US public universities' compliance with recommended tobacco-control policies

Mothers' Out-of-Sequence Postsecondary Education and Their Health and Health Behaviors

Ample research suggests that the links between higher education and heath are robust and growing in strength. This research, however, tends to assume education was completed prior to assuming other adult roles. Importantly, the life course framework raises the question of whether "out-of-sequence" college completion conveys similar health returns. I investigate this question among a population for whom out-of-sequence schooling has grown more common: lower-educated mothers. This focus is also important given the growing education gap in women's health and the links between maternal and child health. Data come from the Fragile Families and Child Wellbeing Study (N = 4,898). Analyses involve random intercept and fixed effects models and diverse health measures. Findings suggest that postsecondary education does not improve mother's health, except for reduced smoking among mothers with high school degrees or less that earned bachelor's degrees. These findings inform health policy debates and theories linking education to health.

A Review of Tobacco Policies on University of California Campuses

Background and Purpose

College and university tobacco control programs have historically neglected cessation. In 2012, the University of California Office of the President (UCOP) released a Smoke and Tobacco Free policy that became effective in January 2014. The policy provided for a comprehensive education and outreach campaign that included resources and referrals for cessation. We sought to determine whether all University of California (UC) campuses met UCOP standards.

Methods

We reviewed the Smoke & Tobacco Free policies created by UCOP and posted at ten UC campuses, searched the tobacco free websites of each campus for cessation resources, and contacted tobacco-free task forces.

Results

We found that all UC campuses met the UCOP standard by addressing tobacco cessation in their campus policies. The provision of cessation services and resources was limited and varied substantially by campus, and no campuses reported collecting data on the use of cessation programs.

Conclusion

Consistent with concerns that college and university tobacco policies neglect cessation, UC campuses mentioned tobacco cessation resources and programs but did not provide consistent services. These campuses also did not report on the use of tobacco cessation resources, making it difficult to assess the effects of offering different types of cessation programs.

A Mixed-Methods Assessment of a Peer-Enforced Tobacco- and Smoke-Free Policy at a Large Urban University

The study aims to evaluate the enforcement, opinions, and effectiveness of the University of South Florida's tobacco free policy one year following implementation. By assessing readiness to change and using geographic information system (GIS) mapping this study sought to introduce a unique and effective way of evaluating college tobacco free policies. A cross-sectional survey was administered to students, faculty, and staff to assess knowledge of policy and resources, tobacco use observations, stage change regarding policy enforcement, self-efficacy to enforce, and policy impact on perceived campus tobacco use (n = 5242). Additionally, using ArcGIS Collector (in: ESRI, ArcGIS desktop: release 10, Environmental Systems Research Institute, Redlands, 2011) volunteers collected geospatial data on tobacco use continuing to occur on campus following policy implementation. Overall there was moderate knowledge of the current policy and low beliefs for policy enforcement. Majority of respondents were not approaching violators to remind them of the policy and did not plan to do so in the future. There were statistically significant differences between smokers and non-smokers as well as between students and faculty and staff. The mapping of observed violations revealed continued tobacco use on campus with 158 data points. From both the geospatial results as well as the survey findings, the current policy is ineffective in reducing tobacco use across campus. With rapidly increasing numbers of smoke and tobacco free universities, new and innovative evaluation tools are needed so institution leaders can efficiently evaluate their implementation.

Online readiness assessment for Smoke- and Tobacco-free campus policies

OBJECTIVE

Develop and test an online survey to assess campus readiness to adopt smoke- and tobacco-free (SF/TF) policies.

PARTICIPANTS

Key informants (N = 18) at four campuses in Kentucky without a SF/TF policy recruited April 2015.

METHODS

Cross-sectional design. The survey assessed six dimensions: knowledge about SF/TF policies; leadership for campus policy; resources for policy development; campus climate surrounding tobacco issues; existing tobacco policies; and political climate for campus policy development. Dimension raw scores were rescaled to range from 0-1 and summed to determine overall stage of readiness (0-6).

RESULTS

Political climate was highest dimension across all campuses (0.83-1.0). Knowledge dimension ranked lowest (0.0-0.50). Overall readiness scores ranged from 2.53-3.94; two campuses in preplanning and two in preparation.

