title: Prevalence and trends in smoking: a national rural study.
abstract: BACKGROUND
  Cigarette smoking is the leading preventable cause of death in the United States.
  
  
  OBJECTIVE
  To estimate the prevalence of and recent trends in smoking among adults by type of rural location and by state.
  
  
  METHODS
  Random-digit telephone survey of adults aged 18 years or older who participated in the Behavioral Risk Factor Surveillance System in 1994-1996 (n = 342,055) and 2000-2001 (n = 385,384). The main outcome measure was current cigarette smoking, defined as persons who smoke every day or some days, while nonsmokers were those who smoke not at all or reported never having smoked as many as 100 cigarettes.
  
  
  RESULTS
  The prevalence of smoking changed little from the mid-1990s; in 2000-2001, it was 22.0% in urban areas, 24.9% in rural adjacent areas, 24.0% in large rural nonadjacent areas, and 24.9% in small rural nonadjacent areas. For rural locations combined, smoking prevalence was not below the 12% goal of Healthy People 2010 for any state, although the 12.5% prevalence in rural Utah approached this target. Prevalence was > or = 28% for rural residents of Kentucky, Ohio, and Indiana. Since the mid-1990s, the prevalence of smoking for rural respondents decreased by more than 2 percentage points in 6 states: California, Connecticut, Maryland, North Carolina, Tennessee, and Utah. However, it increased by 2 percentage points or more in 10 states: Alabama, Delaware, Georgia, Massachusetts, Michigan, Mississippi, New Hampshire, Oklahoma, South Carolina, and Texas.
  
  
  CONCLUSIONS
  Smoking remains a refractory public health problem. Better ways to curb smoking in rural America are needed.
authors.affiliation: Department of Family Medicine, University of Washington School of Medicine, Seattle, Washington 98195-4696, USA. mdoesche@u.washington.edu
authors.forename: Mark P
authors.initials: MP
authors.lastname: Doescher
authors.forename: J Elizabeth
authors.initials: JE
authors.lastname: Jackson
authors.forename: Anthony
authors.initials: A
authors.lastname: Jerant
authors.forename: L
authors.initials: L
authors.lastname: Gary Hart
mesh_terms: D000293:Adolescent; D000328:Adult; D003625:Data Collection; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012424:Rural Population; D012907:Smoking / Q000453:epidemiology* / Q000639:trends; D014481:United States / Q000453:epidemiology