College students' exposure to tobacco marketing in nightclubs and bars

Exploring Support for 100% College Tobacco-Free Policies and Tobacco-Free Campuses Among College Tobacco Users

BACKGROUND

Tobacco-free campus policy is identified as an effective means to address tobacco use on college campuses; however, the prevalence of tobacco-free policies (TFPs) in the United States remains low. This study explores college tobacco users' support for a university's TFP and tobacco-free campuses (TFCs) in general.

METHODS

A standardized and structured questionnaire was administered to 790 college tobacco users recruited in a university located in a tobacco-growing region of the United States, during April-May 2011, to collect information on support for TFPs and TFCs and sociodemographic-political characteristics. Descriptive and multivariable logistic regression analyses were conducted to identify key factors associated with support for TFPs and TFCs.

RESULTS

Approximately 2 of 5 tobacco users favored TFPs and TFCs. Multivariable logistic regression models showed that demographic factors were mostly not significantly associated with attitudes of the college tobacco users. Instead, while knowledge about harmful effects of exposure to secondhand tobacco smoke significantly increased support for both TFPs and TFCs, parental and peer smoking and exposure to tobacco industry promotions significantly decreased the likelihoods of support compared with respective referent groups.

CONCLUSION

Study findings suggest that campus advocacy and education campaigns for campus tobacco policies to pay attention to tobacco use behavior of familial relations, tobacco industry activities, and other political determinants of tobacco users' attitudes. Thus, this study should inform national initiatives to promote TFPs nationwide such as the Tobacco-Free College Campus Initiative.

Evaluation of Bar and Nightclub Intervention to Decrease Young Adult Smoking in New Mexico

PURPOSE

Over 20% of young adults in New Mexico currently smoke. We evaluated cigarette smoking prevalence of young adult bar patrons during an anti-tobacco Social Branding intervention.

METHODS

The Social Branding intervention used a smoke-free brand, "HAVOC," to compete with tobacco marketing within the "Partier" young adult peer crowd. A series of cross-sectional surveys were collected from adults aged 18-26 in bars and nightclubs in Albuquerque, New Mexico, from 2009 to 2013 using randomized time-location sampling. Multivariable multinomial regression using full information maximum likelihood estimation to account for missing data evaluated differences in daily and nondaily smoking during the intervention, controlling for demographics, other risk behaviors, and tobacco-related attitudes.

RESULTS

Data were collected from 1,069 individuals at Time 1, and 720, 1,142, and 1,149 participants at Times 2, 3, and 4, respectively. Current smoking rates decreased from 47.5% at Time 1 to 37.5% at Time 4 (p < .001). Among Partiers, the odds of daily smoking decreased significantly, but nondaily smoking was unchanged. Partiers that recalled, liked, and understood the smoke-free message of HAVOC had lower odds of nondaily (odds ratio: .48, 95% CI: .31-.75) and daily (odds ratio: .31, 95% CI: .14-.68) smoking than those who did not recall HAVOC. HAVOC recall was associated with attitudes that were also associated with smoking behavior.

CONCLUSIONS

The significant decrease in daily smoking among young adult Partiers in New Mexico was associated with HAVOC recall and understanding. Social Branding interventions efficiently target and may decrease tobacco use among young adult bar patrons.

Correlates of smokeless tobacco use among first year college students

OBJECTIVE

Smokeless tobacco (SLT) use is associated with specific adverse health effects. Knowledge of student tobacco use, including SLT, may guide inquiry into other risky health behaviors, and provide opportunities for health education of students.

DESIGN

An incentivized email invitation to complete a web-based survey was sent to students at 11 colleges and universities in North Carolina and Virginia.

METHODS

In autumn 2010, emails were sent to all first-year students (n=29,536) at 11 colleges and universities in North Carolina and Virginia, inviting them to participate in a brief web-based survey to be used to establish a cohort for the parent study evaluating tobacco use over 4 years. Survey items elicited demographic characteristics, tobacco use and other health behaviors.

RESULTS

A total of 10,520 (36%) students responded. Past 30 day smoking and SLT use were 12% and 3%, respectively. Logistic regression analysis revealed that male gender (Adjusted Odds Ratio [AOR] = 11.6, 95% Confidence Interval [CI] = 8.16-16.59); current smoking (AOR = 5.5, 95% CI = 4.21-7.10), ever use of alcoholic energy drinks (AOR = 4.8, 95% CI = 3.63-6.43), and ≥ 5 days vs. < 3 days of physical activity a week (AOR = 1.5, 95% CI = 1.07-2.01) predicted risk of past 30 day SLT use.

CONCLUSION

While SLT use is relatively uncommon, knowledge of significant correlations between student tobacco use, including SLT and other risky health behaviors, might guide clinicians' inquiry and provide opportunities for health education of students.

Social branding to decrease smoking among young adults in bars

OBJECTIVES

We evaluated a Social Branding antitobacco intervention for "hipster" young adults that was implemented between 2008 and 2011 in San Diego, California.

METHODS

We conducted repeated cross-sectional surveys of random samples of young adults going to bars at baseline and over a 3-year follow-up. We used multinomial logistic regression to evaluate changes in daily smoking, nondaily smoking, and binge drinking, controlling for demographic characteristics, alcohol use, advertising receptivity, trend sensitivity, and tobacco-related attitudes.

RESULTS

During the intervention, current (past 30 day) smoking decreased from 57% (baseline) to 48% (at follow-up 3; P = .002), and daily smoking decreased from 22% to 15% (P < .001). There were significant interactions between hipster affiliation and alcohol use on smoking. Among hipster binge drinkers, the odds of daily smoking (odds ratio [OR] = 0.44; 95% confidence interval [CI] = 0.30, 0.63) and nondaily smoking (OR = 0.57; 95% CI = 0.42, 0.77) decreased significantly at follow-up 3. Binge drinking also decreased significantly at follow-up 3 (OR = 0.64; 95% CI = 0.53, 0.78).

CONCLUSIONS

Social Branding campaigns are a promising strategy to decrease smoking in young adult bar patrons.

Momentary effects of exposure to prosmoking media on college students' future smoking risk

OBJECTIVE

This study used ecological momentary assessment to examine acute changes in college students' future smoking risk as a function of their exposure to prosmoking media (e.g., smoking in movies, paid advertising, point-of-sale displays).

METHOD

A sample of 135 college students ("ever" and "never" smokers) carried handheld computers for 21 days, recording their exposures to all forms of prosmoking media during the assessment period. They also responded to three investigator-initiated control prompts during each day of the assessment period (i.e., programmed to occur randomly). After each prosmoking media exposure and after each random control prompt they answered questions that measured their risk of future smoking. Responses between prosmoking media encounters were compared (within subjects) to responses made during random control prompts.

RESULTS

Compliance with the study protocol was high, with participants responding to over 83% of all random prompts. Participants recorded nearly three encounters with prosmoking media each week. Results of linear mixed modeling indicated that all participants had higher future smoking risk following exposure to prosmoking media compared with control prompts (p < .05); this pattern of response did not differ between ever and never smokers (p = .769). Additional modeling of the variances around participants' risk of future smoking revealed that the response of never smokers to prosmoking media was significantly more variable than the response of ever smokers.

CONCLUSION

Exposure to prosmoking media is associated with acute changes in future smoking risk, and never smokers and ever smokers respond differently to these exposures.

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.