The decline in smoking rates over the past 15 years in the U.S. is the result of large gains in urban areas such as Atlanta, while Augusta, where the percentage of women smoking increased slightly, and rural areas struggle, according to county-level data released Monday.
The Institute for Health Metrics and Evaluation at the University of Washington published its findings in the journal Population Health Metrics, looking at smoking rates from 1996 to 2012.
“There are huge and wide disparities in tobacco and smoking in this country. And even within a state,” said Dr. Ali Mokdad, the corresponding author and a professor of global health at the institute. “If you look at the state average, you will miss what is happening in certain counties that have higher rates of smoking.”
In Georgia, for instance, there is nearly a twofold difference in the 2012 smoking rate for the best and worst counties, with Forsyth having the lowest rate, 15.19 percent, and Brantley the highest, 30.17 percent.
Columbia County had the ninth-best rate, 17.63 percent; Richmond County was 52nd at 23.74 percent; and McDuffie was 96th with 25.92 percent.
In reducing rates overall, Columbia County is still in the top 10, with an annual decrease of 1.11 percent. Richmond County shows an annual decrease of 0.45 percent, and Burke County is near the bottom with a negligible annual decrease of 0.16 percent, while 10 counties did not decrease or increased slightly.
Much of that was driven by poor progress among women – the smoking rate increased slightly in Richmond County from 19.05 to 19.25 percent, although the rate for women was still far less than that for men, which was 28.39 percent. That reflects a national trend, Mokdad said.
“Here we see slower progress, unfortunately, among females,” he said. That is having an impact on how long they are living, Mokdad said.
“For females, life expectancy is mirroring what we see here in tobacco, unfortunately,” Mokdad said. Life expectancy is getting better among men but has stagnated or even gotten worse for women in some counties, he added.
Much of the disparity has to do with public policy, such as smoking bans, Mokdad said.
“We encourage people to do local control,” he said. “We want eventually politicians and public health to be able to put forth programs that are good for their own community now that we have provided the risk factors at their community level.”
Even though a tougher smoking ordinance was rejected in November by the Augusta Commission, a workplace clean-air ordinance remains a top priority for Augusta public health advocates, said Jennifer Anderson, the chairwoman of the BreathEasy Augusta coalition and a member of the steering committee for Healthy Augusta.
It is particularly chilling when the link between smoking and life expectancy is pointed out, she said.
“It does add credence to the fact that smoking and second-hand smoke is very hazardous and it is very impactful,” Anderson said. “A lot of people who are not self-reported smokers are in fact exposed to rates and levels of secondhand smoke that are very, very hazardous. It’s kind of the tip of the iceberg for those people who are not lucky enough to work in a community where they do have smoke-free ordinances for workplaces.”