Abstract A016: Race, place, and smoking in rural America across four categories of an urban/rural continuum: Evidence from the Health Information National Trends Survey (HINTS)

Abstract

Abstract Introduction. Although smoking prevalence has declined over the past decade, it is still associated with many types of cancer and is the leading cause of lung cancer. Rural populations are especially at risk as they have been consistently more likely to smoke. However, most research has ignored the marked heterogeneity of rural America, focusing solely on a rural/urban dichotomy. Methods. Using Rural-Urban Commuting Area Codes (RUCAs) from the 2018 Health Information National Trends Survey (HINTS-5) database (n=5,099), we analyze the odds of smoking across four contexts: urban, large-rural, small-rural, and isolated-rural areas. Additionally, we test the interaction of race/ethnicity and rurality on smoking. This gives us a potentially more detailed understanding of the relationship between race, place, and health across the urban-rural continuum. Using an established social determinants framework, a series of logistic regression models were fitted to estimate odds ratios (OR) and 95% confidence intervals (CIs) for smoking. Results. We found that those living in a small rural town had 2.16 times the odds of smoking, compared to those living in an urban area (p<0.001). Additionally, non-Whites living in isolated rural areas had significantly lower odds of smoking (OR 0.03) compared to Whites in isolated rural areas (p<0.05). Conclusions. Place and race matter for health. These findings have implications for the allocation of resources and the design of interventions aimed at smoking cessation in rural America. Such interventions should take into account the nuances of rurality, and race, in order to create culturally appropriate programming. Citation Format: Gilberto Lopez, Heather Mattie. Race, place, and smoking in rural America across four categories of an urban/rural continuum: Evidence from the Health Information National Trends Survey (HINTS) [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr A016.