Related Experiment Video
Updated: Jul 17, 2026
Methods to Evaluate Cytotoxicity and Immunosuppression of Combustible Tobacco Product Preparations
Published on: January 10, 2015
Commercial tobacco retail marketing in rural communities in Appalachian Kentucky, 2024
Saber Feizy1,2, Judy van de Venne2, Melissa Abadi3
1Center for Health, Engagement, and Transformation, College of Medicine, University of Kentucky, Lexington, KY, United States of America.
Objective:
To investigate heterogeneous commercial tobacco marketing patterns across rurality gradient.
Methods:
We conducted audits in all retail stores (n = 279) selling at least one commercial tobacco/nicotine product in eight U.S. Appalachian Kentucky counties in 2024, comprising rural and peri-urban catchments. Trained auditors assessed product availability, discounts, and advertising. Stores were linked to census tract demographics and Index of Relative Rurality (IRR) quartiles. Poisson models assessed prevalence rates of exterior and interior ads and discounts for cigarettes, nicotine vapes, and nicotine pouches (ONP) by IRR quartiles.
Results:
Most stores carried cigarettes, cigarillos, and smokeless products, and over 50 % sold ONP, little cigars, and vapes. Lower proportions of stores in rural catchment carried ONP, little cigars, snus, and vapes. Stores in the least rural areas (Q1) had greater likelihood of exterior ads for vapes/ONPs. Stores across rural areas (Q1-Q3 vs Q4) had greater likelihood of interior vape ads. Stores in moderately-rural areas had greater likelihood of cigarette discounts inside (Q2 and Q3) and outside (Q3) stores (vs Q4).
Conclusions:
Conventional combustible and smokeless products were widely available throughout Appalachian Kentucky. Newer non-combustible products were less available in the most rural areas. Exterior store marketing was less present in the most rural areas.
