking among rural adults.

Using survey data gathered from rural, adult, daily smokers, SPH researchers evaluated the number of quit attempts they undertook in the previous year, as well as the factors that promoted or impeded attempts to quit smoking. The study, published in Nicotine and Tobacco Research, found: 

  • 25.6% of rural residents attempted to quit smoking in the past 12 months.
  • Factors associated with greater odds of attempting to quit smoking included: 
    • Having a level of education beyond high school.
    • Disapproval of smoking from friends or family. 
    • The use of e-cigarettes.
    • Being advised to quit by a doctor.
    • Self-perception of being in fair or poor physical and/or mental health.
    • Thinking more frequently about the health harms of tobacco use. 
  • Factors associated with lower odds of an attempt to quit smoking included use of smokeless tobacco products, such as chewing tobacco, and heavier smoking.
  • Previous studies have shown 55.1% of U.S. smokers attempt to quit smoking annually, but current research demonstrates only 25.6% of rural smokers successfully quit.

“Along with higher smoking rates and fewer attempts to quit smoking, rural communities face limited access to programs, medication and health care professionals as tools to help them quit smoking,” said Lorna Bittencourt, a doctoral student at SPH and lead author. “We found negative perceptions of smoking and disapproval of the habit among friends and family are leading factors associated with attempts to quit smoking. Given that, health communications campaigns and policies that emphasize family support for quit attempts should be a key priority in rural areas.”

The researchers also recommend public health initiatives should develop cultural-sensitivity training that can be used with health care professionals who advise patients to quit smoking. They also call attention to digital resources such as the National Cancer Institute’s program, which can provide tobacco users with immediate access to smoking-cessation support.

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