Faculty and Students Publish on Tobacco Use in Students in Appalachia

Dr. Hadii Mamudu, Professor in the Department of Health Services Management and Policy in the East Tennessee State University College of Public Health, has authored an article in the International Journal of Environmental Research and Public Health.  The article, “Exploring Associations between Susceptibility to the Use of Electronic Nicotine Delivery Systems and E-Cigarette Use among School-Going Adolescents in Rural Appalachia," examines school-going adolescent behavior in a rural distressed county in Appalachian Tennessee.

College of Public Health faculty Dr. Ying Liu and students Christian Nwabueze, Esther Adeniran, Cynthia Blair, and Adeola Awujoola are co-authors.  Additional co-authors include East Tennessee State University faculty Florence Weierbach and David Wood as well as members of California State University, The George Washington University, Baylor University, and the Tennessee Department of Health.

Electronic nicotine delivery systems use, including e-cigarettes, has surpassed the use of conventional tobacco products. According to one study, the overall use among USA middle and high school students was 20.0% (10.5% in middle school, 27.5% in high school) in 2019.  Over 90% of regular users of all tobacco products started as adolescents, and are targeted by the tobacco industry through advertising, marketing, and promotions.  Few studies have addressed adolescents in high-risk, rural, socioeconomically distressed environments. 

This study population involves 8th and 9th grade youth in a school located in an ARC-designated distressed rural county in Appalachian Tennessee.  In collaboration with the school, the County Health Department and the Regional Health Department, the researchers conducted an online survey in March/April 2019. The survey collected data on the prevalence, knowledge, opinions, and perceptions about tobacco product use.  The study found that while 30.6% of the adolescents had tried e-cigarettes 15.5% were current users of e-cigarettes, which is higher than what was found in an earlier Appalachian youth and in an urban setting in Connecticut.

Overall, the results of this exploratory study suggest the need for larger studies to identify unique and generalizable factors that predispose adolescents in this high-risk rural, socioeconomically disadvantaged region to use electronic nicotine delivery systems. Nevertheless, this study offers insight into e-cigarette usage among U.S adolescents in rural, socioeconomically disadvantaged environments and provides a foundation for a closer examination of this vulnerable population.