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Tobacco regulation research focuses impact on Appalachia


The University of Kentucky is planning to research how people across Appalachia access and use tobacco products, as well as the effects on public health throughout the region. Officials said their findings will be passed on to federal regulators to consider as they make rules regarding tobacco.

The Appalachian Tobacco Regulatory Science Team, or AppalTRUST, was awarded a Tobacco Centers of Regulatory Science grant last month, valued at $19 million over five years of research.

According to the Centers for Disease Control and Prevention, 22.5% of Kentucky high school students reported they used tobacco products in 2021, and 4.9% reported using cigarettes. 19.5% of adults in the Commonwealth also reported smoking cigarettes in 2021.

Officials said AppalTRUST will conduct studies in northeastern and southeastern Kentucky, allowing the researchers to gain perspective on relatively urban and rural areas of Appalachia alike.

Dr. Seth Himelhoch is a Co-Director for Administration for AppalTRUST and chair of the Department of Psychiatry at the UK College of Medicine. He said researchers throughout the university hypothesize the study’s results will reflect rural heterogeneity, or the concept of distinct differences between rural communities.

“We are probably the first center that is going to be looking at this idea of rural heterogeneity and really exploring, through a rural lens, issues that really affect tobacco regulation. And I think it’s a real win for Kentucky and for the people of Kentucky, and for our state to finally be a part of the larger conversation,” said Himelhoch.

Dr. Ellen Hahn is an Associate Director of AppalTRUST and a professor at the University of Kentucky College of Nursing. She said these studies will look at a full range of tobacco habits to properly inform public health.

“The whole point of it is to have a deeper understanding of where people are purchasing these products, as well as not only where, but which kind they’re purchasing,” said Hahn. “And why that’s important is, this center will take whatever we’re finding as a group and hopefully inform the Food and Drug Administration when they come up with their rules about regulating these tobacco products.”

The research is comprised of three separate projects investigating tobacco use and consumer behaviors, marketing and FDA regulations in the region, and an experimental tobacco marketplace model. Hahn said the experimental marketplace is a relatively new research method that will simulate consumer habits, and how those purchases change over time, in a controlled virtual environment.

“You’re taking this on your computer, and then you’ll decide which ones you’ll buy and they’ll be different prices and they’ll be different kinds, and they’ll have- maybe some will have more nicotine in them than others. And so, they’re all going to be different products, and people will have to choose and then take survey questions about why they picked the things they picked,” said Hahn.

Officials said the experimenters will provide hotspots, tablets, and other equipment for rural participants with limited internet access.

Himelhoch said rather than taking tobacco products away from participants, the project aims to discover the role tobacco plays in communities across eastern Kentucky.

“We imagine that the team is larger to include all the communities that will be working. And we recognize that trust is extremely important in those communities,” said Himelhoch. “So we not only, want to give to the communities, right? But we want to learn from them and understand, and then provide back what we’ve learned and understood with them,” said Himelhoch.

AppalTRUST is scheduled to begin recruiting participants in early 2024. Officials said the projects will also begin hiring for field staff positions in the coming months.