Villanti AC, Klemperer EM, Sprague BL, et al. - State-level high rurality vs low rurality was related to 5.8% higher cigarette smoking prevalence, higher age-adjusted smoking-associated cancer incidence, higher smoking-related cancer mortality, and 3.4% higher proportion of smoking-attributable cancer deaths.

• Publicly-available national data were used.

• Estimates were obtained for 12 smoking-related cancers.

• In Virginia, 28.2% (24.6% rural) was the estimated median proportion of smoking-attributable cancer deaths.

• Such estimates ranged from 19.9% in Utah (9.4% rural) to 35.1% in Kentucky (41.6% rural).

• For women and men, the highest proportion of smoking-attributable cancer deaths were noted in a largely urban state (Nevada, 5.8% rural) and in a largely rural state (Kentucky), respectively.

• For decreasing cancer disparities in rural populations, tobacco control is important.