CONCLUSIONS

Development of the online measure is timely considering the impetus to implement SF/TF policies. Findings reinforce that campuses are at varying stages of implementing these policies, and stage-based interventions are necessary.

The spatial distribution of smoking violations on a no-smoking campus: Implications for prevention

OBJECTIVE

The present study extends research on campus smoking bans by examining where smokers are violating the policy at a large university in the southeastern region of the United States.

PARTICIPANTS

The data collection was conducted by one graduate student from the university in August of 2014.

METHODS

A global positioning system device was used to collect the geo-coordinates of littered cigarette butts as a proxy measure for smoking violations.

RESULTS

A hot spot analysis found a number of spatial concentrations on campus, largely around classroom and administrative buildings along with parking lots and garages.

CONCLUSIONS

The implications of such findings can direct enforcement to target these areas in order to reduce offenses and fulfill the initial goals of policy-makers and university administrators who support smoke-free campuses.

A tobacco-free campus ambassador program and policy compliance

OBJECTIVE

Assess impact and feasibility of a Tobacco-Free Ambassador Program on campus policy compliance.

PARTICIPANTS

Trained Ambassadors made 253 visits to campus sites over 15 months to observe and/or approach violators.

METHODS

Policy violators were observed at 23 locations during Wave 1 (April-June 2012) and/or Wave 2 (April-June 2013). For locations with at least 5 visits, average violators per visit were compared between the 2 waves using a paired t test. Attributes of violators were summarized. Cigarette butts were collected over 3-day periods in 4 campus hotspots during each wave. Personnel time and cost to implement the program were determined.

RESULTS

There were declines in observed violators per Ambassador visit and number of cigarette butts over time. Rate of violators per visit declined from 5.47 to 1.93, a 65% decrease. Personnel time was equal to 1.5 full-time equivalents annually.

CONCLUSIONS

The Ambassador Program was a feasible and potentially effective strategy to increase policy compliance.

Comparing Two Observational Measures to Evaluate Compliance With Tobacco-Free Campus Policy

Despite potential benefits of tobacco-free campus policies, compliance remains a challenge. Observational measures hold the most promise in determining compliance with these policies. There is need for further study to determine validity of observational measures of compliance with tobacco-free campus policies. The purpose of this study was to determine the validity of two observational measures of compliance with a tobacco-free campus policy: direct observation of violators and cigarette butts. Data collection took place over a 1-year time period. Direct observation was operationally defined as the number of observed violators in hot spots. A cigarette butt protocol previously found to be reliable was used to count the number of butts in campus hot spots. Results indicated a positive relationship between number of violators observed per visit and number of cigarette butts collected. Although most of the hot spots exhibited two or fewer violators per visit and 100 butts or fewer per collection, the data points outside this range supported a positive association between observed violators per visit and cigarette butts. The findings support that direct observation of violators is a valid measure of compliance compared to cigarette butts. Given available resources, using one or the other as evaluation measures is warranted.

Strack R. Protest of tobacco-free policies on college campuses: a historical analysis

Purpose

– Although the threat of protest may be a barrier toward implementing a tobacco policy on college campuses in the USA, the prevalence and severity of such opposition has yet to be investigated. The purpose of this paper was to determine how often campus communities protest against smoke-free policies and rate the disruptiveness of the protests.

Design/methodology/approach

– Researchers located and analyzed news reports regarding 21 protests over newly implemented or proposed policies on college campuses in the USA.

Findings

– Protests over college campus smoking policies are typically non-disruptive and consist of a small group of students who publicly smoke tobacco products and attempt to gain support of fellow students.

Practical implications

– Those advocating for campus tobacco policies should be aware that the campus community may protest, but that a heightened concern of a protest's effect on the campus community may be unfounded.

Originality/value

– To authors’ knowledge, research studies regarding opposition to anti-tobacco policies cannot be found in the literature. This paper may be used as a practical resource by advocates to educate campus administrators about the low turnout and lack of severity of any possible protest to a new campus tobacco policy.

Compliance monitoring of prohibition of smoking (under section-4 of COTPA) at a tertiary health-care institution in a smoke-free city of India

Background:

India enacted a comprehensive tobacco control law known as cigarettes and other tobacco products act (COTPA) in 2003. However, enforcement of the provisions under the law is still a matter of concern. Compliance survey is an effective tool to measure the status of implementation of the law at various public places. Smoke-free hospital campus demonstrates commitment to good health and sends a pro-healthy signal to the community.

