A recently published study examined whether cigarette use among American Indians and Alaska Natives (AI/AN) is lower in metropolitan areas than in rural areas and tribal lands (which are predominantly rural).
· Metropolitan (large or small) areas versus rural areas: no statistically significant differences in cigarette use were found.
· Metropolitan (large or small) areas versus tribal lands: days of cigarette use and daily use were significantly lower in tribal lands.
· Tribal lands were also lower than small metropolitan areas regarding number of cigarettes used and nicotine dependence.
· Rural areas versus tribal lands: cigarette measures were consistently lower in tribal lands. For example, the prevalence of current smokers, daily users and nicotine dependence, respectively, was 37.9%, 25.9%, and 16.3% in rural areas and 27.4%, 13.6%, and 8.9% in tribal lands.
The researchers concluded that differences in cigarette use between AI/AN in nontribal rural and metropolitan areas were not indicated. Instead, the place differences found were lower cigarette use in tribal lands than in nontribal rural areas and, to some extent, metropolitan areas.
Source: Cunningham et al. (2019). Cigarette Use Among American Indians and Alaska Natives in Metropolitan Areas, Rural Areas, and Tribal Lands. Journal of Public Health Management and Practice, Sep/Oct; 25 Suppl 5.