The long-term objective of this study is to improve health and among southern Appalachians. Tobacco is responsible for one in every six deaths in the United States, and southern Appalachian states have a higher incidence of smoking than other regions of the country. Baseline data about this under served and at risk population of smokers would allow development and testing of interventions to promote smoking cessation. The study will use a mixed methodology, beginning with a population-based descriptive cross-sectional study of a random sample of smokers in northeast Tennessee. The study will use random-digit dialing, and subjects will be mailed a written questionnaire if they agree to participate in the study. Over 3,ooo random phone numbers will be called in order to generate an anticipated sample of 750 smokers and former smokers. The questionnaire will include established measure of predictors of smoking cessation and constructs from the Transtheoretical Model of Health Behavior Change. Multivariate modeling procedures will be used to examine similarities between this unique sample and results from previous studies with urban northern samples. The cross-sectional study will be followed by a grounded theory qualitative study in order to generate an inductively derived theory of the process by which this population comes to not smoke. A purposive sample of approximately 15-25 smokers and former smokers will participate in taped interviews regarding their experiences with smoking and quitting. Transcribed interviews will be analyzed using grounded theory constant comparative and theory triangulation analysis methods to gain confirmation and completeness of data interpretation. Findings from phase one and phase two will be contrasted and compared to establish theory and findings from previous large national studies. Constructs from established theory may be expanded or supported with data from the Appalachian Tennessee sample.