Objective:

The objective of this study was to assess the compliance to the prohibition of smoking at public places (under section-4 of COTPA) in a tertiary health-care institution in a smoke-free city of India.

Materials and Methods:

An observational cross-sectional study was conducted at 40 different venues within a tertiary health-care institution in a smoke-free city of India. These places were observed for certain parameters of assessment by a structured checklist, which included evidence of active smoking, evidence of recent smoking, display of signages, presence of smoking aids, cigarette butts and bidi ends.

Results:

Overall compliance rate for section-4 of COTPA was found to be mere 23%. Evidence of active smoking was observed in 21 (52.5%) venues. Signages were seen at only 8 places (20%). Butt ends and other smoking aids were seen in 37 (92.5%) and 26 (65%) places respectively.

Conclusion:

These dismal findings suggest non-compliance to the provisions under COTPA, which calls for a sensitization workshop and advocacy for all the stakeholders.

Tobacco-free Take Action!: Increasing Policy Adherence on a College Campus

INTRODUCTION

One in five college students report tobacco use, thus universities are making strides to reduce tobacco use by adopting smoke- or tobacco-free policies.

PURPOSE

Describe an innovative ambassador program to increase adherence with a tobacco-free campus policy.

METHODS

The Tobacco-Free Take Action! (TFTA!) Ambassador program was created to form an environment of compliance. Hot spots were targeted by Ambassadors, who were trained to use scripted messages. Ambassadors completed an online documentation form to assess the number of violators observed and approached. The Tobacco-Free Compliance Assessment Tool (TF-CAT) was used to collect pre- and post-cigarette butt data at each hot spot.

RESULTS

During the 4-week intervention period, Ambassadors approached 332 violators (529 observed), of which 68% responded positively and complied with the policy. The number of cigarette butts declined by 25%.

DISCUSSION

Adherence with campus tobacco-free policies remains a challenge. Lessons learned from this innovative approach will benefit those currently implementing and planning tobacco-free campus policies.

Using the photovoice method to advocate for change to a campus smoking policy

OBJECTIVE

The authors used the photovoice method as a strategy for empowering students to advocate for change of a campus smoking policy.

PARTICIPANTS

Participants included 49 college students and 160 photo-exhibit attendees during spring 2011.

METHODS

Students were trained in the use of the photovoice method and a public exhibit was used to educate the campus community and advocate for change.

RESULTS

The photovoice initiative resulted in an effective platform for students to successfully advocate for the relocation of ashtrays that were in violation of the policy and for the elicitation of future advocacy targets.

CONCLUSIONS

The photovoice project provided a platform for students to have their views heard by campus community members and policymakers. The project served as a useful tool for grassroots student advocacy. Those interested in addressing campus health policy issues may want to consider conducting a photovoice project similar to the one described in this article.

Quantifying littered cigarette butts to measure effectiveness of smoking bans to building perimeters

OBJECTIVE

The authors estimated the number of violations of a university policy that prohibited smoking within 25 ft of all campus buildings.

PARTICIPANTS

The project was conducted by 13 student researchers from the university and a member of the local public health department.

METHODS

Students quantified cigarette butts that were littered in a 30-day period inside the prohibited smoking area of 7 campus buildings (large residential hall, small residential hall, administrative building, 2 academic buildings, campus cafeteria, and student union).

RESULTS

Investigators found a total of 7,861 cigarette butts (large residential hall: 1,198; small residential hall: 344; administrative building: 107; 2 academic buildings: 1,123 and 806; campus cafeteria: 2,651; and student union: 1,632).

CONCLUSIONS

Findings suggest that there is low compliance with the university's smoking policy. The described project may be repeated by students at other universities as a method to advocate for policy change.

A review of multicomponent interventions to prevent and control tobacco use among college students

OBJECTIVE

Multicomponent tobacco control programs have been implemented at the state and community levels and have led to a reduction in tobacco use. The purpose was to review the public health research literature on tobacco prevention and control programs on college campuses and derive evidence-based implications for comprehensive program implementation.

METHODS

MEDLINE, PsycINFO, ERIC, and PubMed databases were used to search the research literature concerning tobacco prevention and control programs conducted on college campuses published between 2000 and 2009.

