Learn about the connection between tobacco & DEI: Download the report
Smoking Cessation

Quitting Smoking? Why It’s Harder To Do In Tobacco Nation

July 11, 2019
By Pivot
Area of the United States that is highlighted in orange and deemed "Tobacco Nation"

Where you live affects many aspects of your life

The foods you prefer. The clothes you wear. The music you listen to. But what about something as personal as smoking? Recent research shows that you’re 40% more likely to smoke if you live in “Tobacco Nation,” a swath of Midwestern and Southern states. Here’s what you need to know if you live there and want to quit.

What is “Tobacco Nation?”

The term “Tobacco Nation” refers to 13 states in America’s heartland and south: Alabama, Arkansas, Indiana, Kentucky, Louisiana, Michigan, Mississippi, Missouri, Ohio, Oklahoma, South Carolina, Tennessee, and West Virginia. If Tobacco Nation were a real country, its smoking rate would be the fifth highest in the world - behind only Indonesia, Ukraine, China, and the Philippines.

In addition to having higher smoking rates, Tobacco Nation also has heavier usage than the rest of the U.S. Outside of the aforementioned states, the average American who smokes consumes 40.6 packs annually. For people who smoke in Tobacco Nation, that number is 66.6 packs annually—more than a 50% increase.

Why is this important?

According to the National Institute of Health (NIH), 44% of those who smoke say that “surrounding influences” were their primary reason for starting to smoke. That means that the more people who smoke around you, the more likely you are to smoke yourself.

You’ll also probably have a shorter life. Mortality from heart disease is 22% higher in Tobacco Nation states than in the rest of the United States. And the more cigarettes someone who smokes consumes, the higher their mortality rate.

Why do more people smoke in these states?

It’s complicated. Tobacco Nation states face many interrelated challenges. Historically, this grouping of states was the main tobacco-producing region of North America, and as a result of that prevalence, society there has traditionally been more tolerant of smoking.

Add to that the fact that incomes in Tobacco Nation tend to be lower than in the rest of the United States. The region, therefore, has fewer resources to put towards healthcare and public awareness programs. Also, without strong anti-smoking laws in Tobacco Nation, there are fewer pressures (or incentives) to quit.

Is it harder to quit smoking in Tobacco Nation?

It’s tough to quit smoking no matter where you are because the nicotine in cigarettes is so highly addictive. Of the participants cited in the NIH study above, 68% had tried to quit smoking in the past six months but failed. Nationwide, only 8% of people who tried to quit on their own succeeded in their first 6-12 months.

But things can be even tougher in Tobacco Nation. Many of its states have no indoor smoking bans whatsoever, including in restaurants and the workplace. One exception is Arkansas, where some counties have raised the legal age to purchase tobacco products to 21. But this is a drop in the bucket compared with most of the United States, where smoking is illegal in almost all indoor venues.

Would-be quitters in Tobacco Nation can therefore be constantly exposed to secondhand smoke and tempted by tacit peer pressure all around them. Perhaps this explains why smoking rates have not been decreasing in Tobacco Nation, as they have in the rest of the country.

What can those who smoke in Tobacco Nation do to quit?

Examine your reasons for smoking – and your reasons for quitting

Every smoking cessation journey is unique. There’s no one-size-fits-all solution. The clearer you are about why you smoke in the first place, and why you want to stop, the better equipped you will be to overcome the cravings that inevitably arise. Write down what smoking is doing for you. Does it help calm you down? Is smoking taken for granted in your social circle? Has it just become an unquestioned part of everyday life?

Then consider your motivation for quitting. Have loved ones’ deaths from cancer or heart disease been attributed to smoking? Are you hoping for extra years or decades with your children or grandchildren? Make a list that you can refer to frequently.

Don’t expect support from those who smoke around you

In general, people approve of behavior that conforms to the group. This is true even of behavior that’s been proven to be dangerous or unhealthy. Your decision to quit may make other people who smoke in Tobacco Nation uncomfortable, as if you were somehow trying to show them up, or act like you’re better than they are. On the bright side, though, you may become a role model, convincing others to quit.

Look to a program for help

A good example of an integrated tobacco cessation program is Pivot, which includes options for individualized coaching, peer support, nicotine replacement therapy, the first-of-its-kind Breath Sensor, a mobile app, and more. Find a system that feels right for you, and start as soon as you can.

Stick with it

Studies show that most people who smoke attempt to quit between seven and ten times before they’re done for good. So if you slip up, try again. Each time it gets a little easier. Similarly, don’t expect yourself to be able to go cold turkey. But if you try, and if the cold turkey doesn’t work, try other ideas like personalized one-on-one coaching or an online support group.

The bottom line

Nicotine doesn’t care what state you live in. It’s just as addictive and harmful in Tobacco Nation as in the rest of the country. And you have the power to make a choice that can improve almost every facet of your life – even if you live in Tobacco Nation - by reducing or quitting cigarettes.

Logo Illustrating of arrow pointing down
Logo Illustrating of arrow pointing down
Logo Illustrating of arrow pointing down
Logo Illustrating of arrow pointing down
Logo Illustrating of arrow pointing down
Yellow swirl illustration
Discover Pivot

The comprehensive quit program with resources that help all, no matter where you’re at on your journey.

Right pointing arrow icon illustration
Right pointing arrow icon illustration
business people high fiving
Why Your Company Needs an Employer-Provided Smoking Cessation Program
man at laptop looking stressed
How Anxiety Affects Employee Performance
woman smiling while looking at cell phone
Leveraging the Pivot Breathe Community