The Usage and Associated Factors of Alternative Tobacco Products among School-going Youth in Central Appalachia

Introduction:
This text is a summary of a research study examining the usage and associated factors of alternative tobacco products (ATPs) among school-going youth in Central Appalachia. The study aimed to identify the prevalence of ATP use and the factors contributing to their use among middle school students in a predominantly rural region of Tennessee. The key points of the study include the use of a school-based tobacco survey and a multiple logistic regression model to analyze the data. The study found that more than one in ten participants had ever used at least one ATP and that certain factors, such as owning tobacco-branded items and living with a tobacco user, were associated with ATP use.

Key Points:

* The study used data from a school-based tobacco survey conducted in two predominantly rural Central Appalachian counties in Northeast Tennessee in 2015-2016.
* The dependent variable was ever-use of ATPs, defined as any non-cigarette products, including chewing tobacco, e-cigarettes, snuff, dip, cigars, cigarillos, hookah, waterpipe, snus, bidis, pipes, and dissolvable tobacco.
* Independent variables included intrapersonal, interpersonal, and environmental factors.
* The study found that 13.2% of participants had ever used ATPs, with e-cigarettes being the most commonly used product.
* Participants who believed that tobacco users have more friends, owned tobacco-branded items, and lived with a tobacco user had increased odds of ATP use.
* Participants who did not perceive tobacco products as harmful had decreased odds of ATP use.
* Living with a tobacco user, living in homes where smoking is allowed, and ever cigarette smoking were associated with significant increases in the odds of ATP use.

Main Message:
The study highlights the importance of addressing the usage of alternative tobacco products among school-going youth in Central Appalachia. The study found that more than one in ten participants had ever used at least one ATP and that certain factors, such as owning tobacco-branded items and living with a tobacco user, were associated with ATP use. The study suggests that interventions should seek to reduce the positive images of tobacco and make all tobacco products unappealing to youth. Furthermore, the study emphasizes the need for comprehensive state-wide policies that incorporate ATPs and school-based tobacco control programs aimed at associating tobacco products with negative images to counteract the tobacco industry advertising claims.

Owusu, Daniel, Hadii M. Mamudu, Candice Collins, Crystal Robertson, Liang Wang, Boghozian Rafie, and Mary Ann Littleton. “The Usage and Associated Factors of Alternative Tobacco Products among School-Going Youth in Central Appalachia.” Journal of Health Care for the Poor and Underserved 30, no. 1 (2019): 249–64. https://doi.org/10.1353/hpu.2019.0019.