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Geindreau D, Girault A, Gallopel-Morvan K. Tobacco-free university campus policies: A systematic review. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024:1-12. [PMID: 38917353 DOI: 10.1080/07448481.2024.2367999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 06/09/2024] [Indexed: 06/27/2024]
Abstract
Objective: This systematic review aims to provide an update of the scientific evidence regarding tobacco-free/smoke-free campus policies (TFC/SFC), using a complex interventions approach. PARTICIPANTS/METHODS We searched the PubMed, Scopus and Web of Science databases using a combination of 'tobacco-free' or 'smoke-free', 'campus', 'university or college' and 'policy' search terms on all indexed articles published up until June 2023. Studies were included if they presented research on pre-/post-implementation of TFC/SFC or policy components. Two coders extracted and synthesized the data and assessed the risk of bias. RESULTS A total of 113 studies were included, reporting data from 2005 to 2023 across 17 countries. The data was categorized into three of the four phases of the Medical Research Council (MRC) framework, i.e. "feasibility (n=24), "implementation" (n=34), and "evaluation" (n=69). This review finds that a policy draft, communication, enforcement strategies, and cessation services are critical policy components. TCF/SFC are effective for reducing tobacco use and secondhand smoke exposure, but they also increase vaping. Little research has investigated the effect of TFC/SFC on smokeless tobacco use. CONCLUSION This review addresses remaining uncertainties in evidence on the TFC/SFC implementation process. We go on to provide a series of recommendations for university administrators.
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Affiliation(s)
- Diane Geindreau
- EHESP, CNRS, Inserm, Arènes - UMR 6051, RSMS - U 1309, Rennes University, Rennes, France
| | - Anne Girault
- EHESP, CNRS, Inserm, Arènes - UMR 6051, RSMS - U 1309, Rennes University, Rennes, France
| | - Karine Gallopel-Morvan
- EHESP, CNRS, Inserm, Arènes - UMR 6051, RSMS - U 1309, Rennes University, Rennes, France
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Al-Jayyousi GF, Shraim M, Hassan DA, Al-Hamdani M, Kurdi R, Hamad NA, Abdul Rahim HF. University students' and staff attitudes toward the implementation of a "tobacco-free" policy: A view from Qatar. Prev Med Rep 2024; 38:102605. [PMID: 38292026 PMCID: PMC10826297 DOI: 10.1016/j.pmedr.2024.102605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Revised: 01/07/2024] [Accepted: 01/08/2024] [Indexed: 02/01/2024] Open
Abstract
Objectives Tobacco-free campus policies are needed to create environments conducive to prevention or quitting in the Eastern Mediterranean Region (EMR), where the use of various tobacco products is on the rise among university students. The objectives of this study were to assess overall support for a 100% tobacco-free campus policy and its predictors among different stakeholder groups at the largest national university in Qatar and to understand attitudes towards specific policy components. Study design A cross-sectional online survey of faculty and students. Methods We measured sociodemographic variables, tobacco use, and support for components of a 100% tobacco-free campus policy. A total score for support was calculated, and associations with selected predictors were assessed using multivariable linear regression. Results 413 respondents participated in the survey. A majority of faculty/staff and students (76.6% and 75.5%, respectively) supported the implementation of a 100% tobacco-free campus policy, with a majority supporting extension of the policy beyond cigarettes. Support for other components of the policy varied. Among students, overall support was lower among males and tobacco users and higher among the married. Among faculty and staff, support was lower among Qatari nationals and tobacco users. Conclusion In the context of a growing tobacco crisis in the EMR, implementing and understanding the impact of tobacco-free campus policies is essential. This paper underscores the importance of addressing diverse stakeholder attitudes and providing empirical evidence to guide policy implementation and evaluation.
