Most of the country has quit smoking – unless those Americans are poor, uneducated or live in a rural area, the Washington Post reports.
The national smoking rate has dropped to just 15 percent of adults, but among those with a high-school-equivalency diploma, the rate is more than 40 percent – and among rural residents, the rate of adults with lung cancer is 18-20 percent above those of city dwellers, the Post reported.
"If you're educated and live in a well-off area, the smoking problem we're talking about these days is now largely invisible to you," Matthew Myers, president of the Campaign for Tobacco-Free Kids, told the Post.
"In some places, you can go days without bumping into a smoker. So you start to hear the question, why push more resources into this? Meanwhile, the need is getting even greater, because the people left smoking are the ones who can least afford to."
According to the Post, when smoking first gained popularity in the early 20th century, it was a habit of the rich. In the three-and-half decades following the 1964 surgeon general's report on cigarettes' deadly effects, smoking among the nation's highest-income families plummeted by 62 percent.
But among families of the lowest income, it decreased by just 9 percent.
"There's this tendency now to blame the ones still smoking," Robin Koval, president of Truth Initiative, a leading tobacco-control nonprofit group, told the Post.
"The attitude is, 'You're doing it to yourself. If you were just strong enough, you'd be able to quit.'"
"Poorer people don't smoke because anything's different or wrong about them," Koval added. "Their communities are not protected like others are. They don't have access to good health care and cessation programs. If you have a bull's eye painted on your back, it's harder to get away."
Pilot programs in some states to reach those smokers have been launched, the Post reported.
"But the frustrating thing for folks in the public-health community is we know from research exactly what would make the biggest difference," Brian King, deputy director for the Centers for Disease Control and Prevention Office on Smoking and Health, told the Post.
"They're just not being implemented at the policy level. It's bread-and-butter strategies like getting states to pass smoke-free laws, increasing cigarette taxes and funding tobacco cessation and prevention."
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