RESULTS

No studies were found that implemented all 5 recommended components of a comprehensive program. Tobacco control programs containing policy and prevention education were used the most and promotion of tobacco-free environments and banning sales of tobacco products were used the least.

CONCLUSION

The review suggests that despite the recommendation of comprehensive tobacco control programs to reduce tobacco use on college campuses, few institutions have implemented and evaluated programs consisting of multiple components.

Assessment of college and university campus tobacco-free policies in North Carolina

OBJECTIVE

To develop a reliable and efficient method for assessing prevalence and strength of college/university tobacco-related policies.

PARTICIPANTS

North Carolina (NC) public universities, community colleges, and private colleges/universities (N = 110).

METHODS

A census of policies using campus handbooks and Web sites was conducted in March 2011.

RESULTS

The rating tool is reliable and valid. Ninety-nine percent of NC college/university campuses are smoke-free in all indoor areas. The majority (94/110 [85%]) of colleges and universities regulate smoking and/or tobacco in some or all outdoor areas. Less than 20% of campuses had restrictions for industry marketing, promotion, and sales.

CONCLUSIONS

Clean indoor air policies are present at all but 1 NC college/university campus, and a growing number have enacted broad outdoor limits to protect students, faculty, and staff from secondhand smoke. Policy census approaches across all other states would quantify the national tobacco-free college campus policy environment and facilitate adoption of tobacco-free campus policies.

An assessment of America's tobacco-free colleges and universities

OBJECTIVE

This study examined the extent to which US campuses identified as "100% tobacco-free" by the American Lung Association of Oregon adhered to the American College Health Association's the most recent guidelines and recommendations promoting tobacco-free environments in colleges and universities.

PARTICIPANTS

A key informant from 162 of 175 institutions (92.6% response rate) completed an online survey between January 2010 and February 2010.

METHODS

The variables under study were assessed via a cross-sectional research design. Participants completed a 35-item survey regarding their school's tobacco policies, procedures, and enforcement practices.

RESULTS

Although the vast majority of schools had written policies and procedures in place, schools with current policies were the most compliant. Numerous opportunities for improved adherence were identified in the results.

CONCLUSIONS

Findings from this study may help institutions in the development and implementation of a new tobacco policy, as well as strengthen policies among existing tobacco-free schools.

College student reactions to smoking bans in public, on campus and at home

We examined college student reactions to a statewide public smoke-free policy, campus policies and private restrictions through an online survey among 2260 students at a 2-year college and a university and 12 focus groups among smokers. Among survey participants, 34.6% smoked in the past month (35.0% daily, 65.0% non-daily). Correlates of receptivity to public policies included attending the university, not living with smokers and non-smoker status (versus daily and non-daily smoking). Correlates of receptivity to outdoor campus policies included being a university student, unmarried, without children, from homes where parents banned indoor smoking and a non-smoker. Correlates of having home restrictions included not living with smokers, no children, parents banning indoor smoking and non-smoker status. Correlates of having car restrictions included attending the university, not living with smokers, having children, parents banning indoor smoking and non-smoker status. Qualitative findings indicated support for smoke-free policies in public (albeit greater support for those in restaurants versus bars) and on campus. Participants reported concern about smokers' and bar/restaurant owners' rights, while acknowledging several benefits. Overall, 2-year college students and smokers (non-daily and daily) were less supportive of smoke-free policies.

Adoption of an outdoor residential Hall smoking policy in a California public university: a case study

OBJECTIVE

Because secondhand smoke is a public health concern, many colleges have adopted bans to ensure healthier environments. This study demonstrates how outdoor smoking policy change can be accomplished at a large public university.

PARTICIPANTS

The participants were 1,537 students housed in residential communities at the University of California, Berkeley, who completed an online survey.

METHODS

A proposal for smoke-free residential communities that included student resident survey data was prepared.

RESULTS

The survey data indicated that most students (77%) were bothered by secondhand smoke, and most (66%) favored smoke-free environments. The data were used to advocate for a change in the residential community smoking policy.

CONCLUSION

The survey data and institutional comparisons played a key role in administrators' decision-making about campus smoking policy. Despite administrators' concerns about students' safety and freedom of choice, student-led advocacy was able to influence policy change.

