A Rural Appalachian Faith-Placed Smoking Cessation Intervention

Abstract

Although health promotion programming in faith institutions is promising, most faith-based or placed health projects focus on diet, exercise, or cancer screening and many have been located in urban environments. This article addresses the notable absence of faith programming for smoking cessation among underserved rural US residents who experience tobacco-related health inequities. In this article, we describe our faith-oriented smoking cessation program in rural Appalachia, involving 590 smokers in 26 rural churches randomized to early and delayed intervention groups. We present three main themes that account for participants’ positive evaluation of the program; the program’s ability to leverage social connections; the program’s convenience orientation; and the program’s financial support for smoking cessation. We also present themes on the roles of faith and church in smoking cessation programming, including some mixed perceptions on smoking stigma and comfort in church settings; challenges in faith-placed smoking cessation recruitment; and the positive perception of such programming by church leaders. We conclude that faith-placed smoking cessation program offer great potential, although they must be administered with great sensitivity to individual and community norms.

Smoking and Religion: Untangling Associations Using English Survey Data

“…There is, however, potential for all faiths provided it is recognised that religion is both more complex in terms of its role as an epidemiological construct (Levin 1996) and more complex than is commonly understood in health promotion (Liu et al 2016). As Ward et al (2014) note the link between religion and smoking can vary significantly across different religious communities and must (Schoenberg et al 2015) be deployed with careful attention to community norms if it is to be effective.…”

Study design, intervention, and baseline characteristics of a group randomized trial involving a faith-based healthy eating and physical activity intervention (Walk by Faith) to reduce weight and cancer risk among overweight and obese Appalachian adults

“…The baseline characteristics among study participants were similar to BRFSS data, except the self-reported current smoking rate (2.6%) was much lower than expected, suggesting that tobacco use may be less common among Appalachian residents who attend church regularly and voluntarily participate in a health-related study than among the general Appalachian population [57] or that tobacco use is underreported due to a perceived disapproval from fellow church members and church leaders [58]. …”

A randomized controlled trial of a faith-placed, lay health advisor delivered smoking cessation intervention for rural residents

“…Specifically, participants completed the MOS social support scale (19 Likert-type items, higher scores indicated higher levels of social support); ( Sherbourne and Stewart, 1991 ) the Fagerström nicotine dependence scale (6-item scale yielding both continuous and categorical levels of nicotine dependence); ( Buckley et al, 2005 ) adapted measures of smoking cessation self-efficacy (10 Likert-type items, higher scores indicated higher levels of self-efficacy); ( Velicer et al, 1995 ) and smoking cessation decisional balance (5 Likert-type items measuring perceived benefits, 5 Likert-type items measuring perceived barriers, higher scores indicated higher levels of each) ( Prochaska and DiClemente, 1983 ). Data from the formative phase focus groups ( Schoenberg et al, 2014 ) guided the development of a 10-item index of barriers to smoking cessation. Standard sociodemographic and health data were also collected, including race, age, education and income levels, insurance coverage, household composition, and a comprehensive series of questions on health status.…”