Evidence map›Paper›PMID 41466720›Full record

ArticleTobacco use insights2025

Geographic Representativeness of a Digital Tobacco Cessation Intervention: An Exploration of Changes in Rural Reach From 2013-2020.

Elizabeth K Do, Sarah Cha, Kristiann Koris, Diana Davidson, Tatum L McKay, Elizabeth C Hair, Amanda L Graham

Abstract read
In one paragraph

Article in Tobacco use insights, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

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2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

7 authors.

Elizabeth K DoSchroeder Institute, Truth Initiative, Washington, DC, USA.ORCID https://orcid.org/0000-0003-3503-1731
Sarah ChaInnovations Center, Truth Initiative, Washington, DC, USA.
Kristiann KorisSchroeder Institute, Truth Initiative, Washington, DC, USA.
Diana DavidsonSchroeder Institute, Truth Initiative, Washington, DC, USA.
Tatum L McKaySchroeder Institute, Truth Initiative, Washington, DC, USA.
Elizabeth C HairSchroeder Institute, Truth Initiative, Washington, DC, USA.
Amanda L GrahamInnovations Center, Truth Initiative, Washington, DC, USA.ORCID https://orcid.org/0000-0003-3036-9653

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: This study examines the geographic representativeness of people who smoke, among newly registered users of a free digital tobacco cessation program ('EX'). Methods: User-provided ZIP codes from EX® Program registrants were mapped to Rural Urban Continuum Codes (RUCC). Reach Ratios (ReRas) and 95% confidence intervals were used to determine the extent to which geographic representation in EX was proportionate to their representation in the national population of individuals who smoke, as obtained from the United States National Survey of Drug Use and Health (2018-2020). Under- and overrepresentation was demonstrated by ReRas <1 or >1, respectively. Joinpoint regression analyses were used to determine significant changes in trend for ReRas from 2013 to 2020. Results: Individuals who reported smoking residing in nonmetro rural areas were significantly overrepresented in 2018 [ReRa = 1.18 (95% CI: 1.15, 1.23)], 2019 [ReRa = 1.10 (95% CI: 1.07, 1.13)], and 2020 [ReRa = 1.10 (95% CI: 1.06, 1.13)]. Individuals who reported smoking from small metro areas were also overrepresented from 2018 to 2020 [ReRas = 1.09 (95% CI: 1.06, 1.11); 1.06 (95% CI: 1.04, 1.08), and 1.05 (95% CI: 1.03, 1.08), respectively] and individuals who reported smoking from large metro areas were underrepresented during the same time frame [ReRas = 0.87 (95% CI: 0.85, 0.89); 0.92 (95% CI: 0.91, 0.94), and 0.93 (95% CI: 0.91, 0.94), respectively]. ReRas for large metro areas decreased from 2013 to 2018 (annual percentage change, APC = -3.26; 95% CI: -6.69, -1.91). ReRas for non-metro areas increased from 2013 to 2017 (APC = 7.35; 95% CI: 4.10, 17.63). Conclusions: Results suggest that individuals that smoke residing in nonmetro rural areas and small metro areas are proportionally reached by a digital tobacco cessation program. However, there continues to be an underrepresentation of individuals who smoke from large metro areas, which warrants further study.

Indexed as

cessationdigital healthrural healthsmoking

Identifiers

PMID41466720
PMCPMC12743837

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.