Cutting Tobacco’s Rural Roots

Written by  American Lung Association
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The American Lung Association’s latest health disparity report, “Cutting Tobacco’s Rural Roots: Tobacco Use in Rural Communities,” examines the prevalence of tobacco addiction and exposure to secondhand smoke in rural America, particularly among rural youth.

rural-youth-smokingTobacco use is higher in rural communities than in suburban and urban communities, and smokeless tobacco use is shockingly twice as common. Rural youth are more likely to use tobacco and to start earlier than urban youth, perpetuating the cycle of tobacco addiction and death and disease.

“Tobacco use is often accepted as a social norm in rural areas, making it more likely that rural youth will view it as acceptable and more likely that they will become tobacco users themselves,” said Ross P. Lanzafame, Chair of the Board of the American Lung Association. “Community leaders and residents need to take a stand against the culture of tobacco use as part of life and empower their future generations to have healthy, tobacco-free lives.”

There are a number of environmental and social factors that contribute to this generational cycle of tobacco use among youth and adults in rural America.

still-smoke-cigsIncreased tobacco use is associated with lower education levels and lower income, which are both common in rural areas where there may be fewer opportunities for educational and economic advancement. Exposure to secondhand smoke is also higher as rural communities are less likely to have smokefree air laws in place and less likely to have voluntary restrictions on smoking indoors.

For decades, the tobacco industry has used rural imagery, such as the Marlboro Man, to promote its products and appeal to rural audiences. Over the past several years, the tobacco industry’s marketing of smokeless tobacco products has skyrocketed. Sadly as the tobacco industry spends millions of dollars targeting rural youth, these youth are less likely to be exposed to tobacco counter-marketing campaigns. Rural tobacco users are also less likely to have access to tobacco cessation programs and services to get the help they need to quit.

pack-of-cigarettesMany rural states have low tobacco taxes. Raising tobacco prices is a proven strategy to reduce tobacco use. Promotion of the availability of state counseling services by phone and online resources also lags.

The American Lung Association is calling on government agencies, the research and funding community, health systems and insurers, community leaders, schools and families to take steps now to cut tobacco’s rural roots. “The rural community clearly requires special attention if we hope to end the epidemic of tobacco use in this country. We must all work together as neighbors to overcome this health disparity,” said Kimberly Horn, Ed. D., Associate Dean of Research, The George Washington University School of Public Health and Health Services.

The American Lung Association offers smoking cessation resources to help people quit smoking for good:

Freedom From Smoking® is a program that teaches the skills and techniques that have been proven to help hundreds of thousands of adults quit smoking. Freedom From Smoking is available as a group clinic, an online program and a self-help book.

barn-rural-smokingNot-On-Tobacco® (N-O-T) is a group program designed to help 14 to 19 year old smokers end their addiction to nicotine. The curriculum consists of ten 50-minute sessions that typically occur once a week for 10 weeks.

The Lung HelpLine, 1-800-LUNG-USA, offers one-on-one support from registered nurses and respiratory therapists. Individuals have the opportunity to seek guidance on lung health and find out how to participate in and join the Lung Association smoking cessation programs.

In addition to expanding the Lung Association’s capability to provide its programs and services to the rural community, there are also several other action steps to reduce rural tobacco use. These steps are detailed in the full report, and include that state and federal tobacco control programs must make a concerted effort and dedicate funding to reach rural communities; the research community should focus attention and resources on identifying effective cessation treatments for smokeless tobacco use; and school, health and employment systems in rural areas must all implement effective tobacco control strategies including smokefree air policies and access to cessation services.

no-smoking-signThis report is part of the Lung Association’s Disparities in Lung Health Series. For more information, please contact Mary Havell, This e-mail address is being protected from spambots. You need JavaScript enabled to view it . To download a copy of the report, visit:

About the American Lung Association
Now in its second century, the American Lung Association is the leading organization working to save lives by improving lung health and preventing lung disease. With your generous support, the American Lung Association is “Fighting for Air” through research, education and advocacy.

For more information about the American Lung Association, a Charity Navigator Four Star Charity and holder of the Better Business Bureau Wise Giving Guide Seal, or to support the work it does, call 1-800-LUNG-USA (1-800-586-4872) or visit

“American Lung Association Report Aims to Reduce Tobacco Use in Rural Communities” press release reprinted with permission. © 2012 American Lung Association. .”

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