A group-randomized tobacco trial among 30 Pacific Northwest colleges: results from the Campus Health Action on Tobacco study

INTRODUCTION

We conducted a group-randomized trial to increase smoking cessation and decrease smoking onset and prevalence in 30 colleges and universities in the Pacific Northwest.

METHODS

Random samples of students, oversampling for freshmen, were drawn from the participating colleges; students completed a questionnaire that included seven major areas of tobacco policies and behavior. Following this baseline, the colleges were randomized to intervention or control. Three interventionists developed Campus Advisory Boards in the 15 intervention colleges and facilitated intervention activities. The freshmen cohort was resurveyed 1 and 2 years after the baseline. Two-years postrandomization, new cross-sectional samples were drawn, and students were surveyed.

RESULTS

At follow-up, we found no significant overall differences between intervention and control schools when examining smoking cessation, prevalence, or onset. There was a significant decrease in prevalence in private independent colleges, a significant increase in cessation among rural schools, and a decrease in smoking onset in urban schools.

DISCUSSION

Intervention in this college population had mixed results. More work is needed to determine how best to reach this population of smokers.

Cigarette smoking and associated health risks among students at five universities

INTRODUCTION

While most college students and other young adults who smoke fall into the light and intermittent smoking (LITS) category, they remain at risk for tobacco dependence and other adverse health effects from their smoking. This study examines smoking patterns, tobacco dependence, and other health variables among students at five universities to better understand how to identify and address tobacco use and related risks in a college health clinic setting.

METHODS

A health screening survey was completed by 2,091 college and graduate student volunteers seeking routine care at their university health centers or participating in a health class. Independent health variables were analyzed descriptively and in regression analyses with three levels of smoking (none, non-daily, and daily) and tobacco dependence to determine predictors and associated risks.

RESULTS

Nearly a quarter of students reported any current smoking, 41% of whom reported smoking less than 1 cigarette/day (cpd). Of the daily smokers, 80% smoked less than 10 cpd but 45% met criteria for tobacco dependence. Any smoking was associated with high-risk alcohol use, risky driving, relational abuse, depression, less exercise, and utilization of emergency and mental health services. In regression analyses, students who experienced depression had more than double the odds of being dependent smokers (odds ratio [OR] = 2.32), as did those who reported abuse (OR = 2.07) or sought mental health counseling (OR = 2.09).

DISCUSSION

Student health providers should be alerted to the multiple risks and comorbidities that occur among all smokers, including LITS, and intervene concurrently to help prevent or mitigate adverse outcomes that result from these conditions and behaviors.

Enforcing an outdoor smoking ban on a college campus: effects of a multicomponent approach

OBJECTIVES

Data on effective strategies to enforce policies banning outdoor smoking are sparse. This study tested the effects of an enforcement package implemented on a college campus.

PARTICIPANTS

Thirty-nine observers recorded compliance of 709 outside smokers.

METHODS

Smoking within 25 feet of buildings was noncompliant. The intervention included moving receptacles, marking the ground, improving signage, and distributing reinforcements and reminder cards.

RESULTS

The proportion of smokers complying with the ban was 33% during the baseline observation period, increased to 74% during the intervention week, and was at 54% during the follow-up. Differences across conditions was statistically significant (chi2(2, N = 709) = 6.299, p <.001). Compliance proportions varied by location in all conditions.

CONCLUSIONS

Enforcing an outdoor smoking ban using a multiple component package increased compliance with the nonsmoking policy on a college campus.

College students' exposure to secondhand smoke

INTRODUCTION

Exposure to secondhand smoke (SHS) is associated with morbidity and mortality from coronary heart disease, lung cancer, respiratory infections, asthma, sudden infant death syndrome, and other illnesses. Although substantial numbers of college students smoke, little is known about their exposure to SHS. This paper provides data on self-reported exposure of college students to SHS.

METHODS

A Web-based survey of a random sample of undergraduate students at 10 universities (eight public and two private) in North Carolina was conducted (N = 4,223).

RESULTS

A total of 83% of students reported any exposure in the 7 days preceding the survey. Exposure in a restaurant or bar was the most common (reported by 65% of students), followed by exposure at home or in the same room as a smoker (55%) and in a car (38%). Being a daily or nondaily smoker, binge drinking, being a fraternity or sorority member or pledge, female gender, White race, and higher parental education levels were associated with exposure in one or more contexts. Students younger than 21 years were less likely to report exposure in a bar or restaurant and more likely to report exposure in cars or at home. The overall campus smoking rate was positively associated with reported exposure in cars, at home or in someone's room, and in any location.

