An inside view: Using photovoice to explore geocultural interpretations and meanings of smoking in rural low-income women

Background:  Designing successful smoking cessation interventions in vulnerable populations that are not responding to current cessation programs is challenging. High smoking rates continue in populations that share geographic location and/or social status.  To be effective and reduce smoking rates, future smoking cessation initiatives that target these specific populations should reflect an understanding of the geocultural interpretations and meanings associated with smoking as well as social contexts that influence decisions to quit. The purpose of this ongoing study is to uncover how local culture, history, social context, and social relationships influence low-income rural women's decision to smoke using photovoice as a research methodology.

Methods:  Photovoice, as a form of participatory research, is used in three rural North Carolina counties that have poverty, unemployment, and smoking rates above the state and national levels to uncover sociocultural factors that perpetuate smoking as well as those factors that influence the decision to quit smoking in rural low-income women.

Results:  Analysis of participant produced photos and transcribed semi-structured interviews provides an understanding of how study participants experience their world and insight into the nuances and complex social-cultural meanings of smoking in rural low-income women. In addition to presenting the supporting theoretical framework of this methodology, process related findings around study recruitment, enrollment, and participant response to this research methodology will be discussed. This information is useful as targeted smoking cessation interventions are designed that reflect the relationship between local culture, social identity, social networks and social support to an individual's health related decisions.