Internal medicine

Pathology

Smoking cessation

Geography

Quit smoking

Cigarette smoking

Environmental science

Medicine

Environmental health

JAMA Network Open

Findings from 2010-2020 NSDUH data support a persistent rural-urban disparity.Higher smoking prevalence and lower quit ratios were observed in rural vs urban areas after adjusting for sociodemographic characteristics.These results may reflect an earlier stage of motivation to quit 5 and reporting of higher nicotine dependence and heaviness of smoking among rural vs urban residents. 6Rural residents may also face structural barriers to cessation services, including lower rates of insurance coverage and fewer available health care practitioners, 3 which warrant future research.A study strength is its high external validity.Limitations include its cross-sectional design, although we used multiple years of data, and potential measurement error from self-reported data.Intervention at the clinical setting, health system, or population level might improve reach and sustainability of cessation services for rural, especially older, residents.Leveraging existing quit lines and telehealth solutions may minimize barriers to accessing cessation services.

Trends in Rural and Urban Cigarette Smoking Quit Ratios in the US From 2010 to 2020