People In Some Geographic Areas Encounter Barriers to Quitting Successfully

At a glance

  • Most people who smoke want to quit, and more than half of them try to do so each year.
  • Connecting every person who wants to quit with treatment proven to help them quit for good is important for improving people's health.
  • Descriptions of strategies that states and communities can use to help people quit smoking are below.
Smiling farmer sitting on a tractor.

Barriers to quitting

Most people who smoke want to quit, and more than half of them try to do so each year.1 People who live in rural areas may have less access to quitting resources, or face more barriers when trying to quit than people in urban areas.2

For example:

  • Anti-tobacco messages can increase smoking cessation and prevent tobacco use initiation, but youth in rural areas are less likely than urban youth to see or hear anti-tobacco messages in the media.23
  • One study conducted in a large Midwest health system found that patients who smoked and were seen at an outpatient clinic in a rural area were nearly three times less likely to receive smoking cessation treatment than those seen at an urban area clinic.4
  • In 2015, more adults who smoked and lived in the Northeast reported receiving advice to quit smoking from a health care provider than those living in the South or West.1
Photo of a doctor with his patient
People who live in certain geographic regions may not receive advice to quit smoking from a health care provider.

Advised to quit smoking by a health care provider (2015)1

Region
  • Percentage
Northeast
  • 65%
Midwest
  • 60%
South
  • 55%
West
  • 51%

Tried to quit smoking in the past year (2015)5

Region
  • Percentage
Northeast
  • 59%
West
  • 57%
Midwest
  • 54%
South
  • 54%

Connecting people to resources is critical for health equity‎

Connecting every person who wants to quit with treatment proven to help them quit for good is important for improving people's health.

What states and communities can do

Provide barrier-free, widely promoted coverage for all evidence-based cessation treatments by all types of health insurance

For example, as of 2018, only 15 state Medicaid programs fully covered tobacco cessation (quitting) services for all enrollees in traditional Medicaid.6

Integrate clinical screening and treatment for commercial tobacco use in all health care settings and with all types of patientsA

Community health centers and low-cost health clinics serve people who are more likely to use commercial tobacco products.78 Talking to people about commercial tobacco use and quitting as a regular part of health care visits in these settings will help make sure that all people can get effective treatment to help them quit.

Increase access to culturally tailored cessation services

When it comes to health issues, one size does not fit all. Different people and communities have varying needs and make decisions in different ways. For example, people in rural areas tend to use more smokeless tobacco, like dip or chew, which may require different quitting strategies than cigarettes. Treatment services also might need to be provided virtually, online, or through mobile clinics that can visit remote, rural areas.

Share health messages that reach people in geographic areas with the highest tobacco use and in rural areas

Mass media campaigns are proven to increase smoking cessation, prevent tobacco use initiation, and reduce the prevalence of tobacco use.91 Anti-commercial tobacco messaging and mass media campaigns, like CDC's Tips From Former Smokers® (Tips®), are effective in reaching many groups. Such campaigns can help to reduce geographic disparities in commercial tobacco use and exposure by connecting people to treatment resources.

Resources

Websites

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Content Source:
National Center for Chronic Disease Prevention and Health Promotion; Office on Smoking and Health
  1. "Commercial tobacco" means harmful products that are made and sold by tobacco companies. It does not include "traditional tobacco" used by Indigenous groups for religious or ceremonial purposes.
  1. U.S. Dept of Health and Human Services. Smoking cessation. a report of the Surgeon General. U.S. Dept of Health and Human Services, 2020. Accessed March 22, 2022. https://www.hhs.gov/sites/default/files/2020-cessation-sgr-full-report.pdf
  2. American Lung Association. Cutting tobacco's rural roots: tobacco use in rural communities. American Lung Association; 2015.
  3. Centers for Disease Control and Prevention. Best Practices User Guide: Health Equity in Tobacco Prevention and Control. U.S. Dept of Health and Human Services, 2015. Accessed March 22, 2022. https://bpb-us-w2.wpmucdn.com/sites.wustl.edu/dist/e/1037/files/2011/11/UG_HealthEquity-24l2zq2.pdf
  4. Ramsey AT, Baker TB, Pham G, et al. Low burden strategies are needed to reduce smoking in rural healthcare settings: a lesson from cancer clinics. Int J Environ Res Public Health. 2020;17(5):1728.
  5. Babb S, Malarcher A, Schauer G, Asman K, Jamal A. Quitting Smoking Among Adults — United States, 2000–2015. MMWR Morb Mortal Wkly Rep. 2017;65(52):1457–1464.
  6. DiGiulio A, Jump Z, Babb S, et al. State Medicaid Coverage for Tobacco Cessation Treatments and Barriers to Accessing Treatments — United States, 2008–2018. MMWR Morb Mortal Wkly Rep. 2020;69(6):155–160.
  7. Lebrun-Harris LA, Fiore MC, Tomoyasu N, Ngo-Metzger Q. Cigarette smoking, desire to quit, and tobacco-related counseling among patients at adult health centers. Am J Public Health. 2015;105(1):180–188.
  8. Flocke SA, Hoffman R, Eberth JM, et al. The prevalence of tobacco use at Federally Qualified Health Centers in the United States, 2013. Prev Chronic Dis. 2017;14:E29.
  9. U.S. Dept of Health and Human Services. The Health Consequences of Smoking—50 Years of Progress: A Report of the Surgeon General. U.S. Dept of Health and Human Services, 2014. Accessed March 22, 2022. https://www.ncbi.nlm.nih.gov/books/NBK179276/