Perceptions of Smoking Cessation Programs in Rural Appalachia

Kruger, Tina M.; Howell, Britteny M.; Haney, Alicia; Davis, Rian E.; Fields, Nell; Schoenberg, Nancy E.

doi:10.5993/ajhb.36.3.8

Cited by 22 publications

(25 citation statements)

References 26 publications

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“…Thus, in agreement with previous research (X. Chen, Stanton, et al, 2006;Kruger et al, 2012;Twyman et al, 2014;B. P. Zhu et al, 1996), findings from this PhD underscored the point that high prevalence and acceptability of smoking outside of the school undermined tobacco management in schools.…”

Section: Effectiveness Of a Tpb-based Smoking Interventionsupporting

confidence: 90%

“…As found previously, the smoking behaviour of parents and teachers can lead to adolescent smoking and pro-smoking attitudes (X. Chen, Stanton, et al, 2006); high acceptability, and prevalence of smoking outside of schools also served as a barrier for smoking cessation (Kruger et al, 2012;Twyman, Bonevski, Paul, & Bryant, 2014). Consistent with most smoking studies among Chinese secondary school students, coping with academic stress was mentioned by students and teaching staff members as a reason to smoke (Davey et al, 2014;Davey & Zhao, 2012b;Zhao et al, 2017).…”

Section: Discussionmentioning

confidence: 53%

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A Theory-Based Smoking Intervention for Chinese High School Students: Development, Implementation, and Evaluation

Zhao¹

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Background: With 316 million smokers, China is the world's largest tobacco consumer.Adolescent smoking rates are increasing among females, and remain at a high level among males. Reducing smoking behaviour and associated cognitions in this transitional period is important to curb smoking in early adulthood.Objective: There were two objectives in this PhD: (i) to explore the psychological mechanisms underlying Chinese adolescents' smoking behaviour (Study 1); and (ii) to develop, implement, and evaluate a school-based smoking intervention among Chinese adolescents (Study 2). The latter objective was based on the former.Design: Mixed approaches were utilised. Study 1 used semi-structured focus groups based on the Theory of Planned Behaviour (TPB) among high school students. Following the Consensual Qualitative Research (CQR) methods, data were coded into seven domains.Based on the findings in Study 1, a belief-driven smoking programme ("Achieve my healthy future") was designed, and incorporated life skills training. After the implementation of the programme, smoking behaviour, associated cognitions, and skills were evaluated in a longitudinal design (3 time-points). Study 2 also included a qualitative study of the perceptions of school-based tobacco management among high school students and teaching staff members, using focus groups and interviews.Setting: Two middle schools in Kunming, Yunnan Province, China (February -October 2016). Participants: Thirty 10th graders in Study 1 (50% female and 50% male); 207 10 th graders enrolled in Study 2 (106 in the intervention group; 101 in the control group).ii Measurements: Two qualitative studies and one quantitative study were included. For the elicitation study (Study 1), focus groups was used. For the qualitative study (Study 2), smoking behaviour, associated cognitions (intention, attitude, subjective norm, perceived behavioural control, willingness, prototype), and life skills (stress coping, decision making, assertiveness, pragmatics, dispositions towards critical thinking) were tested. For the perception study (Study 2), mixed data from focus groups, interviews, and field observations were used.Intervention: Based on the findings of Study 1, a four-session classroom-based intervention was designed. The programme focused on psychological constructs (attitude, subjective norm, perceived behavioural control, and prototype) as well as life skills (stress coping, decision making, assertiveness and pragmatics, and critical thinking). Each session lasted for 40 minutes.Key findings: (i) Study 1 identified seven domains, namely, advantages, disadvantages, approvers, disapprovers, facilitators, barriers, and smoker images. Smoking as a gendered behaviour, smoking as influenced by cultural and environmental contexts, smoking as a strategy to cope with stress, and awareness of the harm of smoking, are highlighted themes across domains. Based on the elicited beliefs, a smoking intervention programme was designed. Study 2 showed that (ii) the pilot intervention based o...

