Geographic Representativeness of a Digital Tobacco Cessation Intervention: An Exploration of Changes in Rural Reach From 2013-2020.

Background: This study examines the geographic representativeness of people who smoke, among newly registered users of a free digital tobacco cessation program ('EX'). Methods: User-provided ZIP codes from EX® Program registrants were mapped to Rural Urban Continuum Codes (RUCC). Reach Ratios (ReRas...

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Publicado en:Tobacco Use Insights Vol. 18; pp. 1 - 9
Autores principales: Do, Elizabeth K., Cha, Sarah, Koris, Kristiann, Davidson, Diana, McKay, Tatum L., Hair, Elizabeth C., Graham, Amanda L.
Formato: research tables/charts Journal Article
Publicado: Sage Publications Inc. 12/24/2025
Acceso en línea:Ver este registro en EBSCOhost
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      dt: 12/24/2025
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      pub: Sage Publications Inc.
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        atl: Geographic Representativeness of a Digital Tobacco Cessation Intervention: An Exploration of Changes in Rural Reach From 2013-2020.
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          Do, Elizabeth K.
          Cha, Sarah
          Koris, Kristiann
          Davidson, Diana
          McKay, Tatum L.
          Hair, Elizabeth C.
          Graham, Amanda L.
        affil: Schroeder Institute, Truth Initiative, Washington, DC, USA
      sug:
        subj:
          Smoking Cessation Programs
          Smoking
          Program Evaluation
          Rural Areas United States
          Rural Health
          Digital Health
          Human
          Funding Source
          United States
          Female
          Male
          Adolescence
          Adult
          Middle Age
          Aged
          Secondary Analysis
          Descriptive Statistics
          Data Analysis Software
          Confidence Intervals
          Adolescent: 13-18 years
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Aged: 65+ years
          Female
          Male
      ab: Background: This study examines the geographic representativeness of people who smoke, among newly registered users of a free digital tobacco cessation program ('EX'). Methods: User-provided ZIP codes from EX® Program registrants were mapped to Rural Urban Continuum Codes (RUCC). Reach Ratios (ReRas) and 95% confidence intervals were used to determine the extent to which geographic representation in EX was proportionate to their representation in the national population of individuals who smoke, as obtained from the United States National Survey of Drug Use and Health (2018-2020). Under- and overrepresentation was demonstrated by ReRas <1 or >1, respectively. Joinpoint regression analyses were used to determine significant changes in trend for ReRas from 2013 to 2020. Results: Individuals who reported smoking residing in nonmetro rural areas were significantly overrepresented in 2018 [ReRa = 1.18 (95% CI: 1.15, 1.23)], 2019 [ReRa = 1.10 (95% CI: 1.07, 1.13)], and 2020 [ReRa = 1.10 (95% CI: 1.06, 1.13)]. Individuals who reported smoking from small metro areas were also overrepresented from 2018 to 2020 [ReRas = 1.09 (95% CI: 1.06, 1.11); 1.06 (95% CI: 1.04, 1.08), and 1.05 (95% CI: 1.03, 1.08), respectively] and individuals who reported smoking from large metro areas were underrepresented during the same time frame [ReRas = 0.87 (95% CI: 0.85, 0.89); 0.92 (95% CI: 0.91, 0.94), and 0.93 (95% CI: 0.91, 0.94), respectively]. ReRas for large metro areas decreased from 2013 to 2018 (annual percentage change, APC = −3.26; 95% CI: −6.69, −1.91). ReRas for non-metro areas increased from 2013 to 2017 (APC = 7.35; 95% CI: 4.10, 17.63). Conclusions: Results suggest that individuals that smoke residing in nonmetro rural areas and small metro areas are proportionally reached by a digital tobacco cessation program. However, there continues to be an underrepresentation of individuals who smoke from large metro areas, which warrants further study.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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