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Affiliation(s)
- Ghadir Fakhri Al-Jayyousi
- Department of Public Health, College of Health Sciences, QU Health, Qatar University, P.O. Box 2713, Doha, Qatar
| | - Mujahed Shraim
- Department of Public Health, College of Health Sciences, QU Health, Qatar University, P.O. Box 2713, Doha, Qatar
| | - Diana Alsayed Hassan
- Department of Public Health, College of Health Sciences, QU Health, Qatar University, P.O. Box 2713, Doha, Qatar
| | - Mohammed Al-Hamdani
- Department of Public Health, College of Health Sciences, QU Health, Qatar University, P.O. Box 2713, Doha, Qatar
| | - Rana Kurdi
- Department of Public Health, College of Health Sciences, QU Health, Qatar University, P.O. Box 2713, Doha, Qatar
| | - Noor Ahmed Hamad
- Department of Public Health, College of Health Sciences, QU Health, Qatar University, P.O. Box 2713, Doha, Qatar
| | - Hanan F. Abdul Rahim
- Department of Public Health, College of Health Sciences, QU Health, Qatar University, P.O. Box 2713, Doha, Qatar
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Boderie NW, Sheikh A, Lo E, Sheikh A, Burdorf A, van Lenthe FJ, Mölenberg FJ, Been JV. Public support for smoke-free policies in outdoor areas and (semi-)private places: a systematic review and meta-analysis. EClinicalMedicine 2023; 59:101982. [PMID: 37256097 PMCID: PMC10225670 DOI: 10.1016/j.eclinm.2023.101982] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 04/10/2023] [Accepted: 04/12/2023] [Indexed: 06/01/2023] Open
Abstract
Background Smoke-free policies are essential to protect people against tobacco smoke exposure. To successfully implement smoke-free policies that go beyond enclosed public places and workplaces, public support is important. We undertook a comprehensive systematic review of levels and determinants of public support for indoor (semi-)private and outdoor smoke-free policies. Methods In this systematic review and meta-analysis, six electronic databases were searched for studies (published between 1 January 2004 and 19 January 2022) reporting support for (semi-)private and outdoor smoke-free policies in representative samples of at least 400 respondents aged 16 years and above. Two reviewers independently extracted data and assessed risk of bias of individual reports using the Mixed Methods Appraisal Tool. The primary outcome was proportion support for smoke-free policies, grouped according to location covered. Three-level meta-analyses, subgroup analyses and meta-regression were performed. Findings 14,749 records were screened, of which 107 were included; 42 had low risk of bias and 65 were at moderate risk. 99 studies were included in the meta-analyses, reporting 326 measures of support from 896,016 individuals across 33 different countries. Support was pooled for indoor private areas (e.g., private cars, homes: 73%, 95% confidence interval (CI): 66-79), indoor semi-private areas (e.g., multi-unit housing: 70%, 95% CI: 48-86), outdoor hospitality areas (e.g., café and restaurant terraces: 50%, 95% CI: 43-56), outdoor non-hospitality areas (e.g., school grounds, playgrounds, parks, beaches: 69%, 95% CI: 64-73), outdoor semi-private areas (e.g., shared gardens: 67%, 95% CI: 53-79) and outdoor private areas (e.g., private balconies: 41%, 95% CI: 18-69). Subcategories showed highest support for smoke-free cars with children (86%, 95% CI: 81-89), playgrounds (80%, 95% CI: 74-86) and school grounds (76%, 95% CI: 69-83). Non-smokers and ex-smokers were more in favour of smoke-free policies compared to smokers. Support generally increased over time, and following implementation of each smoke-free policy. Interpretation Our findings suggested that public support for novel smoke-free policies is high, especially in places frequented by children. Governments should be reassured about public support for implementation of novel smoke-free policies. Funding Dutch Heart Foundation, Lung Foundation Netherlands, Dutch Cancer Society, Dutch Diabetes Research Foundation and Netherlands Thrombosis Foundation.
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Affiliation(s)
- Nienke W. Boderie
- Department of Public Health, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, Netherlands
| | - Asiyah Sheikh
- Edinburgh Medical School, The University of Edinburgh, Edinburgh, UK
| | - Erika Lo
- Edinburgh Medical School, The University of Edinburgh, Edinburgh, UK
| | - Aziz Sheikh
- Centre for Medical Informatics, Usher Institute, The University of Edinburgh, Edinburgh, UK
| | - Alex Burdorf
- Department of Public Health, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, Netherlands
| | - Frank J. van Lenthe
- Department of Public Health, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, Netherlands
| | - Famke J.M. Mölenberg
- Department of Public Health, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, Netherlands
| | - Jasper V. Been
- Department of Public Health, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, Netherlands
- Division of Neonatology, Department of Neonatal and Paediatric Intensive Care, Erasmus MC Sophia Children’s Hospital, University Medical Centre Rotterdam, Rotterdam, Netherlands
- Department of Obstetrics and Gynaecology, Erasmus MC Sophia Children’s Hospital, University Medical Centre Rotterdam, Rotterdam, Netherlands
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Support for 100% Tobacco-Free Policy on a College Campus in New Jersey: Differences between students and faculty/staff. J Public Health (Oxf) 2022. [DOI: 10.1007/s10389-020-01344-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Pulvers K, Rice M, Stewart SL, Tong E. Tobacco Tracker: A New Tool to Support College Smoke and Tobacco Free Policies. Nicotine Tob Res 2022; 24:241-249. [PMID: 34671812 DOI: 10.1093/ntr/ntab187] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 09/11/2021] [Indexed: 11/12/2022]
Abstract
