Smoke-free coalition cohesiveness in rural tobacco-growing communities

Karen M. Butler, Kathy Begley, Carol Riker, Yevgeniya Gokun, Debra Anderson, Sarah Adkins, Rachael Record, Ellen J. Hahn

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


Promoting tobacco control policies in rural tobacco-growing communities presents unique challenges. The purpose of this study was to assess smoke-free coalition cohesiveness in rural communities and identify coalition members' perceived barriers or divisive issues that impede the development of smoke-free policies. A secondary aim was to evaluate differences in coalition cohesiveness between advocates in communities receiving stage-based, tailored policy advocacy assistance versus those without assistance. Tobacco control advocates from 40 rural Kentucky communities were interviewed by telephone during the final wave of a 5-year longitudinal study of community readiness for smoke-free policy. On average, five health advocates per county participated in the 45-min interview. Participants rated coalition cohesiveness as not at all cohesive, somewhat cohesive, or very cohesive, and answered one open-ended question about potentially divisive issues within their coalitions. The mean age of the 186 participants was 48.1 years (SD = 13.3). The sample was predominantly female (83.6 %) and Caucasian (99.5 %). Divisive concerns ranged from rights issues, member characteristics, type of law, and whether or not to allow certain exemptions. Three of the divisive concerns were significantly associated with their rankings of coalition cohesiveness: raising tobacco in the community, the belief that smoke-free would adversely affect the economy, and government control. Educating coalition members on the economics of smoke-free laws and the actual economic impact on tobacco-growing may promote smoke-free coalition cohesiveness. More resources are needed to support policy advocacy in rural tobacco-growing communities as well as efforts to reduce the divisive concerns reported in this study.

Original languageEnglish
Pages (from-to)592-598
Number of pages7
JournalJournal of Community Health
Issue number3
StatePublished - Jun 2014

Bibliographical note

Funding Information:
Acknowledgments The project described was supported by Award Number R01HL086450 from the National Heart, Lung, And Blood Institute (E. Hahn, PI). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Heart, Lung And Blood Institute or the National Institutes of Health.


  • Coalitions
  • Community readiness
  • Smoke-free laws
  • Tobacco control

ASJC Scopus subject areas

  • Health(social science)
  • Public Health, Environmental and Occupational Health


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