Smoking Quit Attempts and Associated Factors Among Rural Adults Who Smoke Daily in the US

Lorna Bittencourt; Dana Rubenstein; Devon Noonan; F Joseph McClernon; Dana Mowls Carroll

doi:10.1093/ntr/ntad246

Smoking Quit Attempts and Associated Factors Among Rural Adults Who Smoke Daily in the US

Nicotine Tob Res. 2023 Dec 12:ntad246. doi: 10.1093/ntr/ntad246. Online ahead of print.

Authors

Lorna Bittencourt¹, Dana Rubenstein^{2

3}, Devon Noonan⁴, F Joseph McClernon^{2

3}, Dana Mowls Carroll^{1

5}

Affiliations

¹ Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, MN, USA.
² Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA.
³ Clinical and Translational Science Institute, Duke University School of Medicine, Durham, NC, USA.
⁴ Duke University School of Nursing, Durham, North Carolina, USA.
⁵ Masonic Cancer Center, University of Minnesota, Minneapolis, MN, USA.

PMID: 38085266
DOI: 10.1093/ntr/ntad246

Abstract

Introduction: Rural American communities are heavily affected by tobacco-related health disparities. This study aims to evaluate the prevalence of quit attempts (QA) and factors that promote or impede QA among rural adults who smoke daily.

Methods: Data from Wave 5 of the Population Assessment of Tobacco and Health study were analyzed. Multivariable logistic regression was used to identify factors associated with quit attempt. Backwards selection was used to identify variables included in the final model with statistical significance set at p <0.05.

Results: Among 1,610 rural adults who smoked daily, the prevalence of a quit attempt in the past 12 months was 25.6% (95% CI: 23.2, 28.2). Factors associated with greater QA odds: having greater education (aOR = 1.35, 95% CI: 1.03, 1.77), e-cigarette use (aOR=1.35 95% CI: 1.03, 1.80), disapproval of smoking from friends/family (aOR= 1.46, 95% CI: 1.09-1.94), greater frequency of thinking about the harm of tobacco (aOR = 1.48, 95% CI: 1.28, 1.71), fair/poor physical health (aOR=1.31, 95% CI: 1.00, 1.70), and being advised to quit by a doctor (aOR =1.63 , 95% CI:1.25, 2.13). Smokeless tobacco use (aOR = 0.67, 95% CI: 0.47, 0.96) and greater cigarettes per day (aOR = 0.67, 95% CI: 0.47, 0.96) were associated with QA lower odds.

Conclusion: Only 1 in 4 rural adults who smoke made a past year quit attempt. Interventions that promote provider advice to quit smoking, tobacco health harms, and normative beliefs may increase quit attempts in rural communities.

Implications: Along with higher smoking rates and lower quitting attempts, rural communities face limited access to programs, medication, and health care professionals as tools to help them quit smoking. Public Health initiatives should focus on developing cultural sensitivity training targeting health care professionals to advise patients to quit smoking and the role of multiple tobacco products use. Furthermore, given the low rates of smoking quitting attempts future mixed methods research is needed to inform policies and interventions targeted at eliminating tobacco-related health disparities.

© The Author(s) 2023. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.