Exploring the Link between Altitude of Residence and Smoking Patterns in the United States

Danielle Jeanne-Marie Boxer (), Young-Hoon Sung, Nicolas A. Nunez, Colleen Elizabeth Fitzgerald, Perry Franklin Renshaw and Douglas Gavin Kondo
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Danielle Jeanne-Marie Boxer: Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, UT 84112, USA
Young-Hoon Sung: Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, UT 84112, USA
Nicolas A. Nunez: Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, UT 84112, USA
Colleen Elizabeth Fitzgerald: Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, UT 84112, USA
Perry Franklin Renshaw: Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, UT 84112, USA
Douglas Gavin Kondo: Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, UT 84112, USA

IJERPH, 2024, vol. 21, issue 2, 1-14

Abstract: Introduction: Smoking-related diseases affect 16 million Americans, causing approximately 480,000 deaths annually. The prevalence of cigarette smoking varies regionally across the United States, and previous research indicates that regional rates of smoking-related diseases demonstrate a negative association with altitude. The purpose of this study was to determine the relationship between altitude and the prevalence of cigarette smoking by county ( N = 3106) in the United States. We hypothesized that smoking prevalence among adults would be negatively associated with mean county altitude. Methods: A multivariate linear regression was performed to examine the relationship between county-level mean altitude and county smoking rate. Covariates were individually correlated with 2020 smoking data, and significant associations were included in the final model. Results: The multivariate linear regression indicated that the county-level smoking rates are significantly reduced at high altitudes ( p < 0.001). The model accounted for 89.5% of the variance in smoking prevalence, and for each 1000-foot increase in altitude above sea level, smoking rates decreased by 0.143%. Based on multivariate linear regression, the following variables remained independently and significantly associated: race, sex, educational attainment, socioeconomic status, unemployment, physical inactivity, drinking behavior, mental distress, and tobacco taxation. Conclusions: Our results indicate that smoking rates are negatively associated with altitude, which may suggest that altitude affects the pharmacokinetics, pharmacodynamics, and mechanistic pathways involved in cigarette use. Further research is needed to explore the relationship between altitude and smoking and how altitude may serve as a protective factor in the acquisition and maintenance of tobacco use disorders.

Keywords: cigarette smoking; altitude; United States; county data (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2024
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