DISCUSSION

College administrators, other policy makers, and tobacco control advocates should take steps to reduce smoking and concomitant exposure to SHS among college students.

Smoking at school: views of Turkish university students

The recent interest in cigarette smoking among university students has brought attention to problems concerning opinions, attitudes, prevention, health education, policy formulation and implementation. This survey research tested five hypotheses on the views of college students about smoking in school hallways and cafeteria, compliance with anti smoking laws, considering cigarette smoking as an expression of freedom of choice, teachers' smoking in classrooms and in their offices, and school administration's policy on enforcing the law. Hypothesized differences between students' views on the issues according to gender, smoking status and years at school were investigated. Data were obtained from 3,659 students attending six universities in Ankara, Turkey. The study findings provided support for all the hypothesized differences (except a single issue). Males and females differed significantly on all the issues studied. The majority of nonsmoking students have anti-smoking views in regards of the studied issues as compared to regular and occasional smokers. Smokers and nonsmokers markedly disagree on banning cigarette smoking in the cafeteria and hallways. However, the majority of students are against teachers' smoking in classrooms and in their offices with the doors open. Although most students want a smoke free environment, there is no active-anti smoking policy on smoking by universities. Findings point out the need for campus-wide effective smoking prevention programs, as well as cessation programs and services for the students.

Factors related to smoking in college women

Cigarette smoking among American women attending college has increased dramatically since the 1980's. To develop effective smoking prevention and cessation programs, a better understanding of factors associated with smoking in college women is needed. Therefore, the purpose of this study was to examine if selected factors (stress, stress management, nutrition, physical activity, alcohol consumption, and race) were related to smoking in college women. A sample of 354 college women in a southeastern state, 18-22 years of age, participated in the study. Logistic regression analysis indicated that White race (p = < .001), alcohol consumption (p = .0013), and limited physical activity (p = .0078) were significantly associated with smoking. Physically active college women were 2 times less likely to be smokers. However, physical activity mediated the effect of stress and stress management on smoking. Additionally, stress management confounded the effect of stress on smoking. Therefore, in addition to alcohol avoidance, exercise (as a stress management strategy) may be an important component of primary prevention and smoking cessation programs for college women.

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.

A case-based clinician training program for treating tobacco use in college students

Tobacco use rates are high among college students, and while many of them try to quit every year, only a small percentage are successful at maintaining abstinence. Most colleges have campus health centers that offer treatment for tobacco cessation, but few students access these resources. Little is known about how to motivate young adult college students to seek treatment or assist them in their attempts to quit smoking. In the context of a comprehensive, group-randomized intervention study to decrease smoking among college students, a case-based tobacco cessation training program for campus health center providers and staff was developed and conducted at 14 intervention colleges during the 2003-2004 academic year. Six case studies were created for this training, using responses from 39 student elicitation interviews conducted at 12 colleges in Spring 2002. Common themes relating to smoking, quitting, and relapse experiences reported by students in the elicitation interviews were woven into the cases and integrated into the training program.

Preferred smoking policies at 30 Pacific Northwest colleges

OBJECTIVE

Research shows that restrictive smoking policies on college campuses could discourage smoking onset or help facilitate cessation efforts among students. However, many colleges and universities are reluctant to establish restrictive smoking policies for fear of student objections. Our study examined preferred smoking policies among college students in the Pacific Northwest.

METHODS

We conducted a baseline cross-sectional descriptive study of a grouped randomized controlled trial at 30 four-year colleges and universities in Idaho, Oregon, and Washington.

RESULTS

Of the 14,237 students who responded to the survey, 17.3% were smokers. All respondents were knowledgeable about indoor smoking policies; however, there was incongruence regarding outside policies. Some 88% of never smokers wanted a completely smoke-free indoor policy, while a substantial percentage (58%) of smokers concurred (odds ratio [OR]=0.19, p<0.001). Fewer respondents were supportive of outdoor policies (43.3% for never smokers and 6.9% for smokers). Respondents agreed that the desire to breathe clean air should have priority over the desire to smoke; however, smokers agreed to a lesser extent (97.5% for never smokers and 81.5% for smokers [OR=0.012, p<0.001]).

