Analyzing Exposure, Use, and Policies Related to Tobacco Use on Campus for the Development of Comprehensive Tobacco Policies at Canadian Post-secondary Institutions

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.

Development and evaluation of smoke-free or tobacco-free policies in university settings: a systematic scoping review

We conducted a systematic scoping review to map the available evidence on smoke-free or tobacco-free (SF/TF) university policies globally. We specifically looked at (i) how policies were developed and communicated and (ii) what indicators were used to evaluate their impact. We searched for peer-reviewed literature, published up to January 2020, across 10 multi-disciplinary databases. We followed a duplicate, independent data selection, and charting process. We inductively categorized the studies according to the research design and objective of 'process' and 'impact evaluation'. We identified 75 unique studies across 23 countries conducted between 1993 and 2019. Most studies were conducted in the United States (46/75, 61.3%), were based on quantitative research design and focused on impact evaluations; a third (n = 28) reported both process and impact evaluations (37.3%). Community engagement and multi-channel communication strategies were mostly used to disseminate SF/TF policies. The impact was determined by a wide range of indicators for knowledge, attitudes and behaviors related to policies. There is a mature, relevant body of literature describing the development and evaluation of SF/TF policies in universities. Future reviews could quantify the impact of the bans and may consider process indicators as moderating factors to explain the potential heterogeneity of results.

Predicting students' noncompliance with a smoke-free university campus policy

The adoption of university campus smoke-free and tobacco-free policies has risen dramatically, but research on effective implementation is scant. Significant challenges exist regarding policy implementation, particularly enforcement. This study examined college students' noncompliance with a recently implemented smoke-free campus policy at a public university. The sample included students who reported past-month smoking of tobacco or e-cigarettes in a 2013 web-based survey, 9 months after a smoke-free campus policy took effect. Ordinal logistic regression was used to examine predictors of students' having smoked on campus since the policy began (n = 1055). Predictor variables included past-month use of cigarettes, e-cigarettes, smokeless tobacco, and non-cigarette tobacco products, secondhand smoke (SHS) exposure, support for a smoke-free campus, tobacco-related social norms, use of strategies to deal with smoking urges, and other variables. In multivariate analysis, policy violation was positively associated with past-month use of cigarettes and non-cigarette combustible tobacco, SHS exposure on campus, living on campus, and use of nicotine gum/patches to handle urges. Violation was negatively associated with smoke-free campus support, age, estimates of student policy support and cigarette smoking, and self-reported absence of smoking urges. Results suggest that nicotine dependence may be an underlying influence on policy violation. Several recommendations are offered. First, upon policy adoption, campuses should ensure student smokers' access to cessation support and assistance with dealing with nicotine cravings. Second, campus information campaigns should focus particularly on younger students and those living on campus. Third, campuses should establish strong anti-tobacco norms, monitor SHS exposure, and communicate levels of students' policy support.

Predictors of support among students, faculty and staff for a smoke-free university campus

OBJECTIVES

Students, faculty, and staff at a Pacific Northwest public university were surveyed one year after enactment of a smoke-free campus policy. Objectives were to assess levels of support for a smoke-free campus, ascertain exposure levels to outdoor tobacco smoke, and identify correlates of policy support.

METHOD

A 2013 Web-based survey included 5691 students (response rate 26%) and 2051 faculty/staff (response rate 43%). Measures included support for a smoke-free campus, smoking status, exposure to secondhand smoke, and perceptions of levels of policy support and campus smoking. Logistic regression was used to examine predictors of support.

RESULTS

Seventy-two percent of students and 77% of faculty/staff supported a smoke-free campus. Respondents reported limited exposure to smoke near building entrances, but exposure near campus boundaries was reported by majorities of students (77%) and faculty/staff (55%). Predictors of students' policy support included never-smoker status, perceived support by peers, perceived student smoking prevalence, campus smoke exposure, and female gender, among others. Predictors of faculty/staff support included never-smoker status, perceived policy support by students and peers, campus smoke exposure, female gender, and age.

CONCLUSION

Students, faculty, and staff were strongly supportive of the existing smoke-free campus policy. However, the policy led to smoking activity shifting to the campus periphery.