Tobacco use and exposure in rural areas: Findings from the Behavioral Risk Factor Surveillance System

Smoking prevalence in urban and rural populations: findings from California between 2001 and 2012

“…The higher smoking prevalence in Town/Rural areas may be explained by lower socioeconomic status, cultural norms, reach of tobacco control efforts, and access to health services in these areas (3,10). The lower smoking prevalence in Suburban areas likely reflects the high portion of residents (40.1%) with college or above education.…”

“…Higher education level generally indicates higher socioeconomic status, different social norms, and more knowledge about health risk behaviors, which are consistently associated with lower rates of smoking (3,10). Factors associated with higher smoking prevalence in rural populations include disparities in tobacco control programs and resources, adoption of smoke-free policies, sociodemographic characteristics such as lower income and educational attainment, lower health insurance coverage and reduced access to treatment services, and targeted marketing by the tobacco industry (3,10,(21)(22)(23)(24). Higher smoking rates in urban areas have been attributed to higher levels of stress from living in urban areas (4,5,7,20).…”

“…Rural areas also have different social norms and behaviors which need to be taken into consideration by tobacco control programs (3,10). Our study results clearly indicate a need for a population-specific tobacco control approach that addresses the lifestyle, behavior, and education of disparate populations within California in order to lower the higher than average smoking prevalence in such settings.…”

“…Data from the US Behavior Risk Factor Surveillance System (BRFSS) indicate that smoking prevalence tends to be higher among adults aged 18 years and older from rural areas than similarly aged adults in either urban areas (2) or suburban areas (3), but this finding is not consistent across different states (4,5). Different urban/rural classifications have also been employed in these studies, such as metropolitan statistical area (MSA) based classification of urban and rural (2), classification into urban, suburban and rural areas (3), urban, suburban and nonmetropolitan areas (4), remote, rural and metro areas (6), and urban, hub (micropolitan), and rural areas (5).…”

Variation with socioeconomic status of indoor radon levels in Great Britain: The less affluent have less radon

“…He attempted to obtain estimates of smoking prevalence by county within state by allowing for the fraction of the county population that lived in urban areas. In fact, in the United States adults living in rural locations smoke more than those in urban (or suburban) areas (Vander Weg et al, 2011) and it is unclear how effective Cohen's attempted correction will have been. It is the failure to adequately account for correlations between cigarette smoking and radon levels within the sampling units that led to the spurious negative trends of lung cancer and radon of Cohen (Greenland and Robins, 1994); this correction Cohen did not attempt to implement, possibly because of the lack of necessary intra-sampling unit data, although such correction is in principle possible (Sheppard, 2003).…”