title: Smoking prevalence in urban and rural populations: findings from California between 2001 and 2012.
abstract: BACKGROUND
  Tobacco smoking and related health problems are still major public health concerns in the United States despite the declining smoking prevalence.
  
  
  OBJECTIVE
  This study explored differences in smoking prevalence between urban and rural areas potentially relevant to tobacco control efforts in California.
  
  
  METHODS
  Public use adult smoking data from the California Health Interview Survey (CHIS) between 2001 and 2011-2012 were analyzed. A total of 282 931 adults were surveyed across the six CHIS cycles. A ZIP code-based geographic classification (Urban, Second-City, Suburban, and Town/Rural) was used to examine the association between smoking prevalence and area of residency.
  
  
  RESULTS
  The overall smoking prevalence in California decreased from 17.0% in 2001 to 13.8% in 2011-2012. Within each CHIS cycle, the Town/Rural areas had the highest smoking prevalence, followed by Urban and Second-City areas, and Suburban areas had the lowest. Pooled data from all CHIS cycles showed a similar pattern, with rates in Urban, Second-City, Suburban and Town/Rural areas being 15.2%, 15.2%, 13.1% and 17.3%, respectively. Weighted multivariate logistic regression analysis indicated significantly higher odds of smoking in Urban, Second-City and Town/Rural areas compared to Suburban areas (all adjusted odds ratios > 1.10), although this trend varied by race/ethnicity, being present in non-Hispanic Whites and not present in Hispanics.
  
  
  CONCLUSIONS
  Town/Rural and Urban populations of California are consistently at higher risk of smoking than Suburban populations. These results indicate a need for population-specific tobacco control approaches that address the lifestyle, behavior, and education of disparate populations within the same state or region.
authors.affiliation: a Department of Family Medicine and Public Health , University of California, San Diego , La Jolla , CA , USA.
authors.forename: Lianqi
authors.initials: L
authors.lastname: Liu
authors.affiliation: a Department of Family Medicine and Public Health , University of California, San Diego , La Jolla , CA , USA.
authors.forename: Steven
authors.initials: S
authors.lastname: Edland
authors.affiliation: b Psychology Service, Veterans Affairs San Diego Healthcare System, and the Department of Psychiatry , University of California, San Diego , La Jolla , CA , USA.
authors.forename: Mark G
authors.initials: MG
authors.lastname: Myers
authors.affiliation: c Graduate School of Public Health and the Department of Political Science, San Diego State University , San Diego , CA , USA.
authors.forename: C Richard
authors.initials: CR
authors.lastname: Hofstetter
authors.affiliation: a Department of Family Medicine and Public Health , University of California, San Diego , La Jolla , CA , USA.
authors.forename: Wael K
authors.initials: WK
authors.lastname: Al-Delaimy
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002140:California / Q000453:epidemiology; D005006:Ethnicity / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D012424:Rural Population / Q000706:statistics & numerical data*; D012907:Smoking / Q000453:epidemiology*; D013383:Suburban Population / Q000706:statistics & numerical data; D014505:Urban Population / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: California; Smoking prevalence; rural; urban