CONCLUSION

Both non-smokers and smokers have high approval rates for restrictive smoking policies on campus. Administrators can use this information to help enact restrictive campus smoking policies.

Predicting smoking status in a college-age population

OBJECTIVE

The purpose of this study was to determine the factors that predict smoking group membership in a college-age population.

DESIGN

A nonexperimental cross-sectional design was used to examine factors that distinguished among four groups: never established (n = 591), former (n = 41), nondaily (n = 80), and daily (n = 76) cigarette smokers.

SAMPLE

A pencil and paper questionnaire was returned by 788 randomly selected college students, 18-24 years of age.

RESULTS

Significant differences were found among the groups on their mothers', fathers', siblings', and peers' smoking behaviors and attitudes toward smoking. The nondaily and daily smoking groups reported a greater number of risk behaviors than the never established and former smoking groups. The two groups of current smokers also were more likely to report an increased level of depressive symptoms compared with the nonsmoking groups. The number of high school and college friends who smoke and self-reported high-risk alcohol and drug behaviors predicted smoking group membership in a polytomous logistic regression.

CONCLUSIONS

Strategies to alter the social environment and decrease the exposure of nonsmoking students to others who model smoking behaviors may help decrease smoking initiation and prevent relapse on college campuses.

Employee's perceived exposure to environmental tobacco smoke, passive smoking risk beliefs and attitudes towards smoking: a case study in a university setting

Despite the growing literature on workplace smoking policies, few studies have focused on the implementation of such policies in university settings. Smoking in the workplace is still very common in many countries, including Spain. While the law is about to change and more non-smoking policies are to be implemented, it is not clear what kind of restrictions Spanish workers would find acceptable. This study investigated perceived exposure to environmental tobacco smoke (ETS), passive smoking risks beliefs and attitudes towards smoking at the University of Navarra (Spain). A questionnaire was sent by E-mail to 641 randomly selected employees and a response rate of 70.4% was obtained. The survey results suggest that 27.3% of the university employees were smokers and 26.6% were exposed to ETS on a daily basis. The majority of respondents (81.7%) supported a restrictive non-smoking policy. Acceptance among active smokers was significantly lower (59.2 versus 89.3%). Smoking prohibition with the provision of smoking areas was the most favored option (46.9%). Results suggest that employees are ready to restrict smoking in the university, but there was not enough support for a total ban. Employers considering adopting a ban on smoking should be encouraged to conduct a similar survey to identify potential barriers to policy implementation.

College campus smoking policies and programs and students' smoking behaviors

Background

Although tobacco use in the United States has declined over the past 20 years, cigarette use among college students remains high. Additional research is thus needed to determine how university tobacco control policies and preventive education programs affect college students' smoking behaviors.

Methods

Approximately 13,000 undergraduate students at 12 universities or colleges in the state of Texas completed a web-based survey. College smoking policies were obtained from a survey of college administrators and from college websites. Logistic regression analyses were conducted to estimate the effects of individual smoking policies and programs on the odds of cigarette smoking.

Results

Of the individual programs, only having a preventive education program on campus was associated with lower odds of smoking. The existence of smoking cessation programs and designated smoking areas were associated with higher odds of smoking. Policies governing the sale and distribution of cigarettes were insignificantly associated with smoking.

Conclusion

Rather than focusing on policies restricting cigarette sales and use, college administrators should consider implementing or expanding tobacco prevention and education programs to further reduce student smoking rates.

Tobacco on campus: industry marketing and tobacco control policy among post-secondary institutions in Canada

OBJECTIVE

Post-secondary institutions provide a unique opportunity to implement and evaluate leading edge tobacco policies, while influencing a key group of young adults. To date, however, we know little about the tobacco control environment at post-secondary institutions outside the USA.

DESIGN

Telephone surveys were conducted with campus informants from 35 post-secondary institutions in Canada to evaluate tobacco control policies and the presence of tobacco marketing on campus.

MAIN OUTCOME MEASURES

Tobacco marketing on campus, tobacco control policies, and attitudes towards tobacco control.

