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not really, I'm lvl24 and live in a medium-sized european town (~200 000 people)
my GPS sometimes drifts a bit to a nearby pokestop (I live where the orange X is) and I just farm balls for the next day every night
I rarely get any exciting pokemon (which is why most of my Ultraballs are untouched) but at least I can spam Great balls at any mon I like
I haven't spent any real money, just the 15 pounds I had from Google Rewards (2500 gold) and I used it to upgrade my bag and buy incubators