INTRODUCTION University community members are critical to the success of their smoke and tobacco free (STF) policies. The present study evaluates changes in social enforcement-related attitudes and behaviors following introduction of a new online Tobacco Tracker tool in two university settings. METHODS Campus wide surveys were administered to current students, faculty, and staff at two California public universities with 100% STF policies before (November 2018; N = 5078) and after (December 2019-January 2020; N = 4853) introduction of Tobacco Tracker in February 2019. Prospective surveillance reports over 12 months from Tobacco Tracker, a GIS tool for the campus community to report tobacco use and related litter that displays crowdsourced maps of hotspots, were analyzed. Outcomes included awareness and self-reported use of a tobacco reporting tool, readiness for policy social enforcement, an Intellectual Social Affective (ISA) Engagement scale, and environmental surveillance reports from Tobacco Tracker. RESULTS In campus surveys, awareness of a tobacco reporting tool doubled (8.0%-16.9%, p < .0001), use of an online reporting tool tripled (1.1%-3.2%, p < .0001), and readiness to enforce the policy increased (p = .0008). ISA engagement did not change (p = .72). In Tobacco Tracker campus reports (N = 1163), active tobacco use was reported more frequently than tobacco-related litter. CONCLUSIONS Tobacco Tracker is a promising tool for college communities to support STF policy. Introduction of Tobacco Tracker was associated with an increase in campus awareness and utilization of a reporting tool, readiness to enforce policy, and campus tobacco surveillance. Future research should determine how Tobacco Tracker may improve policy compliance. IMPLICATIONS Tobacco Tracker is a promising tool for college communities to support smoke and tobacco free (STF) policy through active surveillance of smoking, vaping, and related litter on campus. Introduction of Tobacco Tracker was associated with changes in social enforcement-related attitudes and behaviors critical to realizing the preventive potential of STF policies. A crowdsourcing-based tool for monitoring tobacco use on college campuses can address a major barrier to social enforcement: discomfort confronting tobacco users. Further, it provides an alternative to punitive enforcement approaches and promises a sustainable solution to an infrastructure issue faced by many universities lacking resources to collect data on campus tobacco use and related litter.
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Affiliation(s)
- Kim Pulvers
- Department of Psychology, California State University San Marcos, San Marcos, CA, USA
| | - Myra Rice
- Department of Psychology, California State University San Marcos, San Marcos, CA, USA
| | - Susan LeRoy Stewart
- Department of Public Health Sciences, University of California, Davis, Sacramento, CA, USA
| | - Elisa Tong
- Department of Internal Medicine, University of California, Davis, Sacramento, CA, USA
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Chaaya M, Farran D, Saab D, Al-Hindi M, Romani M, Khairallah M, Nakkash R. Influence of a University Tobacco-Free Policy on the Attitudes, Perceptions of Compliance, and Policy Benefit Among the University Students: A Pre-Post Investigation. Int J Public Health 2021; 66:614602. [PMID: 34744578 PMCID: PMC8565293 DOI: 10.3389/ijph.2021.614602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 02/11/2021] [Indexed: 11/13/2022] Open
Abstract
Objective: To evaluate the effectiveness of a university tobacco-free policy by examining differences in students' attitudes, perceptions of compliance and policy benefits, after one year of the policy's implementation. Methods: Cross-sectional studies were undertaken to collect data pre- and 1 year post-policy implementation. The two samples were selected using stratified random sampling. Results: The prevalence of smoking decreased from 26% pre-policy implementation to 21% 1 year after (p = 0.035). The proportion of smokers who thought the policy had contributed to a reduction in smoking frequency increased from 10% to 70% (p < 0.001). Smokers' support for the policy rose from 42 to 58% (p = 0.007). Conclusion: Against the background of a strongly pro-tobacco environment in Lebanon, it is possible to create a positive change in the mindset of smokers at the levels of the education and smoking cessation and more efforts should be expended to bring it about.
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Affiliation(s)
- Monique Chaaya
- Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Dina Farran
- Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Dahlia Saab
- Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Mahmoud Al-Hindi
- Department of Mechanical Engineering, Maroun Semaan Faculty of Engineering and Architecture, American University of Beirut, Beirut, Lebanon
| | - Maya Romani
- Department of Family Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Mary Khairallah
- Human Resources Department, American University of Beirut, Beirut, Lebanon
| | - Rima Nakkash
- Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
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University Staff and Students' Attitudes towards a Completely Smoke-Free Campus: Shifting Social Norms and Organisational Culture for Health Promotion. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18137104. [PMID: 34281036 PMCID: PMC8297203 DOI: 10.3390/ijerph18137104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 06/28/2021] [Accepted: 06/29/2021] [Indexed: 12/02/2022]
Abstract
A large university in Queensland, Australia with a diverse staff and student community introduced a campus wide smoke-free policy in 2016. The purpose of this enquiry was to understand attitudes about a new smoke-free policy, its potential impact and the shift in social norms and organizational culture to inform the next phase of implementation. An electronic survey was distributed to all staff and students approximately 12 weeks after the smoke-free policy was implemented. The survey consisted of multiple-choice questions about demographics, smoking behaviour, attitudes towards smoking and tobacco control, awareness of the smoke-free policy, and attitudes towards the effect of a completely smoke-free campus on quality of life, learning and enrolment. The survey was completed by 641 university staff and students. Respondents reported seeking out (80.4%) and socialising in smoke-free environments (86.6%) and supported smoke-free buildings (96.1%), indoor areas (91.6%), and outdoor areas (79%). The results revealed overwhelming support for a completely smoke-free campus (83%) and minority support for designated smoking areas (31%). Overall, respondents reflected positively towards a campus wide smoke-free policy. These findings suggest Queensland’s early adoption of tobacco control laws influenced the social environment, de-normalised smoking, changed behaviour, preference for smoke-free environments and shifted social norms. These findings provide convincing evidence for organisational change and suggest health promotion policy makers should progress the implementation of smoke-free policies nationally across the higher education sector.