RESULTS

The findings indicate that tobacco marketing is prevalent among post-secondary institutions in Canada. Every university and half of all colleges surveyed had participated in some form of tobacco marketing in the past year. Among universities, 80% had run a tobacco advertisement in their paper and 18% had hosted a tobacco sponsored nightclub event. Tobacco control policies varied considerably between institutions. Although several campuses had introduced leading edge policies, such as campus wide outdoor smoking restrictions and tobacco sales bans, there is a general lack of awareness of tobacco issues among campus decision makers and fundamental public health measures, such as indoor smoke-free policies, have yet to be introduced in many cases.

CONCLUSIONS

Post-secondary institutions in Canada remain tobacco friendly environments. Without increased direction and support from the public health community, post-secondary institutions will continue to lag behind, rather than lead current policy standards.

Development and validation of the College Tobacco Survey

The authors report on the development and assessment of an instrument to measure baseline campus cigarette use and outcomes from prevention programs, including those using a social norms approach combined with environmental policy change. They administered the 37-item College Tobacco Survey (CTS) to a convenience sample of 1,279 college students in freshmen-level classes at a large urban university. Factor analysis of 15 belief items revealed 3 factors: Peer Environment, Personal Effects, and Campus Policy Endorsement. The findings support the survey's reliability and validity. The authors discuss potential uses of the survey in terms of social norms and environmental prevention programs.

A review of interventions to reduce tobacco use in colleges and universities

BACKGROUND

Interventions have been designed to reduce the prevalence of smoking in college/university students. This review presents a summary and synthesis of the interventions published in English from 1980 to the present.

METHODS

Seven databases were searched for relevant published articles, and reference lists were examined for additional published studies. The studies were categorized as (1) individual approaches, such as on-campus cessation programs, and (2) institutional approaches, such as smoke-free policies. The studies were categorized by type of institution and geographic location, study design, sample demographics, and outcomes.

RESULTS

Fourteen studies were identified; only five received a "satisfactory" rating based on evaluation criteria. Most studies were based on convenience samples, and were conducted in 4-year institutions. Seven studies used comparison groups, and three were multi-institutional. Individual approaches included educational group sessions and/or individual counseling that were conducted on campus mostly by healthcare personnel. None used nicotine replacement or other medications for cessation. The quit rates for both smokeless tobacco and cigarette users varied, depending on definitions and duration of follow-up contact. Institutional interventions focused mainly on campus smoking restrictions, smoke-free policies, antitobacco messages, and cigarette pricing. Results indicated that interventions can have a positive influence on student behavior, specifically by reducing tobacco use (i.e., prevalence of cigarette smoking and use of smokeless products, amount smoked) among college students, and increasing acceptability of smoking policies and campus restrictions among both tobacco users and nonusers.

CONCLUSIONS

While some promising results have been noted, rigorous evaluations of a wider range of programs are needed, along with studies that address cultural and ethnic diversity on campuses.

Students' opinion of tobacco control policies recommended for US colleges: a national survey

OBJECTIVE

Comprehensive tobacco control policies for US colleges and universities have been proposed by several groups in order to counter the rising use of tobacco by students enrolled in these institutions. Student opinion of these policies is not known, and concern about student opposition is one barrier that deters administrators from adopting the policies. This study measured student support for recommended college tobacco control policies.

DESIGN

Mailed survey of US college students (2001 Harvard School of Public Health College Alcohol Study).

SETTING

119 nationally representative, four-year colleges and universities in the USA.

PARTICIPANTS

10,904 randomly selected undergraduate students enrolled at participating schools.

MAIN OUTCOME MEASURES

Students' opinion of 7 proposed tobacco control policies.

RESULTS

A majority of students supported each policy. Over three quarters of students favoured smoke-free policies for all college buildings, residences, and dining areas, while 71% supported prohibiting tobacco advertising and sponsorship of campus social events, 59% favoured prohibiting tobacco sales on campus, and 51% supported smoke-free campus bars. All policies had more support among non-smokers than smokers (p < 0.001). Among smokers, support for policies was inversely related to intention to quit and intensity of tobacco consumption. Because college students' tobacco consumption is low, a majority of smokers favoured banning smoking in college buildings and dining areas and prohibiting tobacco marketing on campus.

CONCLUSIONS

Student support for proposed campus tobacco control policies is strong, even among smokers, and broadly based across demographic subgroups. These findings should provide reassurance to college administrators who are considering adopting these policies.