People in Some Geographic Areas Encounter Barriers to Quitting Successfully

Photo of a doctor with his patient

People who live in certain geographic regions may not receive advice to quit smoking from a health care provider.

Most people who smoke want to quit, and more than half of them try to do so each year.20 People who live in rural areas may have less access to quitting resources, or face more barriers when trying to quit than people in urban areas.3 For example:

  • Anti-tobacco messages can increase smoking cessation and prevent tobacco use initiation, but youth in rural areas are less likely than urban youth to see or hear anti-tobacco messages in the media.3,40
  • One study conducted in a large Midwest health system found that patients who smoked and were seen at an outpatient clinic in a rural area were nearly three times less likely to receive smoking cessation treatment than those seen at an urban area clinic.41
  • In 2015, more adults who smoked and lived in the Northeast reported receiving advice to quit smoking from a health care provider than those living in the South or West.20
Advised to Quit Smoking by a Health Care Provider (2015)20:
Region Percentage
Northeast 65%
Midwest 60%
South 55%
West 51%
Tried to Quit Smoking in the Past Year (2015)42:
Region Percentage
Northeast 59%
West 57%
Midwest 54%
South 54%

Connecting every person who wants to quit with treatment proven to help them quit for good is important for improving people’s health.

Some strategies that states and communities can use are:

Medical history tablet with a no smoking sign and illustrating the age range of under 65

Provide barrier-free, widely promoted coverage for all evidence-based cessation treatments by all types of health insurance. For example, as of 2018, only 15 state Medicaid programs fully covered tobacco cessation (quitting) services for all enrollees in traditional Medicaid.43

Stethoscope with a no smoking sign.

Integrate clinical screening and treatment for commercial tobacco* use in all health care settings and with all types of patients. Community health centers and low-cost health clinics serve people who are more likely to use commercial tobacco products.44,45 Talking to people about commercial tobacco use and quitting as a regular part of health care visits in these settings will help make sure that all people can get effective treatment to help them quit.

No smoking messages coming out of a person's mouth.

Increase access to culturally tailored cessation services. When it comes to health issues, one size does not fit all. Different people and communities have varying needs and make decisions in different ways. For example, people in rural areas tend to use more smokeless tobacco, like dip or chew, which may require different quitting strategies than cigarettes. Treatment services also might need to be provided virtually, online, or through mobile clinics that can visit remote, rural areas.

television monitor icon with no smoking sign

Share health messages that reach people in geographic areas with the highest tobacco use and in rural areas. Mass media campaigns are proven to increase smoking cessation, prevent tobacco use initiation, and reduce the prevalence of tobacco use.1,20 Anti-commercial tobacco messaging and mass media campaigns, like CDC’s Tips From Former Smokers® (Tips®), are effective in reaching many groups. Such campaigns can help to reduce geographic disparities in commercial tobacco use and exposure by connecting people to treatment resources.

*“Commercial tobacco” means harmful products that are made and sold by tobacco companies. It does not include “traditional tobacco” used by Indigenous groups for religious or ceremonial purposes.
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