228941 Do smoke-free laws in rural, underserved counties encourage cessation?

Tuesday, November 9, 2010 : 2:30 PM - 2:50 PM

Ellen J. Hahn, PhD, RN , Tobacco Research and Prevention Program, University of Kentucky College of Nursing and College of Public Health, Lexington, KY
Mary Kay Rayens, PhD , College of Nursing and College of Public Health, University of Kentucky, Lexington, KY
Ronald E. Langley, PhD , Survey Research Center, University of Kentucky, Lexington, KY
Mark Dignan, PhD , Markey Cancer Center, University of Kentucky, Lexington, KY
Adult smokers in communities with smoke-free laws are more likely to quit smoking compared to those from communities without these laws. However, this has not been studied in rural, economically distressed areas that are disproportionately affected by smoking. The purpose was to examine the association between a longstanding smoke-free law and smoking behaviors and secondhand smoke (SHS) exposure among current and recent former smokers in rural, underserved communities. A quasi-experimental, two-group design compared the smoking/cessation behaviors and SHS exposure between participants from a rural, distressed community with a 3-year old smoke-free law (treatment; n = 252) and those 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 if they were smoking at the time of enactment of the smoke-free law in the treatment county. Those in the treatment county had a greater level of education and were more dependent on tobacco. There was no treatment group difference in the number of cigarettes smoked per day, time since last cigarette, readiness to quit smoking, or quit smoking attempts. Those in the treatment county were more likely to report ever having tried to quit cigars, pipes and smokeless tobacco. Current and former smokers in the treatment county were more likely to report a smoke-free policy at work, but more likely to report smoking in the home. One limitation is that this was a cross-sectional analysis without pre-law comparisons. Smokers living in smoke-free communities may be more hardened compared to those not in smoke-free communities. Our findings are consistent with other research that some subgroups may be more likely to smoke in the home when living in smoke-free communities. In spite of significantly greater nicotine dependence, those in the treatment group were not less likely to report quit attempts, nor did they differ on cigs/day or time since last cigarette. Establishing nonsmoking as a social norm may be more difficult in rural, underserved smoke-free areas.

Learning Areas:
Advocacy for health and health education
Diversity and culture
Public health or related nursing
Public health or related public policy

Learning Objectives:
Examine the effect of a smoke-free law in a rural, distressed area on smoking and cessation behaviors, as well as exposure to secondhand smoke, compared to similar communities without this policy.

Keywords: Tobacco Policy, Rural Populations

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the PI on the larger NIH study.
Any relevant financial relationships? Yes

Name of Organization Clinical/Research Area Type of relationship
NHLBI/NIH Smoke-free Policy Research Grant

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.