TY - JOUR
T1 - Smoking prevalence and trends among a U.S. national sample of women of reproductive age in rural versus urban settings
AU - Nighbor, Tyler D.
AU - Doogan, Nathan J.
AU - Roberts, Megan E.
AU - Cepeda-Benito, Antonio
AU - Kurti, Allison N.
AU - Priest, Jeff S.
AU - Johnson, Harley K.
AU - Lopez, Alexa A.
AU - Stanton, Cassandra A.
AU - Gaalema, Diann E.
AU - Redner, Ryan
AU - Parker, Maria A.
AU - Keith, Diana R.
AU - Quisenberry, Amanda J.
AU - Higgins, Stephen T.
N1 - Publisher Copyright:
This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication.
PY - 2018/11
Y1 - 2018/11
N2 - U.S. smoking prevalence is declining at a slower rate in rural than urban settings and contributing to regional health disparities. Cigarette smoking among women of reproductive age is particularly concerning due to the potential for serious maternal and infant adverse health effects should a smoker become pregnant. The aim of the present study was to examine whether this rural-urban disparity impacts women of reproductive age (ages 15–44) including pregnant women. Data came from the ten most recent years of the U.S. National Survey on Drug Use and Health (2007–2016). We estimated prevalence of current smoking and nicotine dependence among women categorized by rural-urban residence, pregnancy status, and trends using chi-square testing and multivariable modeling while adjusting for common risk factors for smoking. Despite overall decreasing trends in smoking prevalence, prevalence was higher among rural than urban women of reproductive age overall (χ 2 (1) = 579.33, p < .0001) and among non-pregnant (χ 2 (1) = 578.0, p < .0001) and pregnant (χ 2 (1) = 79.69, p < .0001) women examined separately. An interaction between residence and pregnancy status showed adjusted odds of smoking among urban pregnant compared to non-pregnant women (AOR = .58, [.53 –.63]) were lower than those among rural pregnant compared to non-pregnant women (AOR = 0.75, [.62 –.92]), consistent with greater pregnancy-related smoking cessation among urban pregnant women. Prevalence of nicotine dependence was also higher in rural than urban smokers overall (χ 2 (2) = 790.42, p < .0001) and among non-pregnant (χ 2 (2) = 790.58, p < .0001) and pregnant women examined separately (χ 2 (2) = 63.69, p < .0001), with no significant changes over time. Associations involving residence and pregnancy status remained significant in models adjusting for covariates (ps < 0.05). Results document greater prevalence of smoking and nicotine dependence and suggest less pregnancy-related quitting among rural compared to urban women, disparities that have potential for direct, multi-generational adverse health impacts.
AB - U.S. smoking prevalence is declining at a slower rate in rural than urban settings and contributing to regional health disparities. Cigarette smoking among women of reproductive age is particularly concerning due to the potential for serious maternal and infant adverse health effects should a smoker become pregnant. The aim of the present study was to examine whether this rural-urban disparity impacts women of reproductive age (ages 15–44) including pregnant women. Data came from the ten most recent years of the U.S. National Survey on Drug Use and Health (2007–2016). We estimated prevalence of current smoking and nicotine dependence among women categorized by rural-urban residence, pregnancy status, and trends using chi-square testing and multivariable modeling while adjusting for common risk factors for smoking. Despite overall decreasing trends in smoking prevalence, prevalence was higher among rural than urban women of reproductive age overall (χ 2 (1) = 579.33, p < .0001) and among non-pregnant (χ 2 (1) = 578.0, p < .0001) and pregnant (χ 2 (1) = 79.69, p < .0001) women examined separately. An interaction between residence and pregnancy status showed adjusted odds of smoking among urban pregnant compared to non-pregnant women (AOR = .58, [.53 –.63]) were lower than those among rural pregnant compared to non-pregnant women (AOR = 0.75, [.62 –.92]), consistent with greater pregnancy-related smoking cessation among urban pregnant women. Prevalence of nicotine dependence was also higher in rural than urban smokers overall (χ 2 (2) = 790.42, p < .0001) and among non-pregnant (χ 2 (2) = 790.58, p < .0001) and pregnant women examined separately (χ 2 (2) = 63.69, p < .0001), with no significant changes over time. Associations involving residence and pregnancy status remained significant in models adjusting for covariates (ps < 0.05). Results document greater prevalence of smoking and nicotine dependence and suggest less pregnancy-related quitting among rural compared to urban women, disparities that have potential for direct, multi-generational adverse health impacts.
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U2 - 10.1371/journal.pone.0207818
DO - 10.1371/journal.pone.0207818
M3 - Article
C2 - 30485376
AN - SCOPUS:85057442576
SN - 1932-6203
VL - 13
JO - PloS one
JF - PloS one
IS - 11
M1 - e0207818
ER -