Int. J. Environ. Res. Public Health 2011, 8 258 The follow-up analyses to explore the decrease in prevalence from 2007–2008 revealed that the average prevalence rate for the community hospitals (33%) was 8% higher than the regional hospital (25%)—3% higher for 2007 (34% vs. 31%) and an average 10% higher for the other years—33% vs. 23% for 2008, 32% vs. 23% for 2009, and 32% vs. 22% for 2010. For 2008–2010, the most notable difference was for patients under 30 years of age for whom prevalence was 15% higher for rural versus urban communities; for the other age groups, the rural hospital tobacco use rates compared to the regional hospital were 9% higher among patients 30–49 years, 7% higher among patients 50–69 years, and 3% higher among patients 70+ years. The 8% overall higher rate for the rural community hospitals across all four years is consistent with a 7% rural-urban difference in smoking prevalence in a recent report on the health status of rural Canadians [17]. The general population prevalence rates in the report were also virtually identical to the current findings—32% for rural communities and 25% for urban centers [17]. The age-stratified findings from the current study contribute new data to rural-urban differences. Table 1. Tobacco Use Screening and Prevalence by Year. 2007 N % Total visits 120,927 100% Individuals 60,273 50% Screened 53,895 89% Refused 60 <1% Not able 1,466 2% Not asked 4,440 7% Blank 412 1% Males 25,962 48% Age M, SD, range 46  19 (18–107) Smokers by age 18–19 yr 885/2,595 34% 20–24 yr 2,423/5,973 41% 25–29 yr 2,211/4,868 45% 30–34 yr 1,880/4,410 43% 35–39 yr 1,962/4,515 44% 40–44 yr 2,040/4,878 42% 45–49 yr 1,981/5,143 38% 50–54 yr 1,496/4,566 33% 55–59 yr 1,001/3,888 26% 60–64 yr 636/3,110 20% 65–69 yr 375/2,438 15% 70–74 yr 229/2,167 11% 75–79 yr 142/2,090 7% 80–84 yr 75/1,736 4% 85+ yr 34/1,518 2% Total 17,370/53,895 32% 2008 N % 132,211 100% 65,450 50% 57,729 88% 78 <1% 1,332 2% 6,217 10% 94 <1% 27,680 48% 46  19 (18–103) 835/2,878 2,108/6,098 1,983/5,142 1,718/4,611 1,776/4,811 1,715/4,849 1,851/5,442 1,445/5,004 926/4,332 578/3,483 387/2,742 183/2,365 131/2,268 86/1,960 22/1,744 15,744/57,729 29% 35% 39% 37% 37% 35% 34% 29% 21% 17% 14% 8% 6% 4% 1% 27% 2009 N % 147,286 100% 67,920 46% 59,763 88% 15 <1% 1,165 2% 6,152 9% 825 1% 28,399 48% 46  19 (18–105) 887/2,954 2,169/6,452 1,983/5,334 1,788/4,793 1,731/4,827 1,694/4,873 1,787/5,522 1,497/5,333 988/4,497 649/3,805 369/2,784 206/2,468 136/2,298 57/1,992 33/1,831 15,974/59,763 28% 34% 38% 36% 37% 35% 34% 27% 23% 16% 13% 9% 6% 3% 2% 26% 2010 N % 144,928 100% 68,461 47% 58,830 85% 27 <1% 1,222 2% 7,471 11% 911 1% 28,136 48% 47 19 (18–106) 791/2,733 2,076/6,203 1,948/5,159 1,676/4,642 1,685/4,622 1,634/4,608 1,721/5,192 1,441/5,349 1,023/4,521 650/4,001 369/2,876 236/2,637 142/2,300 56/1,982 43/2,005 15,491/58,830 29% 34% 38% 36% 36% 36% 33% 27% 23% 16% 13% 9% 6% 3% 2% 26%