ArticleBMC public health2021
Persistent disparities in smoking among rural Appalachians: evidence from the Mountain Air Project.
Article in BMC public health, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 36 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
36 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Smoking Cessation Interventions and Abstinence Outcomes for People Living in Rural, Regional, and Remote Areas of Three High-Income Countries: A Systematic Review.Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2023Pooled it
- Appalachian Primary Care Patients' Quit Readiness and Tobacco Treatment Receipt.American journal of preventive medicine · 2025Trial
- Evaluating the effects of nicotine concentration on the appeal and nicotine delivery of oral nicotine pouches among rural and Appalachian adults who smoke cigarettes: A randomized cross-over study.Addiction (Abingdon, England) · 2024Trial
- Demographic factors and rural residence history associated with smoking history.Journal of the American Association of Nurse Practitioners · 2026Article
- Exploring the Relationships Between Social Influence, Vaping Behaviors, and Susceptibility Across Grade Levels in Kentucky.American journal of health promotion : AJHP · 2026Article
- Urban-rural disparities in oral nicotine pouch sales and flavors in the United States.The International journal on drug policy · 2026Article
- Barriers and facilitating factors for COVID-19 vaccination in rural appalachia.BMC public health · 2025Article
- Disparities in Human Papillomavirus-Associated Cancer Incidence by Appalachian Residence.JAMA network open · 2025Article
- Tobacco retailer density and rurality across four US states: California, Connecticut, North Carolina, and Ohio.The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association · 2025Article
- Lung Cancer Prevention Among Appalachian Kentucky Women: A Community-Engaged Mixed Method Study.American journal of health promotion : AJHP · 2025Article
- Impact of coal mine dust exposure and cigarette smoking on lung disease in Appalachian coalminers.Respiratory research · 2025Article
- Examining Geographic Disparity: Variation in Cancer Outcomes Within Appalachia.Journal of the American College of Surgeons · 2025Article
- Identifying risk factors for adverse lung health outcomes among rural Appalachian women.The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association · 2025Article
- Secondhand tobacco smoke exposure and sleep disturbance in school-aged children in Appalachian Ohio.Frontiers in pediatrics · 2025Article
- Article
- Rural and Appalachian cancer survivors' responses to tobacco use screening and tobacco treatment offer.Tobacco induced diseases · 2025Article
- Unveiling rural and Appalachian disparities in cigarette smoking through the social vulnerability index and other county-level characteristics.The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association · 2025Article
- Geographic Representativeness of a Digital Tobacco Cessation Intervention: An Exploration of Changes in Rural Reach From 2013-2020.Tobacco use insights · 2025Article
- Environmental exposures and pulmonary function among adult residents of rural Appalachian Kentucky.Journal of exposure science & environmental epidemiology · 2024Article
- Testing the 'Faith Moves Mountains model' to increase Alzheimer's disease awareness, detection, and diagnosis among rural, racially, and ethnically diverse older adults.Aging & mental health · 2024Article
Corrections and comments
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Authors and funding
6 authors.
Funding
Abstract
backgroundAdult smoking prevalence in Central Appalachia is the highest in the United States, yet few epidemiologic studies describe the smoking behaviors of this population. Using a community-based approach, the Mountain Air Project (MAP) recruited the largest adult cohort from Central Appalachia, allowing us to examine prevalence and patterns of smoking behavior.
methodsA cross-sectional epidemiologic study of 972 participants aged 21 years and older was undertaken 2015-2017, with a response rate of 82%. Prevalence ratios and 95% confidence intervals for current smoking (compared to nonsmokers) were computed for the entire cohort then stratified by multiple characteristics, including respiratory health. Adjusted prevalence ratios for current smoking versus not smoking were also computed.
resultsMAP participants reported current smoking prevalence (33%) more than double the national adult smoking prevalence. Current smoking among participants with a reported diagnosis of chronic obstructive pulmonary disease and emphysema was 51.5 and 53.3%, respectively. Compared to participants age 65 years and older, those age 45 years or younger reported double the prevalence of smoking (PR: 2.04, 95% CI: 1.51-2.74). Adjusted analyses identified younger age, lower education, unmet financial need, and depression to be significantly associated with current smoking.
conclusionsDespite declining rates of smoking across the United States, smoking remains a persistent challenge in Central Appalachia, which continues to face marked disparities in education funding and tobacco control policies that have benefitted much of the rest of the nation. Compared with national data, our cohort demonstrated higher rates of smoking among younger populations and reported a greater intensity of cigarette use.
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