Abstract
Introduction: Tobacco use continues to be the leading preventable cause of morbidity and mortality in the Appalachian Tennessee despite the nationwide decline in tobacco use. The main reason contributing to this nationwide decline in tobacco use is tobacco control applied to prevention, cessation and protection efforts. Evidence indicates that regions with comprehensive tobacco control policies and programs have lower tobacco use prevalence than those with fewer policies and less comprehensive programs, which is characteristic of Tennessee. Therefore, this study examines the current capacity that exists around the tobacco control protection in Appalachian Tennessee.
Methods: During 2015-2016, a Population Health Improvement Plan (PHIP) study involving 222 community stakeholders and 91 organizations was conducted in Appalachian Tennessee to assess the capacity of the region in addressing the high burden of tobacco use. First, twenty (20) key informant interviews were conducted with tobacco control professionals within the eight counties in Northeast Tennessee. Afterwards, two community meetings were held in the northern and southern areas of the region with additionally identified stakeholders (n = 36) to gather input on current efforts and methods to increase community capacity for tobacco control in the region. The interviews and discussions were audio-recorded, transcribed, and analyzed using a multifaceted framework approach to tobacco control that focuses on prevention, protection and cessation. This study focuses on important themes identified related to tobacco protection for the Northeast region of Tennessee.
Results: The PHIP assessment process found that most current activities around protection for tobacco control were related to national tobacco control policies such as the Non-Smokers Protection Act (NSPA). Also, differences were found between rural and urban areas in the extent of policy efforts, with better enforcement of existing policies found in more metro areas. Rural counties expressed the need for better education and awareness of current policies to help with enforcement efforts. Assessment of findings for barriers to protection/policy for tobacco control resulted in two themes; the existence of state preemption on tobacco control policies, which limits what policies local governments can enact, and the need for higher tobacco taxes. An overall barrier found for tobacco protection was a cultural tolerance of tobacco use including an intergenerational culture of use in Appalachian Tennessee.
Conclusion: The Appalachian region of the US suffers disproportionately in health risks and adverse health outcomes, including tobacco-related diseases. For this reason, there is the need for comprehensive culturally-tailored and region-specific protection policies that address existing urban-rural disparities including the removal of the state preemption and increase of tax for tobacco products to effectively address the high burden of tobacco use in Appalachian Tennessee.
| Identifer | oai:union.ndltd.org:ETSU/oai:dc.etsu.edu:asrf-1438 |
| Date | 12 April 2019 |
| Creators | Osedeme, Fenose, Littleton, Mary Ann, PhD, Mamudu, Hadii, Robertson, Crystal, Owusu, Daniel, Wang, Liang |
| Publisher | Digital Commons @ East Tennessee State University |
| Source Sets | East Tennessee State University |
| Detected Language | English |
| Type | text |
| Source | Appalachian Student Research Forum |
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