Regional Rural-Urban Differences in E-Cigarette Use and Reasons for Use in the United States

Area of Science:

• Public Health
• Epidemiology
• Tobacco Control

Background:

• E-cigarette use prevalence and motivations vary significantly.
• Understanding geographic disparities is crucial for targeted interventions.

Purpose of the Study:

• To investigate rural/urban differences in e-cigarette use.
• To examine regional variations in reasons for e-cigarette use across 10 Health & Human Services (HHS) regions.

Main Methods:

• Analysis of the 2014-2015 Tobacco Use Supplement-Current Population Survey data.
• Age-adjusted bivariate and multivariable analyses of 225,413 respondents for e-cigarette use prevalence.
• Examination of reasons for use among 16,023 ever-users.

Main Results:

• Nationally, rural residents showed higher e-cigarette use, but adjusted analyses revealed lower use in northern and western HHS regions.
• Reasons for e-cigarette use, including smoking cessation aid, differed by urban/rural status and region.
• Specific regional variations were observed, such as increased use as a cessation aid among rural adults in New England and New York/New Jersey.

Conclusions:

• Significant rural/urban disparities in e-cigarette use and motivations necessitate region-specific public health strategies.
• Tailoring health education, services, and clinical guidance is essential to minimize disparities.
• Public health campaigns should address regional differences in beliefs about e-cigarettes, especially where healthcare access is limited.