Barriers to Establishing Tobacco Prevention and Control Programs in Rural Communities
This section provides an overview of barriers to establishing tobacco prevention and control programs
in rural communities.
Access to Tobacco Cessation Services
have shown that brief
tobacco cessation counseling sessions can have a significant impact on influencing
individuals to quit smoking. However, rural community members may face barriers
in accessing healthcare services that are designed to help them quit tobacco use. For example, patients
may have to travel long distances to receive in-person cessation services. In addition, while practitioners may
advise their patients to quit smoking, they
always provide resources that help ensure successful tobacco cessation (for example, referrals
to counseling or access to low-cost nicotine replacement therapy). Inadequate health insurance coverage or
out-of-pocket costs may also deter rural individuals from accessing or seeking tobacco cessation
Social Attitudes and Personal Beliefs
Tobacco use is deeply embedded in the social environment of many rural communities. Youth
are likely to be surrounded by tobacco-using role models and unlikely to receive anti-tobacco messages
through available media channels. Rural community members may also be more likely to perceive anti-tobacco
policies as a violation of their individual rights or their personal freedoms. The tobacco industry has
capitalized on this argument by establishing an image of rugged
individualism that is associated with tobacco use.
Rural communities may face barriers
to enacting tobacco-free policies. State and local governments in rural areas have been less likely to enact
policies that have successfully reduced tobacco use in other areas. For example, policymakers
in rural areas are less likely to increase excise taxes or eliminate exposure to secondhand smoke in the
workplace or other publicly frequented areas. In addition, rural schools are much less likely to have
tobacco-free campus policies. A study found that only 28% of
schools in Kentucky reported adhering to a 100% tobacco-free policy.
Additionally, local businesses may have concerns about the economic impacts of smoke-free policies. For example,
one study found that some business owners
involved in tourism feared that visitors from areas with fewer smoke-free policies would not return.
Restaurant and bar owners may also view smoke-free policies as detrimental to business
Anti-tobacco media campaigns that advertise the dangers of tobacco use and expose the deceptive marketing
tactics of tobacco companies can effectively decrease
tobacco use and initiation. However, many of these mass media campaigns are broadcast in metropolitan
areas and may not have a large presence in rural communities.