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Al-Jayyousi GF, Kurdi R, Alsaei S, Al-Kaabi H, Alrushdi AJ, Abdul Rahim HF. Students' perceptions of a university 'No Smoking' policy and barriers to implementation: a cross- sectional study. BMJ Open 2021; 11:e043691. [PMID: 34108159 PMCID: PMC8191599 DOI: 10.1136/bmjopen-2020-043691] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
OBJECTIVES Effective policies are an important tool for reducing tobacco use. We examine student perceptions of the existing no-smoking policy in the country's largest national university and identify perceived barriers to its implementation. We explore student support for a 100% tobacco-free campus policy. DESIGN We conducted a cross-sectional survey using a self-administered on-line questionnaire. SETTING This study was conducted at Qatar University (QU), the largest national institution of higher education in Qatar. PARTICIPANTS A total of 199 students participated out of a stratified random sample of students aged ≥18 years with active registration in the Spring 2020 semester. PRIMARY AND SECONDARY OUTCOME MEASURES We assessed students' knowledge of and attitudes towards QU's current no-smoking policy, the perceived barriers to its implementation, and support for a 100% tobacco-free policy. RESULTS Only 26% (95% CI 19.97 to 32.03) and 16.6% (95% CI 11.70 to 22.49) of respondents correctly identified the current policy on traditional and electronic cigarettes, respectively. Less than 30% of respondents held positive attitudes towards policy enforcement, and more male respondents reported positive attitudes towards compliance than women. Support for a 100% tobacco-free policy was at 77.2%, but it was significantly lower among tobacco users compared with non-users (35.9% and 91.8%, respectively; p<0.001). Failure to establish clear penalties, opposition from smoking students, and lack of cessation services were perceived as major barriers to implementation. CONCLUSIONS Clear and comprehensive tobacco-free policies are important tools for creating environments conducive to rejecting smoking and seeking cessation support. The findings underscore the need to increase awareness about the policy, advocate for clear penalties for violations, and promote cessation services on campus. Qualitative research is needed to further understand perceived barriers to successful enforcement of the policy.
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Affiliation(s)
- Ghadir Fakhri Al-Jayyousi
- Department of Public Health, College of Health Sciences, QU Health, Qatar University, Doha, Ad Dawhah, Qatar
| | - Rana Kurdi
- Department of Public Health, College of Health Sciences, QU Health, Qatar University, Doha, Ad Dawhah, Qatar
| | - Shahd Alsaei
- Department of Public Health, College of Health Sciences, QU Health, Qatar University, Doha, Ad Dawhah, Qatar
| | - Haya Al-Kaabi
- Department of Public Health, College of Health Sciences, QU Health, Qatar University, Doha, Ad Dawhah, Qatar
| | - Al Jaziya Alrushdi
- Department of Public Health, College of Health Sciences, QU Health, Qatar University, Doha, Ad Dawhah, Qatar
| | - Hanan F Abdul Rahim
- Department of Public Health, College of Health Sciences, QU Health, Qatar University, Doha, Ad Dawhah, Qatar
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Sendall MC, Le Lievre C, McCosker LK, Brewis L. Going smoke-free: University staff and students' qualitative views about smoking on campus during the implementation of a smoke-free policy. PLoS One 2020; 15:e0236989. [PMID: 32817644 PMCID: PMC7440621 DOI: 10.1371/journal.pone.0236989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Accepted: 07/17/2020] [Indexed: 11/26/2022] Open
Abstract
Background Despite many Australian universities introducing smoke-free policies on campus, there is little information about staff and students understanding of smoking on campus in the context of the implementation of a smoke-free policy. Objective This research explores the qualitative views of university staff and students about smoking on campus during the implementation of a smoke-free policy. Methods In 2016, an electronic survey was distributed to all current staff and students of a large university in Queensland, Australia during the implementation of a smoke-free policy. The survey consisted of multiple-choice questions about demographics, tobacco use, attitudes towards smoking, awareness of and attitudes towards the policy, and intentions to quit smoking. The final question asked for a short, open-ended response: “Would you like to comment on the issue of smoking on QUT* campuses?” This question was extracted from the survey and analysed using inductive thematic analysis. This paper reports the findings from this question. *Queensland University of Technology. Results The survey was completed by 641 staff and students. There were 351 responses to the final question. Five inductive themes emerged about smoking on campus during the implementation of a smoke-free policy: 1) the watering down of the policy, if it is not enforced, 2) the creation of hot spots on campus boundaries affecting those who pass by, 3) concern, especially by those who don’t smoke, about the impact on smokers emotional health and welfare, 4) disagreement about the value of designated smoking areas and 5) suggestions about how to better implement the policy. Conclusion Overall, participants views about smoking on campus during the implementation of a smoke free policy suggest broad agreement but reflect concerns about enforcement, boundaries, non-smokers and designated areas. Consistent and systematic processes for implementation, maintenance and enforcement of policy goals, and cessation support, is needed to create a non-smoking culture on university campuses.
