Rural Versus Urban Use of Traditional and Emerging Tobacco Products in the United States, 2013–2014

Introduction:
This article summarizes a study on the use of traditional and emerging tobacco products in rural and urban areas in the United States. The study uses data from the Population Assessment of Tobacco and Health (PATH) Study to estimate weighted prevalences of adult tobacco use across urban-rural geographies and examines prevalences classified by gender, poverty level, and region of the country.

Key Points:

* The study found that cigarette use and smokeless tobacco use, as well as dual or polytobacco use of traditional products, were more prevalent in rural than in urban areas.
* Cigarillo and hookah use and dual or polytobacco use of emerging products were higher in urban areas.
* There was no significant urban-rural difference in use of e-cigarettes.
* Gender, poverty, and region of the country did not seem to be driving most urban-rural differences, although differences related to cigarillo use and dual or polytobacco use of emerging products became nonsignificant after control for covariates.
* The study highlights important urban-rural differences in tobacco use and suggests that the changing tobacco product landscape may contribute to a continuation of rural health disparities.

Main Message:
The main message of this study is that there are significant urban-rural differences in tobacco use, with rural areas having higher prevalences of cigarette and smokeless tobacco use, as well as dual or polytobacco use of traditional products. While emerging tobacco products, such as e-cigarettes, are often marketed as a safer alternative to traditional tobacco products, the study found no significant urban-rural difference in their use. The study suggests that the changing tobacco product landscape may contribute to a continuation of rural health disparities, and highlights the need for targeted tobacco control efforts in rural areas.

Roberts, Megan E., Nathan J. Doogan, Cassandra A. Stanton, Amanda J. Quisenberry, Andrea C. Villanti, Diann E. Gaalema, Diana R. Keith, et al. “Rural Versus Urban Use of Traditional and Emerging Tobacco Products in the United States, 2013–2014.” American Journal of Public Health 107, no. 10 (October 2017): 1554–59. https://doi.org/10.2105/AJPH.2017.303967.