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Section: Effectiveness Of a Tpb-based Smoking Interventionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 53%

A Theory-Based Smoking Intervention for Chinese High School Students: Development, Implementation, and Evaluation

Zhao¹

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“…Conversely, the over 40 year old participants more readily recognized what Tresza and colleagues (2008) (Hutcheson, et al, 2008) characterize as the “intrinsic factors” of tobacco such as the negative health consequences and the enormous challenges of the addiction process related to tobacco use. Likewise, the smokers 40 years and older were more likely to discuss their needs for greater support and resources to quit as demonstrated in another study in Appalachian Kentucky (Kruger, et al, 2012). …”

Section: Discussionmentioning

confidence: 82%

“…The majority of published studies on smoking cessation efforts in Appalachia represent communities located in Kentucky (Schoenberg, et al, 2014, Butler, et al, 2012, Kruger, et al, 2012) and the central and southern regions (Northridge, et al, 2008). Relatively little is known about the effectiveness of population-based interventions to reach smokers in Northern Appalachia.…”

Section: Introductionmentioning

confidence: 99%

Perspectives on Smoking Cessation in Northern Appalachia

et al. 2015

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This study applies qualitative research methods to explore perspectives on cessation among smokers/former smokers recruited from an area of Northern Appalachia. Six focus groups, stratified by age group (18–39 years old and 40 years and older), were conducted among participants (n=54) recruited from community settings. Participants described varied interest in and challenges with quitting smoking. Smokers 40 years and older more readily endorsed the health risks of smoking and had greater interest in quitting assistance. Participants expressed frustration with the U.S. government for allowing a harmful product (e.g., cigarettes) to be promoted with minimal regulation. Use of social media was robust among both age groups; participants expressed limited interest in various social media/technology platforms for promoting smoking cessation. Findings from this understudied area of northern Appalachia reflect the heterogeneity of this region and contribute novel information about the beliefs, attitudes, and experiences of current and formers smokers with regard to cessation.

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“…Furthermore, these high rates of smoking are reflective of the high rates of smoking and tobacco use in the Appalachian region, a region particularly in need of smoking cessation intervention. 44 Independent pharmacies are more likely to be found in rural areas throughout the state where they can best meet the needs of their community, making them an important resource for health promotion, 45 particularly for tobacco cessation. They also had greater decision-making control over whether or not their pharmacies sold tobacco products.…”

Section: Discussionmentioning

confidence: 99%

Pharmacists’ Perceptions of Tobacco Sales in an Elevated-Risk Population

Kelly

Agarwal

Attarabeen

et al. 2015

Journal of Pharmacy Technology

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Background: Policies by the American Medical Association and the American Pharmacists Association advocate for the discontinuation of tobacco sales in pharmacies, yet tobacco sales remain lucrative for pharmacies in the United States. West Virginia has the highest smoking rate (29%) and the second highest lung cancer incidence in the country. Objective: This study examined pharmacists' perceptions of tobacco sales in pharmacies and awareness of relevant policies. Methods: West Virginia pharmacists (n = 195) were surveyed to understand tobacco sales in West Virginia pharmacy, utilizing Diffusion of Innovations as a theoretical framework. Results: Eighty-one percent were community pharmacists, and 39% practiced at independent pharmacies. Sixty-two percent reported that their pharmacies did not sell tobacco. Pharmacists at independent pharmacies were more likely to be in rural areas/small towns, have decision-making control over tobacco sales, and not currently selling tobacco products. Other community pharmacists (ie, at regional and national chains) were more likely to sell tobacco products, not have decision-making control over tobacco sales, and perceive revenue loss from discontinuing tobacco sales. Other types of pharmacists (eg, hospital) estimated a greater number of patients who were smokers/tobacco users. A logistic regression showed that less perceived revenue loss was associated with greater likelihood of not selling tobacco products (all Ps < .05). Conclusions: Findings indicate a strong movement among community pharmacists to curtail the use of tobacco. Generating support for the elimination of tobacco sales and adoption of tobacco cessation initiatives in community pharmacy could help reduce smoking rates in elevated-risk populations.

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Perceptions of Smoking Cessation Programs in Rural Appalachia

Cited by 22 publications

References 26 publications

A Theory-Based Smoking Intervention for Chinese High School Students: Development, Implementation, and Evaluation

A Theory-Based Smoking Intervention for Chinese High School Students: Development, Implementation, and Evaluation

Perspectives on Smoking Cessation in Northern Appalachia

Pharmacists’ Perceptions of Tobacco Sales in an Elevated-Risk Population

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