Tobacco Cessation and Smoke-free Laws in Rural, Economically Distressed Communities

Adult smokers in communities with long-standing smoke-free laws are more likely to quit smoking compared with those from communities with more recent smoke-free laws. However, this phenomenon has not been studied in rural, economically distressed areas that are disproportionately affected by smoking. The purpose of this study is to examine the association between implementation of a longstanding smoke-free law and cessation behaviors among current and recent former smokers in rural, distressed communities in Kentucky. A quasi-experimental, two-group design compares the smoking and cessation behaviors between participants from a rural, distressed community with a longstanding comprehensive smoke-free law (treatment; n = 250) and those living in four rural, economically distressed communities without smoke-free laws (control; n = 250)). The four control counties were matched to the treatment county on educational attainment, income and smoking prevalence. Current and recent former smokers were recruited using random digit dialing and were eligible to participate in a phone survey if they were a resident of the community and were smoking at the time of enactment of the smoke-free law in the treatment county. Group comparisons of smoking and cessation outcomes will be made using chi-square tests for stratified survey design with respondents nested within communities. These findings will reveal the impact of a comprehensive smoke-free law as a cessation intervention in rural, economically distressed communities with disproportionately high smoking rates.