Disparities in Rural Tobacco Use, Smoke-Free Policies, and Tobacco Taxes

Buettner-Schmidt, Kelly; Miller, Donald R.; Maack, Brody

doi:10.1177/0193945919828061

Cited by 67 publications

(57 citation statements)

References 49 publications

(68 reference statements)

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“…We found that a significantly higher percentage of participants from rural areas reported that they had increased tobacco use during this pandemic compared to those from urban areas. Several studies demonstrated that tobacco use is significantly higher among rural inhabitants than those of urban areas [ 26 , 27 ]. However, the reasons behind the increased frequency of tobacco use among rural participants compared to those in urban areas during this pandemic remain unclear.…”

Section: Discussionmentioning

confidence: 99%

“…The warnings provide general statements about the health consequences of tobacco use, stating that smoking causes death, lung cancer, stroke, heart disease, respiratory problems, or other problems. The text warnings cover up at least 50% of the front and back of cigarette and bidi packs [ 27 ]. In addition, the Bangladesh government initiated a policy to increase the price and taxes for all kinds of cigarettes and tobacco products, including upward adjustment tax rates [ 26 , 27 ].…”

Section: Discussionmentioning

confidence: 99%

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Changes in Tobacco Use Patterns during COVID-19 and Their Correlates among Older Adults in Bangladesh

Mistry

Ali

Rahman

et al. 2021

IJERPH

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The present study explored the changes in tobacco use patterns during the COVID-19 pandemic and their correlates among older adults in Bangladesh. This cross-sectional study was conducted among 1032 older adults aged ≥60 years in Bangladesh through telephone interviews in October 2020. Participants’ characteristics and COVID-19-related information were gathered using a pretested semi-structured questionnaire. Participants were asked if they noted any change in their tobacco use patterns (smoking or smokeless tobacco) during the COVID-19 pandemic compared to pre-pandemic (6 months prior to the survey). Nearly half of the participants (45.6%) were current tobacco users, of whom 15.9% reported increased tobacco use during the COVID-19 pandemic and all others had no change in their tobacco use patterns. Tobacco use was significantly increased among the participants from rural areas, who had reduced communications during COVID-19 compared to pre-pandemic (OR = 2.76, 95%CI:1.51–5.03). Participants who were aged ≥70 years (OR = 0.33, 95% CI: 0.14–0.77), widowed (OR = 0.36, 95% CI: 0.13–1.00), had pre-existing, non-communicable, and/or chronic conditions (OR = 0.44, 95% CI :0.25–0.78), and felt themselves at the highest risk of COVID-19 (OR = 0.31, 95% CI: 0.15–0.62), had significantly lower odds of increased tobacco use. Policy makers and practitioners need to focus on strengthening awareness and raising initiatives to avoid tobacco use during such a crisis period.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Changes in Tobacco Use Patterns during COVID-19 and Their Correlates among Older Adults in Bangladesh

Mistry

Ali

Rahman

et al. 2021

IJERPH

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“…In particular, the higher prevalence at lower age group and lower age at first initiation compared to national data point to the need for enhanced tobacco control policies, such as taxes, smoke-free policies, and regulation of marketing practices. Historically, such policies and practices have not been widely implemented in rural communities [ 65 , 66 ].…”

Section: Resultsmentioning

confidence: 99%

Persistent disparities in smoking among rural Appalachians: evidence from the Mountain Air Project

et al. 2021

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Background Adult smoking prevalence in Central Appalachia is the highest in the United States, yet few epidemiologic studies describe the smoking behaviors of this population. Using a community-based approach, the Mountain Air Project (MAP) recruited the largest adult cohort from Central Appalachia, allowing us to examine prevalence and patterns of smoking behavior. Methods A cross-sectional epidemiologic study of 972 participants aged 21 years and older was undertaken 2015–2017, with a response rate of 82%. Prevalence ratios and 95% confidence intervals for current smoking (compared to nonsmokers) were computed for the entire cohort then stratified by multiple characteristics, including respiratory health. Adjusted prevalence ratios for current smoking versus not smoking were also computed. Results MAP participants reported current smoking prevalence (33%) more than double the national adult smoking prevalence. Current smoking among participants with a reported diagnosis of chronic obstructive pulmonary disease and emphysema was 51.5 and 53.3%, respectively. Compared to participants age 65 years and older, those age 45 years or younger reported double the prevalence of smoking (PR: 2.04, 95% CI: 1.51–2.74). Adjusted analyses identified younger age, lower education, unmet financial need, and depression to be significantly associated with current smoking. Conclusions Despite declining rates of smoking across the United States, smoking remains a persistent challenge in Central Appalachia, which continues to face marked disparities in education funding and tobacco control policies that have benefitted much of the rest of the nation. Compared with national data, our cohort demonstrated higher rates of smoking among younger populations and reported a greater intensity of cigarette use.

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“…First, disparate subpopulations are inherently heterogeneous. Buettner-Schmidt, Miller, and Maack (2019) consider the heterogeneity of the rural population as critically important, and interventions may need to be tailored in rural areas. Similarly, Okoli and Seng (2019) found that different psychiatric diagnoses are associated with tobacco use and recommend tailoring tobacco treatment to the diagnosis as well as the place (rural vs. urban).…”

mentioning

confidence: 99%

“…Nurses have their roots in social justice and are particularly well suited to consider tobacco as a social justice issue. Buettner-Schmidt et al (2019) call on nurses to mobilize to level of the tobacco control “playing field” in both rural and urban areas. Targeting vulnerable groups and tailoring prevention and treatment within these groups, and recognizing the heterogeneity within subpopulations are critically important to promoting social justice.…”

mentioning

confidence: 99%