Geographic Disparities by Rural-Urban Status and Drive Time to Care in Tobacco Treatment for COPD

Are rurality and drive time to health care services associated with the provision of tobacco dependence treatment (TDT) among individuals with chronic obstructive pulmonary disease (COPD) who smoke?In this cohort study evaluating 238 433 individuals with COPD who smoked tobacco, TDT was provided to 36.3% of participants, but only 4.3% received comprehensive TDT, defined as combined pharmacotherapy and counseling. Individuals living in a rural area had lower probability of TDT compared with their urban counterparts, and the odds of TDT significantly declined with longer drive times to pulmonary specialty care.In this study, TDT among individuals with COPD was low, particularly among those living in rural areas and with longer drive times to pulmonary specialty care.

Corresponding Author: Arianne K. Baldomero, MD, MS, Pulmonary, Allergy, Critical Care, and Sleep Medicine (111N), Minneapolis VA Health Care System, One Veterans Drive, Minneapolis, MN 55417 (baldo004@umn.edu).

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