Cigarette use among Canadian undergraduates

The attitudes and behaviors of students, staff and faculty towards smoke-free and tobacco-free campus policies in North American universities: A narrative review

INTRODUCTION

In Canada, a series of recent public health policies and interventions have successfully led to a decline in national tobacco use rates. However, tobacco use among young adults remains high and the tobacco industry continues to place a strong marketing emphasis towards young adults on university campuses. In response, many universities across Canada are beginning to adopt smoke-free or tobacco-free campus policies. While the effectiveness of smoke-free and tobaccofree campus policies has been demonstrated in several countries, little is known about the attitudinal responses of university students, faculty and staff towards these policies. As such, we conducted a review of the literature to summarize the findings of studies conducted in North America regarding the attitudes and beliefs of campus community members towards smoke-free or tobacco-free campus policies.

METHODS

Using a pre-defined search strategy and Boolean string, we searched three databases for published articles pertaining to the research question. Only primary and peer-reviewed articles of studies conducted on North American university campuses were eligible for inclusion. Studies included for review were those published in English within the last five years. All studies included in the review contained outcome measurements related to the attitudes and behaviors of faculty, staff and students towards smoke-free and/or tobacco-free campus policies.

RESULTS

A total of 11 articles were included for analysis and result synthesis. Recent research indicates that individuals' attitudes and beliefs towards smoke-free or tobacco-free campus policies are influenced by social norms, smoking status, secondhand smoke exposure, and sociodemographics.

CONCLUSIONS

This literature review provides timely information for universities in the process of developing or implementing a smoke-free campus policy. The attitudes and beliefs of university students, faculty and staff can determine success and compliance to newly implemented smoke-free campus policies.

The impact of tuition fees amount on mental health over time in British students

BACKGROUND

Previous studies have shown a relationship between debt and mental health problems in students. This study aimed to examine the effect of differences in tuition fees amount on changes in mental health over time.

METHODS

A prospective cohort study followed 390 first-year British students who differed on their tuition fees level at 4 time points across their first 2 years at university. Participants completed measures of global mental health, depression, anxiety, stress, alcohol-related problems at up to four time points in their first two years at university. Mixed-factorial ANOVAs were used to assess the impact of tuition fees amount on changes in scores over time.

RESULTS

There was no difference based on fees at Time 1 for anxiety, stress, depression and global mental health. At Time 2, those charged £0-2.9k or £3-4k improved while those charged £8-9k stayed the same. However, this trend reversed by Times 3 and 4.

CONCLUSIONS

Undergraduates mental health is partially affected by the level of tuition fees; however, the recent increase in tuition fees does not appear to have had a lasting impact at present.

Taking the right action in the right way: a comparison of frameworks for assessing the health and quality of life of a postsecondary student campus community

The focus of campus health research, historically, has been on population health at the individual or aggregate level with little effort to examine the health of the students at a community level with a focus on the broader determinants of health and community-level intervention. The purpose of this article is to critique three models or frameworks of campus health, articulate the World Health Organization (WHO) vision of a health-promoting university, and demonstrate the efficacy of adapting the Community Health Action model for use in university and college settings. Foundational within this proposed model is taking the right action using the right process, an inclusive participatory process. Adaptation of the model requires careful attention to student engagement in community, a healthy campus infrastructure and processes, and relationships beyond the campus. Effective student community assessment and improvement of student community health, ultimately, will serve to generate knowledge and build skills at various levels to benefit the health and quality of life of the students, their student community, the educational institution, and the broader community.

Patterns of associations between eating disordered behaviors and substance use in two non-clinical samples: a university and a community based sample

This study examined shared patterns of associations between disordered eating behaviors and substance use in two different non-clinical samples of young women. Participants were recruited from a university (526 women) and varied community (517 women) settings. Participants completed the Women's Health Survey, examining engagement in a wide range of licit and illicit substances and disordered eating patterns during the past 12 months. In both samples, the cluster of bingeing, dieting and purging was significantly associated with binge drinking, drinking associated with negative consequences, and with cocaine use. The cluster of dieting and purging was associated with the use of stimulants/amphetamines. Health services, including assessment and treatment, and health promotion activities, should consider these patterns of comorbidity.

Social norms of alcohol, smoking, and marijuana use within a Canadian university setting

OBJECTIVE

to study actual and perceived substance use in Canadian university students and to compare these rates with US peers.

PARTICIPANTS

students (N = 1,203) from a large Canadian university.

METHODS

participants were surveyed using items from the National College Health (NCHA) Assessment of the American College Health Association questionnaire.

RESULTS

alcohol was the most common substance used (65.8%), followed by marijuana (13.5%) and cigarettes (13.5%). Substance use and norms were significantly less than the NCHA US data. Overall, respondents generally perceived the typical Canadian student to have used all 3 substances. Perceived norms significantly predicted use, with students more likely to use alcohol, cigarettes, or marijuana if they perceived the typical student to use these substances.

