A Bridge to Understanding Smoking among Women in Rural Central Appalachia: Qualitative Interviews with Local Nurses


  • Cathy Jo Baker Ohio University
  • Sarah Catherine Showalter Ohio University




The rural Central Appalachian area of Southeast Ohio has a persistently higher rate of tobacco-related women’s health issues, low birth weight, and preterm birth than other parts of the state and the nation. Nurses from Appalachia can provide a bridge for health care providers who are not from the region to understand the perspectives of people who reside in Central Appalachian counties. The purpose of this study was to learn more about the influences and the special needs in Central Appalachia to inform women’s health promotion and smoking cessation interventions.

Method: Semi-structured small focus group and individual interviews were conducted with 15 nurses working with women in rural Central Appalachia. Participants were asked about smoking and smoking cessation in relation to their knowledge and experience of women in their home county.

Findings: Major themes discovered included reasons for smoking, reasons for quitting, barriers to quitting, and perceptions of current interventions. The influence of the rural social environment on smoking, such as smokers in the social network and ambivalence toward the dangers of smoking, were particularly emphasized.

Conclusions: The particularly strong influence of the social environment is a force for change that must be considered in women’s health promotion activities in this area. Tips for quitting smoking in Public Health Service guidelines may be more discouraging than helpful for women in the region according to study participants. Using the information gathered, smoking cessation interventions for rural women in this region should incorporate salient issues such as the social environment, smokers in the household, and the desire for gradual smoking cessation. The data suggests that the social context of smoking may dramatically affect smoking cessation efforts in this region. 

Keywords: Smoking cessation, Women’s health, Appalachia

DOI:  http://dx.doi.org/10.14574/ojrnhc.v18i1.505