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The Importance of Location for Tobacco Cessation: Rural–Urban Disparities in Quit Success in Underserved West Virginia Counties
Author(s) -
Northridge Mary E.,
Vallone Donna,
Xiao Haijun,
Green Molly,
Blackwood Julia Weikle,
Kemper Suzanne E.,
Duke Jennifer,
Watson Kimberly A.,
Burrus Barri,
Treadwell Henrie M.
Publication year - 2008
Publication title -
the journal of rural health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.439
H-Index - 57
eISSN - 1748-0361
pISSN - 0890-765X
DOI - 10.1111/j.1748-0361.2008.00146.x
Subject(s) - disadvantaged , tobacco control , smoking cessation , context (archaeology) , west virginia , medicine , odds ratio , health equity , demography , residence , gerontology , rural area , environmental health , geography , public health , economic growth , nursing , sociology , archaeology , pathology , economics
Context:Adults who live in rural areas of the United States have among the highest smoking rates in the country. Rural populations, including Appalachian adults, have been historically underserved by tobacco control programs and policies and little is known about their effectiveness. Purpose: To examine the end‐of‐class quit success of participants in A Tobacco Cessation Project for Disadvantaged West Virginia Communities by place of residence (rural West Virginia and the urban area of Greater Charleston). Methods: This collaborative program was implemented in 5 underserved rural counties in West Virginia and consisted of 4 intervention approaches: (1) a medical examination; (2) an 8‐session educational and behavioral modification program; (3) an 8‐week supply of pharmacotherapy; and (4) follow‐up support group meetings. Findings: Of the 725 program participants, 385 (53.1%) had successfully quit using tobacco at the last group cessation class they attended. Participants who lived in rural West Virginia counties had a lower end‐of‐class quit success rate than those who lived in the urban area of Greater Charleston (unadjusted odds ratio [OR]= 0.69, 95% confidence interval [CI]= 0.48, 0.99), even after taking into account other characteristics known to influence quit success (adjusted OR = 0.58, 95% CI = 0.35, 0.94). Conclusions: Tobacco control programs in rural West Virginia would do well to build upon the positive aspects of rural life while addressing the infrastructure and economic needs of the region. End‐of‐class quit success may usefully be viewed as a stage on the continuum of change toward long‐term quit success.