Abstract
In Appalachian areas, strong tobacco control policies are not in place, so residents are not adequately protected from secondhand smoke exposure. This area is predominantly rural, and residents experience a high burden of tobacco-related illnesses. There has been limited examination of elements that hinder smoke-free policy adoption in these vulnerable communities. Key informant interviews were conducted with individuals identified as being knowledgeable about local tobacco control policy activities within a random selection of Appalachian communities within 6 states with (n = 15) and without (n = 12) local smoke-free policies. Five key themes emerged from the qualitative interviews: (1) opposition to tobacco control, (2) need for local involvement, (3) role of community coalitions, (4) leveraging outside advocates, and (5) working with decision makers. In Appalachian communities, the local context and locally-based coalitions were critical to promote the adoption of smoke-free policies.
Similar content being viewed by others
References
Ferketich, A. K., Liber, A., Pennell, M., Nealy, D., Hammer, J., & Berman, M. (2010). Clean indoor air ordinance coverage in the Appalachian region of the United States. American Journal of Public Health, 100(7), 1313–1318.
Appalachian Regional Commission. (2004). The Appalachian region. http://www.arc.gov/appalachian_region/TheAppalachianRegion.asp. Accessed February 20, 2013.
Haaga, J. (2004). Educational attainment in Appalachia. Washington, DC: Population Reference Bureau, Appalachian Regional Commission.
Black, D., & Sanders, S. G. (2004). Labor market performance, poverty, and income inequality in Appalachia. Washington, DC: Appalachian Regional Commission.
American Nonsmokers’ Rights Foundation. (2013). Municipalities with local 100 % smokefree laws. American Nonsmokers’ Rights Foundation, Berkeley, CA. http://www.no-smoke.org/pdf/100ordlisttabs.pdf. Accessed June 23, 2013.
Siegel, M. (2002). The effectiveness of state-level tobacco control interventions: A review of program implementation and behavioral outcomes. Annual Review of Public Health, 23, 45–71.
York, N. L., Hahn, E. J., Rayens, M. K., & Talbert, J. (2008). Community readiness for local smoke-free policy change. American Journal of Health Promotion, 23(2), 112–120.
Bartosch, W. J., & Pope, G. C. (2002). Local enactment of tobacco control policies in Massachusetts. American Journal of Public Health, 92(6), 941–943.
Moreland-Russell, S., Black, E. K., Brossart, L., Mueller, N. B., Luke, D. A., Schell, S. F., et al. (2009). Coalitions state and community interventions. Atlanta, GA: Centers for Disease Control and Prevention, Office on Smoking and Health.
Hahn, E. J., Rayens, M. K., & York, N. (2013). Readiness for smoke-free policy and overall strength of tobacco control in rural tobacco-growing communities. Health Promotion Practice, 14(2), 238–246.
Hubbell, A. P., & Dearing, J. W. (2003). Local newspapers, community partnerships, and health improvement projects: Their roles in a comprehensive community initiative. Journal of Community Health, 28(5), 363–376.
Lind, P., & Finley, D. (2000). County commissioners as a key constituency for public health. Journal of Public Health Managment and Practice, 6(2), 30–38.
Satterlund, T. D., Cassady, D., Treiber, J., & Lemp, C. (2011). Barriers to adopting and implementing local-level tobacco control policies. Journal of Community Health, 36(4), 616–623.
Rayens, M. K., York, N. L., Adkins, S. M., Kaufman, E. L., & Hahn, E. J. (2012). Political climate and smoke-free laws in rural Kentucky communities. Policy, Politics and Nursing Practice, 13(2), 90–97.
Acknowledgments
Support for this work was provided by a grant from the Robert Wood Johnson Foundation New Connections program.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Klein, E.G., Liber, A.C., Kauffman, R.M. et al. Local Smoke-Free Policy Experiences in Appalachian Communities. J Community Health 39, 11–16 (2014). https://doi.org/10.1007/s10900-013-9733-6
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10900-013-9733-6