Abstract
Objective: To investigate heterogeneous commercial tobacco marketing patterns across rurality gradient.
Methods: We conducted audits in all retail stores (n = 279) selling at least one commercial tobacco/nicotine product in eight U.S. Appalachian Kentucky counties in 2024, comprising rural and peri-urban catchments. Trained auditors assessed product availability, discounts, and advertising. Stores were linked to census tract demographics and Index of Relative Rurality (IRR) quartiles. Poisson models assessed prevalence rates of exterior and interior ads and discounts for cigarettes, nicotine vapes, and nicotine pouches (ONP) by IRR quartiles.
Results: Most stores carried cigarettes, cigarillos, and smokeless products, and over 50 % sold ONP, little cigars, and vapes. Lower proportions of stores in rural catchment carried ONP, little cigars, snus, and vapes. Stores in the least rural areas (Q1) had greater likelihood of exterior ads for vapes/ONPs. Stores across rural areas (Q1-Q3 vs Q4) had greater likelihood of interior vape ads. Stores in moderately-rural areas had greater likelihood of cigarette discounts inside (Q2 and Q3) and outside (Q3) stores (vs Q4).
Conclusions: Conventional combustible and smokeless products were widely available throughout Appalachian Kentucky. Newer non-combustible products were less available in the most rural areas. Exterior store marketing was less present in the most rural areas.
Document Type
Article
Publication Date
2025
Digital Object Identifier (DOI)
https://doi.org/10.1016/j.pmedr.2025.103354
Funding Information
This work was supported by grant number U54DA058256 from the National Institute of Drug Abuse (NIDA) of the National Institutes of Health (NIH), and the Food and Drug Administration (FDA) Center for Tobacco Products (CTP). The content is solely the responsibility of the authors and does not necessarily represent the official views of NIDA, NIH, or FDA/CTP.
Repository Citation
Feizy, Saber; van de Venne, Judy; Abadi, Melissa; Christian, W. Jay; Jayawardhana, Jayani; Fennell, Bethany Shorey; Mattingly, Delvon T.; and Rose, Shyanika W., "Commercial tobacco retail marketing in rural communities in Appalachian Kentucky, 2024" (2025). Behavioral Science Faculty Publications. 97.
https://uknowledge.uky.edu/behavsci_facpub/97
Notes/Citation Information
2211-3355/© 2025 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).