Dataset Information

'It's about the smoke, not the smoker': messages that motivate rural communities to support smoke-free policies.

ABSTRACT: Rural residents are exposed to sophisticated tobacco advertising and tobacco growing represents an economic mainstay in many rural communities. There is a need for effective health messages to counter the pro-tobacco culture in these communities. To determine relevant cultural themes and key message features that affect receptivity to pro-health advertisements among rural residents, 11 exploratory focus groups and surveys with community advocates (N = 82) in three rural Kentucky counties were conducted. Participants reviewed and rated a collection of print media advertisements and branding materials used by rural communities to promote smoke-free policies. Findings reveal that negative emotional tone, loss framing, appeals to religiosity, and shifting focus away from smokers are effective strategies with rural audiences. Potential pitfalls were identified. Attacks on smokers may not be a useful strategy. Health risk messages reinforced beliefs of secondhand smoke harm but some argued that the messages needed to appeal to smokers and emphasize health hazards to smokers, rather than to non-smokers only. Messages describing ineffectiveness of smoking sections were understood but participants felt they were only relevant for restaurants and not all public spaces. Emphasis on religiosity and social norms shows promise as a culturally sensitive approach to promoting smoke-free environments in rural communities.

SUBMITTER: Kostygina G

PROVIDER: S-EPMC3894665 | biostudies-literature | 2014 Feb

REPOSITORIES: biostudies-literature

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'It's about the smoke, not the smoker': messages that motivate rural communities to support smoke-free policies.

Kostygina Ganna G Hahn Ellen J EJ Rayens Mary Kay MK

Health education research 20130822 1

Rural residents are exposed to sophisticated tobacco advertising and tobacco growing represents an economic mainstay in many rural communities. There is a need for effective health messages to counter the pro-tobacco culture in these communities. To determine relevant cultural themes and key message features that affect receptivity to pro-health advertisements among rural residents, 11 exploratory focus groups and surveys with community advocates (N = 82) in three rural Kentucky counties were co ...[more]

PMID: 23969628

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Project description:Low-cost media campaigns increase demand for smoke-free policies in underserved rural areas. The study examined the impact of loss- and gain-framed smoke-free print ads on recall and perceived effectiveness in rural communities, controlling for personal characteristics.Following 6- to 9-month print media campaigns in three rural counties, recall and perceived effectiveness of loss-framed (ie, targeting dangers of secondhand smoke [SHS]) and gain-framed (ie, highlighting positive aspects of smoke-free air) ads were assessed using random-digit-dial phone surveys. Respondents were asked if they remembered each ad, whether they liked it, whether they were prompted to contact a smoke-free coalition, whether the ad made them think, and whether it prompted emotion. Mixed modeling assessed whether personal factors predicted ad recall or perceived effectiveness.Loss-framed ads were less likely to be recalled but more likely to prompt emotion. For ads of both frame types, females reported greater recall and perceived effectiveness than males. Those with less education reported higher perceived effectiveness of the ads but lower recall. Nonsmokers were more likely than smokers to perceive the ads as effective. Knowledge of SHS risk and support for smoke-free workplaces were positively associated with recall and effectiveness.Ad recall and perceived effectiveness were associated with framing and demographic and personal characteristics. Smoke-free efforts in rural areas may be bolstered by continuing to promote benefits of smoke-free workplace policies and educate on SHS risks. Rural areas may need to provide a combination of ad types and framing strategies to appeal to a wide audience.Rural communities are disproportionately affected by SHS and less likely to be protected by smoke-free policies. This study adds evidence-based guidance for tailoring rural smoke-free media campaigns using different framing: gain-framed messages (ie, benefits of smoke-free environments) to promote recall and loss-framed content (ie, dangers of SHS) to prompt emotion. Further, gain-framed messages that are localized to the rural community may be especially effective. Findings support designing smoke-free campaigns in rural communities with the audience in mind by tailoring messages to age, sex, and education level.

Project description:IntroductionParents/guardians can effectively reduce tobacco smoking and secondhand smoke exposure among youth by adopting and enforcing rules against indoor tobacco smoking (ie, home smoke-free policies). We investigate home smoke-free policies from childhood to adolescence in the United States and across rural, suburban, and urban households.Aims and methodsWe analyzed 2019-2020 National Survey of Children's Health data from n = 5,955 parents of youth aged 0-17, living at home with a tobacco smoker in the United States (U.S). Geographical categories were: rural, suburban, and urban. Home smoke-free policy reflected prohibiting tobacco smoking inside the home. Weighted logistic regressions examined the (1) association between youth age and home smoke-free policies, (2) interaction between geographic category and youth age, and (3) differing associations between youth age and home smoke-free policies by geography. Models controlled for youth race, ethnicity, sex, parental education, household annual income, and home structure.ResultsApproximately 13.2% of U.S. households with a smoker did not have a home smoke-free policy. Stratified analyses found one-year increase in youth age was associated with lower odds of having a home smoke-free policy in rural (aOR:0.91; 95%CI: 0.87-0.95) and urban (aOR: 0.96; 95%CI: 0.92-1.00; p = .039), but not suburban (aOR:1.00; 95%CI: 0.95-1.05) households, controlling for covariates.ConclusionOdds of having a smoke-free home in the U.S. declined significantly in rural (9% per year) and urban (4%) but not suburban (0%) households. We quantify declines in home smoke-free policies as children age and identify geographic disparities for this environmental determinant of health.ImplicationsHealth promotion efforts targeting secondhand smoke prevention is needed, particularly for parents of older youth. Furthermore, there is a clear geographic bias in secondhand smoke exposure among all youth particularly older youth. Tailored interventions are needed to address geographic disparities in secondhand smoke exposure among rural and urban youth.

