American Lung Association Report Aims to Reduce Tobacco Use in Massachusetts’s Rural Communities

Waltham, MA (August 15, 2012)

Today, the American Lung Association released its latest lung health disparity report, “Cutting Tobacco’s Rural Roots: Tobacco Use in Rural Communities,” which examines tobacco addiction and exposure to secondhand smoke in rural America, particularly among rural youth. Eighty-eight percent of adult smokers report starting prior to the age of 18, according to the Centers for Disease Control and Prevention (CDC).

Tobacco use is higher in rural communities than in suburban and urban communities, and smokeless tobacco use is shockingly twice as common.  Rural youth are more likely to use tobacco and to start earlier than urban youth, perpetuating the cycle of tobacco addiction and death and disease. In Massachusetts, 16% of high school students smoke, a full 2% higher than the state’s adult smoking rate.   

“Tobacco use is often more socially acceptable in rural areas, making it more likely that kids living in these communities will also start to use tobacco,” said Jeff Seyler, President and CEO of the American Lung Association of the Northeast.  “Far too often, the public forgets that Massachusetts has a large rural population; more than 525,000 residents live in rural communities. This report should remind Massachusetts’ community leaders and residents to take a stand against the culture of tobacco use and empower our future generations to lead healthy, tobacco-free lives.”

There are a number of environmental and social factors that contribute to this generational cycle of tobacco use among rural America. Increased tobacco use is associated with lower education levels and lower income, which are both common in rural areas where there may be fewer opportunities for educational and economic advancement.  Exposure to secondhand smoke is also higher as rural communities are less likely to have smokefree air laws in place and residents are less likely to refuse to allow smoking in their homes or other indoor places. In western Massachusetts, farmers along the Connecticut River Valley have been growing tobacco for generations, further integrating tobacco into the local culture. 

Michele Komosa, Director of the Tobacco Free Community Partnership of Hampshire and Franklin Counties, in Northampton, commented, “I find there are numerous barriers to reducing tobacco use in our rural areas including high rates of poverty and unemployment. The largest barrier I see is a lack of connectedness to resources, with many communities that still cannot easily access the internet and with few personal and public transportation options to get people to support services they need to quit smoking.”
For decades, the tobacco industry has used rural imagery, such as the Marlboro Man, to promote its products and appeal to rural audiences.  Over the past several years, the tobacco industry’s marketing of smokeless tobacco products has skyrocketed. Sadly as the tobacco industry spends millions of dollars targeting rural youth, these youth are less likely to be exposed to tobacco counter-marketing campaigns.  Rural tobacco users are also less likely to have access to tobacco cessation programs and services to get the help they need to quit.

Many rural states also have low tobacco taxes. Raising tobacco prices is a proven strategy to reduce tobacco use and to prevent young people from ever starting to use tobacco. Massachusetts’ current cigarette tax of $2.51 per pack is the tenth highest in the nation but the lowest compared to all of its neighboring states except for New Hampshire. Other tobacco products, including chewing tobacco and dissolvable smokeless products, are taxed at a lower rate than cigarettes. For the first time in Massachusetts, youth are using these cheaper other tobacco products at a higher rate than cigarettes (17.6% vs. 16%, respectively).

The American Lung Association in Massachusetts  is calling on government agencies, the research and funding community, health systems and insurers, community leaders, schools and families to take steps now to cut tobacco’s rural roots. “Rural communities here in Massachusetts and across the country need special attention if we’re going to make a major dent in tobacco prevalence,” said Katie King, Massachusetts Director of Health Promotion and Public Policy for the American Lung Association of the Northeast. “If residents, community leaders, organizations and decision-makers all work together, we can make progress in reducing the health disparity caused by tobacco use in rural communities.”  

In Massachusetts, 14.1 percent of the total adult population smokes and overall, 8 percent live in rural areas. The American Lung Association offers smoking cessation resources to help people living in rural, suburban, and urban communities quit smoking for good:

  • Freedom From Smoking® is a program that teaches the skills and techniques that have been proven to help hundreds of thousands of adults quit smoking. Freedom From Smoking is available as a group clinic, an online program and a self-help book.
  • The Lung HelpLine, 1-800-LUNG-USA, offers free one-on-one support from registered nurses and respiratory therapists.  Individuals have the opportunity to seek guidance on lung health and find out how to participate in and join the Lung Association smoking cessation programs.   

In addition to expanding the Lung Association’s capability to provide its programs and services to the rural community, other recommended action steps to reduce rural tobacco use include : state and federal tobacco control programs making a concerted effort and dedicate funding to reach rural communities; the research community focusing attention and resources on identifying effective cessation treatments for smokeless tobacco use; and school, health and employment systems in rural areas implementing effective tobacco control strategies including smokefree air policies and increased access to cessation services.

This report is part of the Lung Association’s Disparities in Lung Health Series.

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