Transitions from cigarette smoking by geolocation among US adults: Results from waves 1-6 of the Population Assessment of Tobacco and Health (PATH) study 2013–2021
Year: 2026
Type: article
Abstract: Introduction: Adults in rural US areas experience higher rates of tobacco use and related disease. They also have lower cigarette cessation success than those in non-rural areas, but it is unknown how transitions from exclusive cigarette use to other product use differ by geolocation. This study examined longitudinal associations between geolocation (urban, suburban, town, rural) and transitions from exclusive cigarette smoking. Methods: We conducted a secondary analysis of pooled wave-pair observations from US adults participating in Waves (W) 1-6 of the Population Assessment for Tobacco and Health Study (2013-2021) who had exclusive past 30-day cigarette smoking at the wave-pair baseline and one of the following at the wave-pair follow-up: 1) continued exclusive cigarette smoking, 2) continued smoking with other added tobacco products, 3) switched to exclusive e-cigarette use, or 4) quit tobacco completely (reference group). Survey-weighted random-intercept multinomial logistic regressions were conducted, adjusting for sociodemographics, smoking-related factors, and survey wave. Results: Of 13634 wave-pairs (32.3% suburban, 28.3% urban, 27.3% rural, 12.1% town), 90.8% continued smoking (73.7% exclusively smoking cigarettes, 17.1% with other added tobacco products), 1.2% switched to e-cigarettes, and 8.0% quit tobacco completely. Town (adjusted relative risk ratio, ARRR=1.52; 95% CI: 1.10-2.10) or rural (ARRR=1.34; 95% CI: 1.05-1.69) adults were significantly more likely to continue exclusive smoking than urban adults, with no significant associations between geolocation and other tobacco transitions. Conclusions: Living in town or rural (vs urban) US areas was associated with an increased likelihood of continued exclusive cigarette smoking compared to quitting tobacco, suggesting that targeted interventions and policies are needed to support these populations.
Source: Tobacco Induced Diseases
DOI: 10.18332/tid/226559
Institutions: Pacific Institute For Research and Evaluation, Rosalind Franklin University of Medicine and Science, National Institutes of Health, National Institute on Drug Abuse, Kelly Services (United States), The Ohio State University Wexner Medical Center, Nanyang Technological University, New York University, University of Kentucky
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,372
Funders: U.S. Department of Health and Human Services, National Institutes of Health, National Heart, Lung, and Blood Institute, National Institute on Drug Abuse, National Cancer Institute, National Institute of Diabetes and Digestive and Kidney Diseases, U.S. National Library of Medicine, National Institute on Minority Health and Health Disparities, Center for Tobacco Products
Awards: G1408341014, G2596127530, G2847530427, G3569198743, G386049073, G4036344609, G4056085920, G537561352, G6958478170, Effect of Menthol to Non-Menthol Cigarette Switching on Subclinical Inflammatory Biomarkers of Cardiovascular Health: Simulating a Menthol Cigarette Ban, Using Causal Machine Learning Methods to Inform Tobacco Regulatory Science
OpenAlex ID: W7224161551