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Affiliation(s)
- Marguerite C. Sendall
- School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
- * E-mail:
| | - Chantal Le Lievre
- School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Laura K. McCosker
- School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Lauren Brewis
- School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia
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Atiba YM, Olubodun T, Odukoya OO. Young Peoples' support for a smoke-free campus policy: A case for smoke-free campuses in the statewide smoking law in Lagos State, Nigeria. Ann Afr Med 2020; 19:53-59. [PMID: 32174616 PMCID: PMC7189885 DOI: 10.4103/aam.aam_27_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background: Smoke-free policies are increasingly being enacted in several countries. In 2014, Lagos State, the commercial capital of Nigeria, enacted a statewide smoke-free policy; however, university campuses were excluded from the list of public places where smoking would be disallowed. This study aimed to assess students’ support for smoke-free campus policies, their attitudes, and exposure toward secondhand smoke (SHS). Methods: This cross-sectional descriptive study was carried out among 421 university undergraduates in two premier universities in the state. Respondents were selected using a multistage sampling method, and the data were collected using a pretested self-administered questionnaire. Results: Many (55.4%) of the respondents agreed that students who are non-smokers have the right to inhale smoke-free air on campuses and expressed feelings of irritation (57.1%) or anger (17.1%) when exposed to SHS on campus. Majority (80.1%) of the respondents were in support of a smoke-free policy on their campus and in favor of a ban on smoking in enclosed spaces on campus (79.6%). Exposure to SHS on campus was high, as one in five respondents were exposed to SHS in their hostel rooms (19.9%) and 44.9% were exposed in outdoor campus spaces in the preceding week. There was a statistically significant association between respondents’ age, gender, smoking status, and attitudes toward SHS and support for a smoke-free campus policy. Conclusion: Although the majority of the students were non-smokers, significant exposure to SHS on campuses still exists. There is a huge support for smoke-free campus policies. The state government should consider including campuses on the list of smoke-free public spaces in the review of the statewide smoking law.
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Affiliation(s)
- Yetunde Morenike Atiba
- Department of Community Health and Primary Care, College of Medicine, University of Lagos, Lagos, Nigeria
| | - Tope Olubodun
- Department of Community Health and Primary Care, Lagos University Teaching Hospital, Lagos, Nigeria
| | - Oluwakemi Ololade Odukoya
- Department of Community Health and Primary Care, College of Medicine, University of Lagos; Department of Community Health and Primary Care; Non-Communicable Disease Research Group, Lagos University Teaching Hospital, Lagos, Nigeria
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Ramachandran S, Bentley S, Casey E, Bentley JP. Prevalence of and factors associated with violations of a campus smoke-free policy: a cross-sectional survey of undergraduate students on a university campus in the USA. BMJ Open 2020; 10:e030504. [PMID: 32198295 PMCID: PMC7103814 DOI: 10.1136/bmjopen-2019-030504] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVE The aim of this study is to estimate the prevalence of smoking behaviour on campus and to identify the key factors that influence adherence to a campus smoke-free policy. DESIGN & PARTICIPANTS This study employed a cross-sectional, self-administered survey of undergraduate students at the University of Mississippi. A random sample of all available undergraduate classes was recruited for data collection. Students were provided a survey that included questions on demographics, alcohol use, smoking status, policy awareness, policy attitudes, smoking attitudes, policy support, barriers to policy success and policy violations. RESULTS The prevalence of past 30-day smoking was 23%. More than 63% of current smokers report ever smoking on campus, but less than 10% ever received a warning or a ticket for their violation. Nearly all respondents (92.5%) reported witnessing someone smoking on campus, and 22% reported witnessing someone receiving a ticket. Barriers to policy success include lack of reminders about the policy, lack of support from students and University administrators, and insufficient fines. Smoking behaviour (OR: 7.96; 95% CI: 5.13 to 12.36), beliefs about policy adherence (OR: 0.52; 95% CI: 0.40 to 0.69), support for the policy (OR: 0.71; 95% CI: 0.55 to 0.91) and attitudes against smoking behaviour (OR: 0.35; 95% CI: 0.25 to 0.49) were all significantly associated with self-reported policy violations. CONCLUSIONS This study found that violations of the campus smoke-free policy were fairly frequent and the policy has been largely ineffective, indicating a need for other interventions. Approaches to improve adherence to the policy should address barriers such as reminders about the policy, better policy enforcement and support from the administration.
