Abstract
Introduction: Medical prescriptions for opioids are higher in rural areas of the US as compared to urban areas. Tobacco use may also play a role in this process. This analysis examines the association between differing types of tobacco use and medical opioid use. Methods: We analyze the relationship between tobacco product use and medical opioid use among the US general population living in rural (non-metropolitan) areas using the publicly available sample adult file 2019 National Health Interview Survey (NHIS) (n = 5028). Tobacco use was classified into the following categories: only using cigarettes, only using e-cigarettes/vapes, only using cigars, only using smokeless tobacco, or using two or more of the following products. We used a binary logistic regression, controlling for individual differences. Results: Individuals who reported using only traditional cigarettes (and no other tobacco product, OR = 1.62, 95% CI: 1.31, 2.01), or who reported being a poly-tobacco users (OR = 2.13, 95% CI: 1.40, 3.22) had higher odds of medical opioid use in the last twelve months. Conclusion: Results suggest a link between tobacco use, particularly cigarette use and poly-tobacco use, and medical opioid use in rural communities. Clinical and structural level interventions need to be implemented in rural communities to reduce comorbid tobacco and opioid use.
Highlights
Death and injury from non-medical prescription opioid misuse is one of the contributing factors to a higher unintentional injury death rate in rural regions of the United States [1,2]
We analyze the relationship between tobacco product use and medical opioid use among the United States (US) general population living in rural areas using the publicly available sample adult file 2019 National Health Interview Survey (NHIS) (n = 5028)
Individuals who reported using only traditional cigarettes, or who reported being poly-tobacco users (OR = 2.13, 95% CI: 1.40, 3.22) had higher odds of medical opioid use in the last
Summary
Death and injury from non-medical prescription opioid misuse is one of the contributing factors to a higher unintentional injury death rate in rural regions of the United States [1,2]. Medical prescriptions for opioids are higher in rural areas of the US as compared to urban areas [3]. This is important because there is a link between medical opioid use and the use of illegal narcotics and non-medical opioids [4,5]. The co-use of tobacco and opioids is extremely high among individuals with substance use disorder in comparison to other substances that might be co-used [10,11]. Smoking may be a risk factor for opioid use among individuals suffering from chronic pain [14,15]
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