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Rurality, tobacco use, and COPD: an analysis of two national datasets

Award Number: R21HL161758
ORGANIZATION: NATIONAL HEART, LUNG, & BLOOD INSTITUTE
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 09/20/2021
PERIOD OF PERFORMANCE END DATE: 08/31/2025

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Rurality, tobacco use, and COPD: an analysis of two national datasets - Project Abstract Individuals with chronic obstructive pulmonary disease (COPD) who live in rural areas of the United States have worse health outcomes compared with their non-rural counterparts. Although it is known that rural areas have higher rates of cigarette smoking, and that cigarette smoking is associated with worse outcomes in COPD, less is known about geographic variations in the motivations and beliefs that influence tobacco product appeal and use, especially among newer tobacco products including e-cigarettes. Further, it is largely unknown how much variability in tobacco use accounts for the geographic differences seen in COPD outcomes. Our long-term goal is to identify potentially modifiable determinants of tobacco product use that contribute to worse COPD in rural US, leading to future geographically tailored interventions designed to improve outcomes. Our overall objective for this application, which is the next step toward attainment of our long-term goal, is to quantify the perceptions of risk and benefit on the pattern of tobacco use in rural and urban populations in the United States, and to determine the impact of such patterns on COPD outcomes. Our central hypothesis is that perceptions of risk and benefit of tobacco products differ by geographic location in the US, and that tobacco exposure contributes significantly to the increased COPD risks associated with rural location. The rationale for this project is that identifying factors that influence tobacco product appeal and use will provide detailed insight into potentially modifiable contributors to geographic disparities in health outcomes and inform regulatory strategy. Using existing datasets, we will test our hypothesis in two specific aims: 1) To quantify and compare patterns of tobacco product use by geographic location, and to determine how perceptions of risk and benefit of tobacco products differ by geographic location; 2) To determine the relationship between geographic location and COPD prevalence, incidence, and respiratory symptoms, and to quantify the contribution of tobacco product exposure to these relationships. To address our aims, will use data from the Population Assessment of Tobacco and Health (PATH) Study and the National Health Interview Survey (NHIS).The PATH Study is a longitudinal, nationally representative study that includes detailed questions on the motivations, beliefs, and perceptions influencing tobacco product use, allowing us to analyze the longitudinal association of these trends with COPD risk and respiratory symptoms within a broad definition of urbanicity. In a separate, focused analysis, we will determine the cross-sectional association between tobacco products and COPD prevalence across urban/rural continuum using nationally representative data from the NHIS study. Our research team has extensive experience working with these datasets, each providing complimentary longitudinal and cross sectional perspectives to allow for comprehensive assessment of the contribution of tobacco use to observed disparities in COPD outcomes in rural populations.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2026 ( Subtotal = -$3,239 )
2026	2022	DARTMOUTH-HITCHCOCK CLINIC	1 MEDICAL CENTER DR	LEBANON	NH	03756	GRAFTON	USA	Family Smoking Prevention and Tobacco Control Act Regulatory Research	000	2	3/23/2026	NON-COMPETING CONTINUATION	-$3,239
														Subtotal = -$3,239

Issue Date FY: 2025 ( Subtotal = $0 )
2025	2022	DARTMOUTH-HITCHCOCK CLINIC	1 MEDICAL CENTER DR	LEBANON	NH	03756	GRAFTON	USA	Family Smoking Prevention and Tobacco Control Act Regulatory Research	000	2	1/22/2025	NON-COMPETING CONTINUATION	$0
														Subtotal = $0

Issue Date FY: 2024 ( Subtotal = $0 )
2024	2022	DARTMOUTH-HITCHCOCK CLINIC	1 MEDICAL CENTER DR	LEBANON	NH	03756	GRAFTON	USA	Family Smoking Prevention and Tobacco Control Act Regulatory Research	000	2	8/23/2024	NON-COMPETING CONTINUATION	$0
														Subtotal = $0

Issue Date FY: 2023 ( Subtotal = $0 )
2023	2022	DARTMOUTH-HITCHCOCK CLINIC	ONE MEDICAL CENTER DR	LEBANON	NH	03756	GRAFTON	USA	Family Smoking Prevention and Tobacco Control Act Regulatory Research	000	2	2/15/2023	NON-COMPETING CONTINUATION	$0
2023	2022	DARTMOUTH-HITCHCOCK CLINIC	ONE MEDICAL CENTER DR	LEBANON	NH	03756	GRAFTON	USA	Family Smoking Prevention and Tobacco Control Act Regulatory Research	001	2	8/28/2023	NON-COMPETING CONTINUATION	$0
														Subtotal = $0

Issue Date FY: 2022 ( Subtotal = $240,223 )
2022	2022	DARTMOUTH-HITCHCOCK CLINIC	ONE MEDICAL CENTER DR	LEBANON	NH	03756	GRAFTON	USA	Family Smoking Prevention and Tobacco Control Act Regulatory Research	001	2	8/22/2022	NON-COMPETING CONTINUATION	$240,223
2022	2021	DARTMOUTH-HITCHCOCK CLINIC	ONE MEDICAL CENTER DR	LEBANON	NH	03756	GRAFTON	USA	Family Smoking Prevention and Tobacco Control Act Regulatory Research	000	1	1/27/2022	NEW	$0
														Subtotal = $240,223

Issue Date FY: 2021 ( Subtotal = $252,174 )
2021	2021	DARTMOUTH-HITCHCOCK CLINIC	ONE MEDICAL CENTER DR	LEBANON	NH	03756	GRAFTON	USA	Family Smoking Prevention and Tobacco Control Act Regulatory Research	000	1	9/20/2021	NEW	$252,174
														Subtotal = $252,174

Grand Total All Awards = $489,158

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Rurality, tobacco use, and COPD: an analysis of two national datasets

Award Number: R21HL161758

ORGANIZATION: NATIONAL HEART, LUNG, & BLOOD INSTITUTE

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 09/20/2021

PERIOD OF PERFORMANCE END DATE: 08/31/2025

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