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Affiliation(s)
- Sujith Ramachandran
- Pharmacy Administration, University of Mississippi, University, Mississippi, USA
| | - Sandra Bentley
- Pharmacy Practice, University of Mississippi, University, Mississippi, USA
| | - Ethan Casey
- Pharmacy, Wal-Mart Stores Inc, Horn Lake, Mississippi, USA
| | - John P Bentley
- Pharmacy Administration, University of Mississippi, University, Mississippi, USA
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Wong SL, Epperson AE, Rogers J, Castro RJ, Jackler RK, Prochaska JJ. A multimodal assessment of tobacco use on a university campus and support for adopting a comprehensive tobacco-free policy. Prev Med 2020; 133:106008. [PMID: 32027917 PMCID: PMC7396290 DOI: 10.1016/j.ypmed.2020.106008] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2019] [Revised: 01/28/2020] [Accepted: 02/01/2020] [Indexed: 11/19/2022]
Abstract
Many college campuses now prohibit tobacco use. At a private U.S. university, the current study assessed cigarette and e-cigarette use and characterized the climate for adopting a comprehensive tobacco-free policy. Data were gathered January-August 2018 via an: environmental scan; cigarette-urn audit; and representative surveys with campus community members. Despite low prevalence of tobacco (0.5%-8%) and e-cigarette use (0.9%-6%) among all groups, campus cigarette clean-up costs exceeded $114,000 for an estimated >1 million butts left on campus annually. A majority of respondents (63% of N = 2218) favored a campus-wide tobacco-free policy, 16% opposed, and 21% abstained. Most respondents endorsed benefits of supporting health (93%), ensuring tobacco-free air to breathe (92%), reducing litter (88%), preventing tobacco use (84%) and fires (83%), and helping tobacco users quit (65%). Identified challenges included policy enforcement (69%) and stigmatization of smoking (57%); 30% viewed a policy as compromising personal freedoms. In a model explaining 35% of variance in policy support, those more likely to favor comprehensive tobacco-free campus policy were Asian respondents; diagnosed with asthma; exposed to secondhand smoke on campus; who viewed campus cigarette butt litter as problematic; and identified health, prevention, and cessation benefits of a tobacco-free campus. Those less likely in favor were students, those who smoke, and those perceiving impingement upon personal freedoms, stigmatization, and broader (slippery slope) implications. Findings indicate low tobacco use prevalence among the campus community, yet a large volume of butt litter and high tobacco clean-up costs. Predictors of policy support can inform campus outreach efforts.
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Affiliation(s)
- Samantha L Wong
- Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, USA
| | - Anna E Epperson
- Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, USA
| | - Jayna Rogers
- Health Improvement Program, Stanford University, USA
| | - Ralph J Castro
- Office of Alcohol Policy & Education, Stanford University, USA
| | - Robert K Jackler
- Department of Otolaryngology-Head & Neck Surgery, Stanford University School of Medicine, USA
| | - Judith J Prochaska
- Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, USA.
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13
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Linnansaari A, Schreuders M, Kunst AE, Rimpelä A, Lindfors P. Understanding school staff members' enforcement of school tobacco policies to achieve tobacco-free school: a realist review. Syst Rev 2019; 8:177. [PMID: 31324212 PMCID: PMC6642528 DOI: 10.1186/s13643-019-1086-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Accepted: 07/02/2019] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND School tobacco policies (STPs) that aim to achieve a tobacco-free environment require consistent enforcement by school staff. However, little is known about why staff choose whether or not to enforce STPs. Therefore, we investigated staff members' responses to STPs that determine enforcement. Furthermore, we examined how these responses depend on contextual factors at the individual, interpersonal, school, implementation, and national levels. METHODS We performed a realist review (RR), which synthesizes existing primary evidence into a programme theory demonstrating key causal pathways through Context-Mechanism-Outcome configurations (CMOs). These CMOs link contextual factors to outcomes (i.e. staff enforcement) by explaining the underlying generative mechanisms (i.e. staff members' cognitive, psychosocial, and behavioural responses). A systematic literature search for the period 2000-2016 was performed using Academic Search Premier, PsycInfo, and MEDLINE. Forty English-language articles were identified for the synthesis. RESULTS Our programme theory demonstrated three CMOs: when contextual factors make staff members experience STP enforcement as part of their professional role and duties, it may lead to staff members showing responsibility for STP enforcement (CMO1); when contextual factors make staff members feel their contribution is leading to positive outcomes, it may lead to staff members showing motivation to enforce STPs (CMO2), and when contextual factors make staff members feel that they are able to deal with students' responses, it may lead to staff members showing confidence in STP enforcement (CMO3). Moreover, the programme theory provided more precise insights into what contextual factors contribute to triggering the individual mechanisms and the consequent outcomes. CONCLUSIONS By applying a realist approach, we have been able to detect three CMOs explaining staff members' STP enforcement. The findings provide useful insights explaining how stakeholders can support staff members' STP enforcement and consequently improve the impact of STPs on adolescent smoking.
