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

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.  


“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.  “When you look at the percentage of New York residents living in rural areas it may not seem especially significant, but that percentage equates to 2.3 million New Yorkers who are at increased risk for tobacco-related disease.  It is imperative that they have access to the quit-smoking resources they need."

There are a number of environmental and social factors that contribute to this generational cycle of tobacco use among youth and adults in 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.


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 have low tobacco taxes.  Raising tobacco prices is a proven strategy to reduce tobacco use.  In New York, the tobacco tax is $4.35, which is the highest in the nation and higher than the current average state cigarette tax of $1.46 per pack.  Promotion of the availability of state quit-smoking counseling services by phone and online resources also lags across the country.

“This report is a valuable tool that aligns with New York State’s policy-focused, population-based Tobacco Control Program aimed at reducing cigarette usage in our communities,” said State Health Commissioner Nirav R. Shah, M.D., M.P.H. “The Health Department's anti-tobacco media campaigns, strong Medicaid smoking cessation benefit and other program activities and actions are important resources for all New Yorkers, including our rural residents."   

The American Lung Association in New York  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 New York and across the country need special attention if we’re going to make a major dent in tobacco prevalence,” said Michael Seilback, Vice President of Public Policy and Communications at the American Lung Association of the Northeast in the Long Island office.   “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.”   


The American Lung Association offers smoking cessation resources to help people quit smoking for good. In New York, 15.5 percent of the total adult population smokes and overall, more than 12 percent lives in rural areas:


·         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.


·         Not-On-Tobacco® (N-O-T) is a group program designed to help 14 to 19 year old smokers end their addiction to nicotine. The curriculum consists of ten 50-minute sessions that typically occur once a week for 10 weeks.


·         The Lung HelpLine, 1-800-LUNG-USA, offers 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, there are also several other action steps to reduce rural tobacco use.  These steps are detailed in the full report, and include that state and federal tobacco control programs must make a concerted effort and dedicate funding to reach rural communities; the research community should focus attention and resources on identifying effective cessation treatments for smokeless tobacco use; and school, health and employment systems in rural areas must all implement effective tobacco control strategies including smokefree air policies and access to cessation services.


This report is part of the Lung Association’s Disparities in Lung Health Series.  To download a copy of the report, visit: