Quit attempts, use of smoking cessation treatments and quitting intention among treatment seekers in rural areas.

Introduction: Rural populations have higher rates of tobacco use but are less likely to use evidence-based smoking cessation treatments than urban residents. There is limited evidence on the use of smoking cessation treatments and the factors associated with their use in rural populations. This study explored quit attempts, use of smoking cessation treatments, quitting intention and associated factors among rural residents seeking smoking cessation treatment.

Methods: Participants were adult rural or remote residents of New South Wales, Australia who enrolled in a randomized trial of smoking cessation treatment (n = 1244). Participants completed an online baseline survey assessing quit attempts, quitting intention, and prior use of smoking cessation treatments. Multivariable logistic regressions that adjusted for other variables examined associations and derived odds ratios.

Results: Almost half (48.3 %) of participants made a quit attempt in the last 12 months, and 44.6 % intended to quit in the next 30 days. Women (OR = 0.74, 95 % CI 0.56-0.99), Australian-born participants (OR = 0.67, 95 % CI 0.45-0.99) and those with moderate (OR = 0.53, 95 % CI 0.40-0.71) or high (OR = 0.42, 95 % CI 0.28-0.63) nicotine dependence had significantly lower odds of making a quit attempt in the last 12 months. Among participants who had ever made a quit attempt, most had used pharmacotherapies (82.2 %) or behavioral interventions (68.3 %) during any quit attempt. Participants with moderate (OR = 1.96, 95 % CI 1.37-2.79) or high (OR = 3.27, 95 % CI 1.66-6.45) nicotine dependence and chronic conditions (OR = 1.45, 95 % CI 1.00-2.11) had significantly greater odds of pharmacotherapy use while those who drank alcohol daily or almost daily (OR = 0.46, 95 % CI 0.26-0.81) had significantly lower odds of pharmacotherapy use. Those with moderate (OR = 1.38, 95 % CI 1.02-1.87) or high (OR = 3.31, 95 % CI 1.94-5.66) nicotine dependence, university education (OR = 1.47, 95 % CI 1.04-2.07), moderate (OR = 1.63, 95 % CI 1.19-2.22) or high (OR = 1.73, 95 % CI 1.12-2.68) financial stress, and anxiety (OR = 1.61, 95 % CI 1.16-2.22) had significantly greater odds of using behavioral treatments whereas those with depression (OR = 0.66, 95 % CI 0.47-0.92) had significantly lower odds.

Conclusions: Some sub-groups had lower odds of using smoking cessation treatments. Understanding if particular barriers hinder use of smoking cessation treatments among certain sub-groups of rural residents is needed.