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Affiliation(s)
- Anu Linnansaari
- Faculty of Social Sciences, Health Sciences, Tampere University, P.O. Box 100, 33014, Tampere, Finland
| | - Michael Schreuders
- Department of Public Health, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Institute, Amsterdam, The Netherlands
| | - Anton E Kunst
- Department of Public Health, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Institute, Amsterdam, The Netherlands
| | - Arja Rimpelä
- Faculty of Social Sciences, Health Sciences, Tampere University, P.O. Box 100, 33014, Tampere, Finland.,PERLA-Tampere Centre for Childhood, Youth and Family Research, Tampere University, 33014, Tampere, Finland.,Department of Adolescent Psychiatry, Pitkäniemi Hospital, Tampere University Hospital, 33380, Nokia, Finland
| | - Pirjo Lindfors
- Faculty of Social Sciences, Health Sciences, Tampere University, P.O. Box 100, 33014, Tampere, Finland.
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14
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Guillaumier A, Bonevski B, Paul C, Wiggers J, Germov J, Mitchell D, Bunch D. Australian university smoke-free policy implementation: a staff and student survey. Health Promot J Austr 2019; 28:165-169. [PMID: 27894416 DOI: 10.1071/he16063] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2016] [Accepted: 10/07/2016] [Indexed: 11/23/2022] Open
Abstract
Issue addressed Universities represent important settings for the implementation of public health initiatives such as smoke-free policies. The study aimed to assess staff and student attitudes towards policy enforcement and compliance as well as the acceptability of the provision of cessation support in this setting. Methods A cross-sectional study was conducted following the introduction of a designated-areas partial smoke-free policy at two campuses of one Australian university in 2014. Staff (n=533) and students (n=3060) completed separate online surveys assessing attitudes towards smoke-free policy enforcement and compliance, and acceptability of university-provided cessation support. Results Students held significantly stronger beliefs than staff that the smoke-free policy required staff enforcement (69% vs 60%) and violation penalties (67% vs 60%; both P's <0.01); however, most staff (66%) did not believe enforcement was part of their role. Only 55% of student smokers were aware that the university provided any cessation support. 'Free or cheap nicotine replacement therapy' (65%) and 'free stop smoking counselling service' (60%) were the most popular strategies student smokers thought the university should provide. Conclusions University staff and students hold conflicting views over the need for policy enforcement and who is responsible for enforcement roles. Students view the university as an acceptable setting for the provision of smoking cessation support. So what? Where staff are expected to enforce smoke-free policies, specific education and training should be provided. Ongoing monitoring of compliance and enforcement behaviour appears necessary to avoid the pervasive kind of non-compliance to smoke-free policies that have been seen in other settings.
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Affiliation(s)
- Ashleigh Guillaumier
- School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle and Hunter Medical Research Institute, Locked Bag 1000, New Lambton, NSW 2305, Australia
| | - Billie Bonevski
- School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle and Hunter Medical Research Institute, Locked Bag 1000, New Lambton, NSW 2305, Australia
| | - Christine Paul
- School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle and Hunter Medical Research Institute, Locked Bag 1000, New Lambton, NSW 2305, Australia
| | - John Wiggers
- School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle and Hunter Medical Research Institute, Locked Bag 1000, New Lambton, NSW 2305, Australia
| | - John Germov
- School of Humanities and Social Science, Faculty of Education and Arts, University of Newcastle, University Drive, Callaghan, NSW 2308, Australia
| | - Dylan Mitchell
- Human Resource Services, University of Newcastle, University Drive, Callaghan, NSW 2308, Australia
| | - Diane Bunch
- Human Resource Services, University of Newcastle, University Drive, Callaghan, NSW 2308, Australia
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15
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Braverman MT, Geldhof GJ, Hoogesteger LA, Johnson JA. Predicting students' noncompliance with a smoke-free university campus policy. Prev Med 2018; 114:209-216. [PMID: 30049663 DOI: 10.1016/j.ypmed.2018.07.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Revised: 06/29/2018] [Accepted: 07/02/2018] [Indexed: 10/28/2022]
Abstract
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.
