Tobacco use, typically initiated during adolescence, can escalate into young adulthood, even among experimenting or intermittent users. Despite declines in cigarette smoking among US adolescents, use of other tobacco products and poly-tobacco are on the rise among Appalachian adolescents. Unfortunately, Appalachian adolescent tobacco users also are less likely to receive effective tobacco interventions due to various barriers: a) accessibility (e.g. service and provider shortages, affordability, and transportation; b) acceptability (e.g. issues of privacy and stigma); and c) cultural relevance. The present review provides critical considerations synthesized from an extensive body of literature on the suitability of virtual tobacco interventions, the need for well-timed interventions that address complex tobacco use, and the rationale for leveraging and scaling evidence-based interventions inform novel interventions for Appalachian adolescent tobacco users. Borrowing strength from existing in-person evidence-based adolescent tobacco interventions and state-of-the-art virtual health services, a well-planned virtual scale out of tobacco interventions holds potential to minimize barriers unique to Appalachia.

Original languageEnglish
Article number39
JournalTobacco Prevention and Cessation
Issue numberNovember
StatePublished - Nov 2022

Bibliographical note

Publisher Copyright:
© 2022 Horn K. et al. This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 International License. (https://creativecommons.org/licenses/by/4.0/)


  • Adolescent tobacco cessation
  • Rural youth tobacco prevention
  • Virtual tobacco intervention

ASJC Scopus subject areas

  • Epidemiology
  • Health(social science)
  • Health Professions (miscellaneous)
  • Public Health, Environmental and Occupational Health


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