Examining the significance of urban-rural context in tobacco quitline use: does rurality matter?

ABSTRACT

OBJECTIVES: The purpose of this study was to examine the importance of urban-rural context as a determinant of call rates to smoking cessation lines. METHODS: This study used individual level New Zealand Quitline call data from 2005 to 2009, and 2006 New Zealand Census data on smoking to calculate Quitline call rates for smokers. Negative binomial regression examined the relationship between call rates and a sevenfold urban-rural classification, controlling for age, sex, ethnicity and deprivation. RESULTS: We found a significant urban-rural gradient in the rate of smokers calling Quitline. Rates were highest among smokers in main-urban areas [0.09 (95 % confidence interval (CI) = 0.089, 0.091)] decreasing with successive urban-rural classifications to the lowest rate in rural/remote areas [0.036 (95 % CI = 0.03, 0.04)]. This association was not confounded by age, sex, ethnicity or deprivation. CONCLUSIONS: Smokers in rural areas are less likely to use the New Zealand Quitline, even after controlling for confounding factors. This suggests that the national quitline is less effective in reaching rural smokers and more attention to the promotion of smoking cessation in rural communities is needed.