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A Qualitative Study to Explore Perception of Impacts of Preemption of Tobacco Regulation on Counties in Appalachian Tennessee

Author

Listed:
  • Hadii M. Mamudu

    (Department of Health Services Management and Policy, College of Public Health, East Tennessee State University, P.O Box 70264, Johnson City, TN 37614, USA)

  • Fenose Osedeme

    (Department of Behavioral and Community Health, College of Public Health, East Tennessee State University, P.O Box 70264, Johnson City, TN 37614, USA)

  • Crystal Robertson

    (School of Plant Environmental and Soil Sciences, Louisiana State University, Baton Rouge, LA 70808, USA)

  • Mary Ann Littleton

    (Department of Behavioral and Community Health, College of Public Health, East Tennessee State University, P.O Box 70264, Johnson City, TN 37614, USA)

  • Daniel Owusu

    (Tobacco Center of Regulatory Science (GSU TCORS), Georgia State University, Urban Life Building 850, 140 Decatur St, Atlanta, GA 30030, USA)

  • Liang Wang

    (Department of Biostatics and Epidemiology, College of Public Health, East Tennessee State University, P.O Box 70659, Johnson City, TN 37614, USA)

  • Donley T. Studlar

    (Department of Behavioral and Community Health, College of Public Health, East Tennessee State University, P.O Box 70264, Johnson City, TN 37614, USA)

Abstract

Bottom-up processes, starting at the local government level, are valuable for more-stringent tobacco control measures. The existence of industry-backed state-level tobacco control preemption in states has impeded policy progress within the state and localities/communities. A national public health goal under Healthy People 2020 is to eliminate state-level preemption across the United States. This study explored individual-level perceptions of the impact of state-level preemption in Appalachian Tennessee—a high-smoking, low-income region. During 2015–2016, a community-engagement project to develop a Population Health Improvement Plan (PHIP) involving over 200 stakeholders and 90 organizations was conducted in Appalachian Tennessee to identify policies/programs to address tobacco use. Using a multifaceted framework approach that focused on prevention, protection, and cessation, interviews and meeting discussions were audio-recorded and transcribed. Content analysis using NVivo 11 was conducted to generate themes. Although the central focus of the PHIP was not preemption, the issue emerged naturally in the discussions as a major concern among participants. Cultural and normative factors in Appalachian Tennessee were identified as key rationales for participants’ aversion to state preemption. Thus, repealing preemption would facilitate culturally tailored and region-specific policies/programs to the high tobacco use among Appalachian Tennessee communities where statewide/nationwide policies/programs have not had the intended impacts.

Suggested Citation

  • Hadii M. Mamudu & Fenose Osedeme & Crystal Robertson & Mary Ann Littleton & Daniel Owusu & Liang Wang & Donley T. Studlar, 2020. "A Qualitative Study to Explore Perception of Impacts of Preemption of Tobacco Regulation on Counties in Appalachian Tennessee," IJERPH, MDPI, vol. 17(9), pages 1-16, May.
    • Handle: RePEc:gam:jijerp:v:17:y:2020:i:9:p:3230-:d:354524
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    References listed on IDEAS

    as
    1. Ferketich, A.K. & Liber, A. & Pennell, M. & Nealy, D. & Hammer, J. & Berman, M., 2010. "Clean indoor air ordinance coverage in the appalachian region of the United States," American Journal of Public Health, American Public Health Association, vol. 100(7), pages 1313-1318.
    2. Nixon, M L & Mahmoud, L & Glantz, Stanton A. Ph.D., 2004. "Tobacco industry litigation to deter local public health ordinances: the industry usually loses in court," University of California at San Francisco, Center for Tobacco Control Research and Education qt3217s0k3, Center for Tobacco Control Research and Education, UC San Francisco.
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