title: '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.
authors: Center for Tobacco Control Research and Education, University of California San Francisco, San Francisco, CA, USA and Tobacco Policy Research Program, University of Kentucky College of Nursing, Lexington, KY, USA.
authors: Ganna
authors: G
authors: Kostygina
authors: Ellen J
authors: EJ
authors: Hahn
authors: Mary Kay
authors: MK
authors: Rayens
mesh_terms: D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D003469:Culture; D005260:Female; D017144:Focus Groups; D006266:Health Education / Q000458:organization & administration*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007629:Kentucky; D008297:Male; D008402:Mass Media; D008875:Middle Aged; D009042:Motivation; D012307:Risk Factors; D012424:Rural Population; D061845:Smoke-Free Policy; D012907:Smoking / Q000009:adverse effects* / Q000208:ethnology; D012922:Social Change; D040241:Social Marketing; D014028:Tobacco Smoke Pollution / Q000009:adverse effects
chemical_list: D014028:Tobacco Smoke Pollution
references: Health Promot Pract. 2013 Mar;14(2):238-46
references: 22773621
references: J Health Commun. 2002 Mar-Apr;7(2):123-37
references: 12049421
references: JAMA. 2001 Jul 25;286(4):436-41
references: 11466122
references: J Epidemiol Community Health. 2007 Apr;61(4):298-301
references: 17372288
references: BMJ. 2000 Aug 5;321(7257):351-4
references: 10926595
references: Health Educ Res. 2008 Aug;23(4):709-22
references: 17947246
references: Health Commun. 2009 Apr;24(3):219-27
references: 19415554
references: Public Health Rev. 1998;26(2):147-74
references: 10327830
references: Am J Prev Med. 2008 Jul;35(1):14-9
references: 18482819
references: J Pers Soc Psychol. 1987 Mar;52(3):500-10
references: 3572721
references: JAMA. 1998 Jul 22-29;280(4):323; author reply 324
references: 9686542
references: Tob Control. 2002 Mar;11(1):14-9
references: 11891362
references: Nurs Clin North Am. 2012 Mar;47(1):31-43
references: 22289396
references: Res Nurs Health. 2000 Aug;23(4):334-40
references: 10940958
references: Am J Public Health. 2006 Aug;96(8):1359-63
references: 16809588
references: Vis Anthropol Rev. 2009 May 1;25(1):1-24
references: 20160936
references: Health Commun. 2009 Jan;24(1):50-9
references: 19204858
references: J Hazard Mater. 2001 Sep 14;86(1-3):17-24
references: 11532356
references: JAMA. 1998 Mar 11;279(10):772-7
references: 9508154
references: Health Educ Behav. 2006 Aug;33(4):502-14
references: 16740511
references: Am J Public Health. 2006 May;96(5):906-13
references: 16571709
references: Am J Prev Med. 2008 Jun;34(6):519-22
references: 18471589
references: J Health Commun. 2005 Mar;10(2):127-43
references: 15804904
references: Am J Health Promot. 2008 Nov-Dec;23(2):112-20
references: 19004161
references: J Natl Cancer Inst. 2003 Nov 19;95(22):1681-91
references: 14625259
references: Tob Control. 2005 Oct;14(5):307-14
references: 16183981
references: J Community Health. 2011 Aug;36(4):616-23
references: 21193951
references: J Health Commun. 2004 May-Jun;9(3):259-74
references: 15360037
references: Science. 1981 Jan 30;211(4481):453-8
references: 7455683