# AppalTRuST Project 2: Exposure to tobacco marketing for novel tobacco products and associations with future tobacco use in Appalachian young adults: tobacco regulatory science implications

> **NIH NIH U54** · UNIVERSITY OF KENTUCKY · 2024 · $564,788

## Abstract

ABSTRACT – Project 2
Federal tobacco regulatory policies enacted by the US Food and Drug Administration (FDA) are critical to curb
the tobacco epidemic in rural Appalachia and reduce cancer burden. Kentucky (KY) is 50th in the nation for
adult smoking rates with 21.4% of KY adults smoking cigarettes, a rate not seen nationally in 20 years.
Kentucky also has wide geographic disparities between rural and urban residents particularly in Appalachian
KY, an economically disadvantaged part of the state. In this context, Federal policies can be particularly
influential in areas with weak tobacco control policies and high rates of tobacco use. In particular, (1) the
introduction of novel non-combustible products, (2) product standards on flavored cigars/menthol cigarettes
and (3) lowering nicotine in cigarettes have great potential to shift the tobacco marketplace, moving rural
Appalachian residents to quit smoking, switch to potentially less harmful products, or never initiate tobacco use
at all. Project 2 seeks to expand the evidence base about the extent to which marketing exposure, tobacco use
behaviors, and attitude towards tobacco products differ across rural communities and the extent to which
regulatory actions by the FDA can potentially reduce use of tobacco among young adults in these areas.
Additionally, few studies examine how the retail environment, novel products, and potential policies could
interact to reduce tobacco-related health disparities among young adult populations by rurality. Tobacco
retailer density is higher in rural areas by population but little is known about how retailers’ market in stores in
this region. The purpose of the study is to examine how marketing and product availability of such novel
tobacco products may change over time and how these patterns may influence tobacco use attitudes and
patterns in rural communities, providing guidance on future policy targets. To accomplish the study purpose,
we will conduct several aims. (1) We will assess marketing trends over time in retail store and digital audits
(store websites and social media) in tobacco retailers in 2 rural catchment areas of KY. (2) We will compare
marketing exposure to and appeal and harm perceptions of novel products in young adults through ecological
momentary assessment (EMA), evaluating differences by rurality at the individual and census tract level. (3)
Finally, among EMA participants, we will assess the predictive validity of exposure to novel product marketing
exposure on use of tobacco at 6-month and 12-month follow-up, and evaluate whether these outcomes are
associated with rurality. For all of these activities, we will partner closely with the AppalTRUST team, cores,
and local community advisory boards to disseminate lessons learned to communities about industry actions
and potential regulatory policies. Achieving the aims of this Project will expand the evidence base of the
potential impacts of FDA policies on reducing tobacco use and potent...

## Key facts

- **NIH application ID:** 10934522
- **Project number:** 5U54DA058256-02
- **Recipient organization:** UNIVERSITY OF KENTUCKY
- **Principal Investigator:** Shyanika W Rose
- **Activity code:** U54 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $564,788
- **Award type:** 5
- **Project period:** 2023-09-30 → 2028-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10934522

## Citation

> US National Institutes of Health, RePORTER application 10934522, AppalTRuST Project 2: Exposure to tobacco marketing for novel tobacco products and associations with future tobacco use in Appalachian young adults: tobacco regulatory science implications (5U54DA058256-02). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/10934522. Licensed CC0.

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