CONCLUSIONS

similar to their US peers, Canadian university students have inaccurate perceptions of peer substance use. These misperceptions may have potentially negative influences on actual substance use and could be a target for intervention. Further research examining the cross-cultural differences for substance abuse is warranted.

Campus physicians' tobacco interventions with university students: a descriptive study of 16 Ontario university clinics

OBJECTIVE

About one-quarter of Canadian post-secondary students smoke cigarettes. We examined how physicians from Ontario university health clinics intervene with these young adult smokers.

METHOD

A convenience sample of 16 universities was identified and surveys were hand-delivered to all 228 physicians from these schools. A total of 125 doctors (54.82%) responded; 70 were from universities that were involved in a government-sponsored, coordinated, multi-campus, tobacco control initiative.

RESULTS

Twenty percent of doctors reported asking all or almost all patients about tobacco use; 25.22% asked fewer than half. Describing how they respond to patients identified as smokers, 96.00% of physicians advised cessation, 72.00% offered assistance, and 64.00% arranged for follow-up. Doctors discussed patients' tobacco use with 78.59% of smokers. Nicotine replacement therapies were rarely offered to patients wanting to quit. Doctors from universities involved in the tobacco control initiative were more likely to keep patient education materials in the examining room.

CONCLUSION

Because most doctors ask only some patients about tobacco use, they may be missing opportunities to provide appropriate advice and assistance to all smokers.

PRACTICE IMPLICATIONS

Physician education and support to the clinic are needed to improve the frequency and quality of physician-delivered smoking cessation services to post-secondary students.

Characteristics of smoking among physicians in the Federal District of Brazil

OBJECTIVE

To profile the characteristics of smoking among physicians working in the Federal District of Brazil.

METHODS

A questionnaire on smoking, adapted from that used by the World Health Organization, was mailed to all physicians registered with the Federal District Regional Council of Medicine. Of the 7023 questionnaires mailed, 830 (12%) were duly completed and returned.

RESULTS

Among the physicians participating in the study, the prevalence of smoking was 7.2% (5.9% being regular smokers and 1.3% being occasional smokers). The remainder of the sample consisted of nonsmokers (70.1%) and former smokers (22.7%). In terms of gender, approximately 8.5% of the male physicians were smokers, compared with 5.3% of the female physicians (p > 0.05). Of the physicians who smoked, 80% had taken up the habit before the age of 20, 13% from 21 to 30, and 7% after the age of 31. The prevalence of smoking by specialty was as follows: Surgeons, 10.3%; Anesthesiologists, 10.3%; Clinicians, 9.1%; Gynecologists, 2.9%; and Pediatricians, 2.4%. Approximately 75% of the smoking physicians had been advised by their own doctors to stop smoking, although only 34.9% had tried to quit smoking with the preceding year. Of the physicians responding, 57.1% agreed that smoking is a health hazard, and 26.3% reported smoking in hospitals or doctors offices.

CONCLUSION

Efforts to control smoking in the Federal District should be intensified and, despite the fact that the prevalence of smoking is declining among physicians, smoking cessation programs should target this population.

Prevalence and characteristics of smoking among youth attending the University of Brasília in Brazil

OBJECTIVE

To determine the prevalence of smoking and to describe the profile and smoking habits of students attending the Universidade de Brasília (University of Brasília) in Brasília, Brazil.

METHODS

A total of 1341 students responded to a smoking questionnaire, adapted from the World Health Organization questionnaire, including questions directed at smokers, former smokers and nonsmokers. Twenty different courses in the areas of health, exact sciences and human sciences were evaluated. The students included in the study were duly enrolled in day courses and were evaluated during the second semester of 2003.

RESULTS

The overall prevalence of smoking was 14.7%. Approximately 80.8% of the students were nonsmokers, and 4.5% were former smokers. In the study sample, 57.3% of the students were male. No significant difference (p > 0.05) in the prevalence of smoking was observed in terms of gender or class year. The mean age of the study population was 21.6 +/- 3.6 years, and the mean age at which the smoking habit was acquired was 17 +/- 2.8 years. The percentage of smokers was higher in the Geology, Communication, and History courses (32.9, 26.3 and 24.4%, respectively). Mean consumption was 7.5 cigarettes per day. The majority (72.6%) of the students used commercial cigarettes rather than other types of tobacco.

CONCLUSION

The high prevalence of smoking observed in the present study is similar to that reported for other universities and indicates the need for smoking control policies in university environments.

The relationship between college class and cigarette smoking

Purpose

The purpose of this paper is to explore the relation between college class and cigarette‐smoking behavior in the USA.

