Smokeless Tobacco and the Rural Teen: How Culture and Masculinity Contribute to Adolescent Use

Donald W. Helme, Carrie Oser, Hannah K. Knudsen, Edward Morris, Ana de la Serna, Carina Zelaya

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


Tobacco use is the leading preventable cause of disease, disability, and death in the United States. Smokeless tobacco (SLT) is primarily used by younger, rural males and often in the presence of other males. This formative study examined how hegemonic masculinity and male norms can lead to initiation and continued use of SLT by rural adolescent males and females. Survey data collected from high school sophomores in 4 rural high schools (n = 293) explores perceptions of masculinity and male norms’ contribution to SLT uptake and use. About 22.5% of total sample reported lifetime use (34.4% male, 13.7% female), 10.9% reported past-month use (20.0% male, 4.2% female). Logistic regressions show a one-unit increase in adherence to traditional perceptions of masculinity more than doubled the odds of ever using SLT and significantly increased odds of 30-day use. Having male household family members who uses SLT significantly increased the odds of lifetime and 30-day SLT use for both genders, while having male family members who smoke cigarettes was not a significant correlate. Recognition of health warnings on SLT packaging was negatively associated with SLT use for both genders. Implications for inclusion of masculinity and male role models in SLT prevention intervention strategies are discussed.

Original languageEnglish
Pages (from-to)311-318
Number of pages8
JournalJournal of Health Communication
Issue number3
StatePublished - Mar 4 2019

Bibliographical note

Funding Information:
This work was supported by the University of Kentucky, Office of the Vice President for Research.

Funding Information:
Address correspondence to Donald W. Helme Department of Communication, University of Kentucky, 271 Blazer Dining, Lexington, KY 40526-0012. Supported in part by a Research Support Grant from the University of Kentucky Office of the Vice President for Research

Publisher Copyright:
©, Copyright © Taylor & Francis Group, LLC.

ASJC Scopus subject areas

  • Health(social science)
  • Communication
  • Public Health, Environmental and Occupational Health
  • Library and Information Sciences


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