Developing Messages to Prevent Smokeless Tobacco and Nicotine Pouch Uptake Among Early Career Rural Firefighters in California: A Qualitative Study

This study describes participants' views and insights into crafting effective communication aimed at smokeless tobacco and nicotine pouch prevention among fire academy trainees and new recruits. Firefighters have elevated rates of smokeless tobacco use compared with the general population. Nicotine pouches have also gained popularity among this occupational group. We launched a pilot project centered in rural Northern California counties to uncover factors that can be used to communicate smokeless tobacco and nicotine pouch prevention messages within the firefighter workplace. As a first step, we conducted semi-structured interviews with firefighter subject matter experts, including fire chiefs, fire academy instructors, wildlands firefighters, and recent fire academy graduates. This purposive sample (<i>n</i> = 13) was obtained through referrals from the project's Community Advisory Board, composed of fire service professionals. Interviews were audio recorded and transcribed. Next, the qualitative interviews were thematically analyzed. The results focus on two aspects of effective workplace communication in the service to delivery of smokeless tobacco and nicotine pouch prevention messages: content (core information conveyed in a message), and format (how the message is transmitted or displayed). Examples of the former are the importance of keeping oneself healthy so that one can do one's job; do not risk a future compensation claim due to smokeless tobacco or nicotine pouch use. Examples of the latter are the use of brevity; humor. Because firefighters often initiate use of these products after they join the fire service, communicating prevention messages in the workplace during the firefighter training and recruitment stage may help disrupt the uptake of nicotine products.