Design/methodology/approach

National College Health Risk Behavior Survey (NCHRBS) data were employed. Five binary and two cumulative logit equations are estimated to explore the impact of college class on: having ever tried smoking cigarettes; having smoked in the past 30 days; having ever smoked on a daily basis; whether the student currently smoked daily; whether the student had quit entirely, that is, had not smoked for the past 30 days; the number of days smoked per month; and the number of cigarettes smoked per day.

Findings

The paper finds that second‐year students were more likely than other undergraduates to be current cigarette smokers. Among current smokers, first‐ and second‐year students smoked the most days per month and second‐year students smoked the most cigarettes per day. Of students who had ever smoked on a daily basis, third‐year students were least likely to have quit and fourth‐year students were most likely.

Research limitations/implications

The paper shows that since the NCHRBS was conducted only in 1995, there is no follow‐up data to determine whether the patterns have continued. It is also more difficult to disentangle college class effects from cohort and period effects.

Originality/value

This paper shows heterogeneity in college smoking and encourages efforts to better target anti‐smoking activities for greater effectiveness.

Associations between disordered eating behaviors and licit and illicit substance use and abuse in a university sample

OBJECTIVES

To examine associations between discrete eating disordered behaviors as well as clusters of eating disordered behaviors in relation to the use and abuse of a wide spectrum of substance classes, both licit and illicit, in a female university sample.

METHODS

Women with particular types of eating disordered behaviors were selected from a pool of 526 students who completed the Women's Health Survey. Analyses compared the frequencies of lifetime engagement in a wide range of licit and illicit substances between each of the eating disorder groups and the normal control group.

RESULTS

Associations were found between severe levels of alcohol consumption and binge eating, dieting with purging and the use of central nervous stimulants, and bingeing with dieting and tobacco use and the abuse of prescription medications.

CONCLUSION

Examining a broad range of substance classes, with differing physiological properties and effects, in relation to specific disordered eating behaviors, could contribute to theory development regarding the functions of the specific co-occurring behaviors.

Physical activity, smoking, and obesity among Canadian school youth. Comparison between urban and rural schools

BACKGROUND

More information is needed to document the prevalence of health risk factors in youth. The purpose of this study is to compare the prevalence of physical inactivity, smoking and overweight/obesity among youth in urban and rural schools.

METHODS

Data were obtained from a Student Physical Activity and Smoking Survey of 2,697 high school students in four urban schools in Ontario and four rural schools in Alberta. Prevalence of physical inactivity was assessed by examining compliance with Canada's Physical Activity Guide to Healthy Active Living, and with daily energy expenditure classification values. Prevalence of smoking was assessed by examining current smoking status. Overweight and obesity prevalences were examined by comparing BMI values to the BMI index for age and sex percentiles set by the Centers for Disease Control and Prevention.

RESULTS

Physical activity prevalence was found to be low in our study, with only 57.0% of youth achieving Canada's Physical Activity Guidelines, and with 26.0% classified as sedentary based on the daily energy expenditure classification values. A higher proportion of rural students reported "trying smoking" than urban school students (73.0% versus 64.4%, p<0.001). A significantly higher proportion of rural males were 'overweight' than urban males, and a significantly higher proportion of rural females were 'obese' in comparison to urban females.

CONCLUSION

Our findings add further support for an urgent need to promote physical activity among Canadian youth. Additionally, our results suggest that it is especially important to target rural students, particularly girls, for smoking prevention programs. Future studies are required to examine such rural and urban differences within provinces.

Physical activity, smoking, and obesity among Canadian school youth. Comparison between urban and rural schools

BACKGROUND

More information is needed to document the prevalence of health risk factors in youth. The purpose of this study is to compare the prevalence of physical inactivity, smoking and overweight/obesity among youth in urban and rural schools.

METHODS

Data were obtained from a Student Physical Activity and Smoking Survey of 2,697 high school students in four urban schools in Ontario and four rural schools in Alberta. Prevalence of physical inactivity was assessed by examining compliance with Canada's Physical Activity Guide to Healthy Active Living, and with daily energy expenditure classification values. Prevalence of smoking was assessed by examining current smoking status. Overweight and obesity prevalences were examined by comparing BMI values to the BMI index for age and sex percentiles set by the Centers for Disease Control and Prevention.

RESULTS

Physical activity prevalence was found to be low in our study, with only 57.0% of youth achieving Canada's Physical Activity Guidelines, and with 26.0% classified as sedentary based on the daily energy expenditure classification values. A higher proportion of rural students reported "trying smoking" than urban school students (73.0% versus 64.4%, p<0.001). A significantly higher proportion of rural males were 'overweight' than urban males, and a significantly higher proportion of rural females were 'obese' in comparison to urban females.

CONCLUSION

Our findings add further support for an urgent need to promote physical activity among Canadian youth. Additionally, our results suggest that it is especially important to target rural students, particularly girls, for smoking prevention programs. Future studies are required to examine such rural and urban differences within provinces.