Project description:OBJECTIVES:To examine trends in smoking prevalence in key venues (workplaces, restaurants, bars) and in public support for comprehensive smoke-free laws, with comparisons between cities and rural areas in China. DESIGN:Data are from Waves 3-5 (2009-2015) of the International Tobacco Control (ITC) China Survey, a cohort survey of smokers and non-smokers. Logistic regression analyses employing generalised estimating equations assessed changes in smoking prevalence and support for smoke-free laws over time; specific tests assessed whether partial smoking bans implemented in three cities between Waves 3 and 4 had greater impact. SETTING:Face-to-face surveys were conducted in seven cities (Beijing, Changsha, Guangzhou, Kunming, Shanghai, Shenyang and Yinchuan) and five rural areas (Changzhi, Huzhou, Tongren, Yichun and Xining). PARTICIPANTS:In each survey location at each wave, a representative sample of approximately 800 smokers and 200 non-smokers (aged 18+) were selected using a multistage cluster sampling design. MAIN OUTCOME MEASURES:Prevalence of smoking (whether respondents noticed smoking inside restaurants, bars and workplaces); smoking rules inside these venues; and support for complete smoking bans in these venues. RESULTS:Although smoking prevalence decreased and support increased over time, neither trend was greater in cities that implemented partial smoke-free laws. Smoking was higher in rural than urban workplaces (62% vs 44%, p<0.01), but was equally high in all restaurants and bars. There were generally no differences in secondhand smoke (SHS) exposure between smokers and non-smokers except in rural workplaces (74% vs 58%, p<0.05). Support for comprehensive bans was equally high across locations. CONCLUSIONS:Partial laws have had no effect on reducing SHS in China. There is an urgent need for comprehensive smoke-free laws to protect the public from exposure to deadly tobacco smoke in both urban and rural areas. The high support among Chinese smokers for such a law demonstrates that public support is not a barrier for action.

Project description:BackgroundSmoke-free policies are essential to protect people against tobacco smoke exposure. To successfully implement smoke-free policies that go beyond enclosed public places and workplaces, public support is important. We undertook a comprehensive systematic review of levels and determinants of public support for indoor (semi-)private and outdoor smoke-free policies.MethodsIn this systematic review and meta-analysis, six electronic databases were searched for studies (published between 1 January 2004 and 19 January 2022) reporting support for (semi-)private and outdoor smoke-free policies in representative samples of at least 400 respondents aged 16 years and above. Two reviewers independently extracted data and assessed risk of bias of individual reports using the Mixed Methods Appraisal Tool. The primary outcome was proportion support for smoke-free policies, grouped according to location covered. Three-level meta-analyses, subgroup analyses and meta-regression were performed.Findings14,749 records were screened, of which 107 were included; 42 had low risk of bias and 65 were at moderate risk. 99 studies were included in the meta-analyses, reporting 326 measures of support from 896,016 individuals across 33 different countries. Support was pooled for indoor private areas (e.g., private cars, homes: 73%, 95% confidence interval (CI): 66-79), indoor semi-private areas (e.g., multi-unit housing: 70%, 95% CI: 48-86), outdoor hospitality areas (e.g., café and restaurant terraces: 50%, 95% CI: 43-56), outdoor non-hospitality areas (e.g., school grounds, playgrounds, parks, beaches: 69%, 95% CI: 64-73), outdoor semi-private areas (e.g., shared gardens: 67%, 95% CI: 53-79) and outdoor private areas (e.g., private balconies: 41%, 95% CI: 18-69). Subcategories showed highest support for smoke-free cars with children (86%, 95% CI: 81-89), playgrounds (80%, 95% CI: 74-86) and school grounds (76%, 95% CI: 69-83). Non-smokers and ex-smokers were more in favour of smoke-free policies compared to smokers. Support generally increased over time, and following implementation of each smoke-free policy.InterpretationOur findings suggested that public support for novel smoke-free policies is high, especially in places frequented by children. Governments should be reassured about public support for implementation of novel smoke-free policies.FundingDutch Heart Foundation, Lung Foundation Netherlands, Dutch Cancer Society, Dutch Diabetes Research Foundation and Netherlands Thrombosis Foundation.

Dataset Information

'It's about the smoke, not the smoker': messages that motivate rural communities to support smoke-free policies.

Publications

'It's about the smoke, not the smoker': messages that motivate rural communities to support smoke-free policies.

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