ArticleJournal of community health2012
Factors influencing smokeless tobacco use in rural Ohio Appalachia.
Article in Journal of community health, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 42 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
42 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Exploring the perceived socio-cultural factors in the initiation of smokeless tobacco among adolescents: a qualitative systematic review.BMC public health · 2026Pooled it
- Potential for non-combustible nicotine products to reduce socioeconomic inequalities in smoking: a systematic review and synthesis of best available evidence.BMC public health · 2019Pooled it
- Health Warning Labels for Smokeless Tobacco: The Impact of Graphic Images on Attention, Recall, and Craving.Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2017Trial
- Commercial tobacco retail marketing in rural communities in Appalachian Kentucky, 2024.Preventive medicine reports · 2026Article
- Tobacco Susceptibility and Use Among Rural Adolescents: The Role of Tobacco Marketing Exposure and Screen Media Use.Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2025Article
- Rural-urban movement and stability in relation to minority stress-related factors, tobacco norms, and tobacco use among a sample of US sexual minority-identifying young adults.The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association · 2025Article
- Prevalence and predictors of chronic disease among rural and medically underserved populations using smokeless tobacco.Frontiers in public health · 2025Article
- Testing oral nicotine pouches versus nicotine replacement therapy for cigarette harm reduction in Appalachia: The ARISE study protocol.PloS one · 2025Article
- The Tax Incidence and Tax Pass-Through of Smokeless Tobacco in the US.International journal of environmental research and public health · 2024Article
- 'No-Barriers' tobacco product? Selling smokeless tobacco to women, people of colour and the LGBTQ+ community in the USA.Tobacco control · 2023Article
- The Impact of Social Media Use and Gaming on Initiation of Smokeless Tobacco Use Among Rural Male Youth.The Journal of adolescent health : official publication of the Society for Adolescent Medicine · 2023Article
- Urban-rural differences in tobacco product availability in food retailers, United States, 2017.The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association · 2023Article
- Perceptions of oral nicotine pouches & their marketing among Ohio Appalachia smokers and smokeless tobacco users.PloS one · 2023Article
- Associations between Cognitive and Affective Responses to Tobacco Advertisements and Tobacco Use Incidence: A Four-Year Prospective Study among Adolescent Boys.International journal of environmental research and public health · 2021Article
- Impact of tobacco and/or nicotine products on health and functioning: a scoping review and findings from the preparatory phase of the development of a new self-report measure.Harm reduction journal · 2021Article
- Persistent disparities in smoking among rural Appalachians: evidence from the Mountain Air Project.BMC public health · 2021Article
- Students' beliefs about smokeless tobacco use in Chabahar city: A qualitative study using focus groups.Journal of education and health promotion · 2021Article
- Shared and unique risk factors for tobacco use among rural versus urban adolescents.Preventive medicine · 2020Article
- Disparate survival of late-stage male oropharyngeal cancer in Appalachia.Scientific reports · 2020Article
- Sociodemographic Determinants of Acute Myocardial Infarction Hospitalization Risks in Florida.Journal of the American Heart Association · 2020Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
Abstract
The burden of smokeless tobacco (ST) use disproportionally impacts males in rural Ohio Appalachia. The purpose of this study was to describe the cultural factors contributing to this disparity and to articulate the way in which culture, through interpersonal factors (i.e. social norms and social networks) and community factors (i.e. marketing and availability), impacts ST initiation and use of ST among boys and men in Ohio Appalachia. Fifteen focus groups and 23 individual qualitative interviews were conducted with adult (n = 63) and adolescent (n = 53) residents in Ohio Appalachian counties to ascertain factors associated with ST use and the impact of ST marketing. Transcriptions were independently coded according to questions and themes. ST use appears to be a rite of passage in the development of masculine identity in Ohio Appalachian culture. Interpersonal factors had the greatest influence on initiation and continued use of ST. Ohio Appalachian boys either emulated current ST users or were actively encouraged to use ST through male family and peer networks. Users perceived their acceptance into the male social network as predicated on ST use. Community factors, including ST advertisement and access to ST, reinforced and normalized underlying cultural values. In addition to policy aimed at reducing tobacco marketing and access, interventions designed to reduce ST use in Ohio Appalachia should incorporate efforts to (1) shift the perception of cultural norms regarding ST use and (2) address male social networks as vehicles in ST initiation.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.