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New Findings on Rural Tobacco Use and Chronic Disease

October 8, 2025

In new research studies authored by Westat experts and funded by the National Heart, Lung, and Blood Institute (NHLBI), evidence was found that people living in rural areas, women, and those who smoked cigarettes during childhood face a higher risk of being diagnosed with chronic obstructive pulmonary disease (COPD) and report a lower quality of life. Rural residence was also associated with higher rates of current smoking, lower likelihood of household tobacco bans, and perceptions that downplay the health harms of tobacco use. These findings can help improve clinical care and guide tobacco control policies aimed at reducing chronic diseases linked to tobacco.

The studies were conducted through a partnership between Westat researchers Jenny Ozga, PhD, and Cassandra Stanton, PhD, and scientists at Dartmouth. The research aimed to examine how factors such as geolocation and perceptions of tobacco-related health harms are linked to COPD diagnosis.

To date, the collaboration has produced 10 empirical papers published in peer-reviewed scientific journals. These studies provide valuable data to help identify clinical targets for preventing chronic disease. In the most recent paper, led by Ozga, female sex—compared with male—was associated with a higher risk of COPD prevalence and incidence among U.S. adults aged 40 and older.

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