Abstract 18094: Appalachian Youth and Tobacco Products: Perceptions, Attitudes, and Behaviors

Abstract

Crucial to ending the scourge of tobacco addiction is reducing youth use of the various products. Despite reduction in youth cigarette use, other products (e.g., hookah, e-cigs) have increased in popularity in this age group (CDC, 2013, 2015). Use patterns are also influenced by factors such as social acceptance, peer use, SES, and accessibility (US DHHS, 2012, 2015). Some areas have higher youth tobacco use rates (Kruger et al., 2012; US DHHS, 2012, 2015); for example, use of tobacco by middle and high school students in Appalachia continues to exceed rates in other areas. Increased understanding of the factors promoting this use is vital to developing effective youth anti-tobacco campaigns and public policy. Objective: To assess Appalachian middle and high school students’ perceptions of, attitudes about, and use of tobacco products. Methods: Data were collected in three Appalachian states: Kentucky, New York, and North Carolina. These states were selected for differences in overall use of tobacco by youth (i.e., Kentucky: high, North Carolina: mid-level, New York: low). From October 2014-May 2015, 23 focus groups were conducted with middle and high school students (N=203). Each participant completed a questionnaire on perceptions of and attitudes about tobacco, use of tobacco, and views of health consequences and engaged in an open-ended focus group discussion. Results: Traditional tobacco products continue to be popular with Appalachian youth. For example, 29% of the participants have tried at least one tobacco product, with significant numbers of daily users (9% smokeless tobacco; 6% cigarettes). E-cig use was nearly as high, with approximately 22% reporting some experience. Findings also revealed varying attitudes and discrepant conclusions surrounding e-cigs. Comparisons between tobacco users and nonusers as well as by middle and high school status and state will be addressed.