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Affiliation(s)
- Marc T Braverman
- School of Social and Behavioral Health Sciences, Oregon State University, Corvallis, OR 97331, USA.
| | - G John Geldhof
- School of Social and Behavioral Health Sciences, Oregon State University, Corvallis, OR 97331, USA.
| | | | - Jessica A Johnson
- Southern Nevada Health District, Office of Chronic Disease Prevention and Health Promotion, 280 S. Decatur Blvd., Las Vegas, NV 89107, USA.
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16
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Ickes MJ, Rayens MK, Wiggins A, Hahn EJ. Students' Beliefs About and Perceived Effectiveness of a Tobacco-Free Campus Policy. Policy Polit Nurs Pract 2017; 18:17-25. [PMID: 28558518 DOI: 10.1177/1527154417700633] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Tobacco-free (TF) college campus policies have potential to be a high-impact tobacco control strategy. The purposes of the study presented here were to (a) determine the demographic and personal characteristics associated with students' beliefs about and perceived effectiveness of a TF campus policy and (b) assess whether tobacco use status and exposure to secondhand smoke (SHS) predicted beliefs and perceived effectiveness. Five thousand randomly selected students from a large southeastern university were invited by e-mail to participate in an online survey in April 2013, three and a half years after policy implementation. Students held positive beliefs about the policy (average rating 84% of the maximum possible score). Sixty-one percent believed that the policy was successful at reducing SHS exposure; and 40% thought the policy encouraged quitting. Males were less likely than females to believe the policy was effective in reducing SHS exposure and encouraging quitting. Lower undergraduates were more likely to perceive the policy as less effective in reducing SHS exposure; international students were more likely than domestic students to perceive the policy as more effective at encouraging quitting. Students most exposed to SHS were less likely to perceive the policy was effective. Compared with nonusers, those who smoked cigarettes were less likely to perceive the policy as effective in encouraging quitting. Tailored messaging regarding policy benefits are necessary. Perceived effectiveness of TF policies may be related to compliance with the policy and should be further investigated. Objective measures of effectiveness and tobacco use behaviors are needed to fully measure the success of TF campus policies.
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Affiliation(s)
- Melinda J Ickes
- 1 Department of Kinesiology and Health Promotion, University of Kentucky, Lexington, KY, USA.,2 BREATHE, College of Nursing, University of Kentucky, Lexington, KY, USA
| | - Mary Kay Rayens
- 2 BREATHE, College of Nursing, University of Kentucky, Lexington, KY, USA.,3 College of Nursing and College of Public Health, University of Kentucky, Lexington, KY, USA
| | - Amanda Wiggins
- 2 BREATHE, College of Nursing, University of Kentucky, Lexington, KY, USA.,4 College of Nursing, University of Kentucky, Lexington, KY, USA
| | - Ellen J Hahn
- 2 BREATHE, College of Nursing, University of Kentucky, Lexington, KY, USA.,3 College of Nursing and College of Public Health, University of Kentucky, Lexington, KY, USA
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17
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Hart E, Burns S. The relationship between alcohol consumption and related harm among young university students. Health Promot J Austr 2017; 27:15-20. [PMID: 26827614 DOI: 10.1071/he15086] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2015] [Accepted: 11/04/2015] [Indexed: 11/23/2022] Open
Abstract
Issue addressed Research has shown that Australian university students consume alcohol at a higher level than their peers from the general population and are therefore more likely to witness and experience alcohol-related harm. This study measured the prevalence of alcohol consumption among 18-24-year-old university students and the association between alcohol consumption and witnessed and experienced harms. Methods A random cross-sectional sample of university students aged 18-24 years (n=2466) was recruited via the University Survey Office and through random intercept at campus market day. All participants completed an online survey that included the Alcohol Use Disorders Identification Test, Alcohol Problems Scale and an additional scale measuring witnessed harm. Results Principal Components Analysis revealed three factors within the Alcohol Problems Scale; i.e. Criminal and Aggressive Behaviour, Health and Emotional Harms and Sexual Harms. Students who consume alcohol at high-risk levels were significantly more likely to score highly on each factor, 1.6 times more likely to experience harm and 1.1 times more likely to witness harm than students who consume alcohol at low-risk levels. Conclusions The positive association between alcohol consumption and alcohol-related harm supports previous findings. This study adds previous research through the categorisation of harm into factors. So what? Integrated and comprehensive interventions addressing alcohol consumption among young university students that are informed by evidence-based research can be tailored to ensure that they meet the needs of the target group.
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Affiliation(s)
- Ellen Hart
- Collaboration for Evidence, Research, and Impact in Public Health, Curtin University, GPO Box U1987, Perth, WA 6845, Australia
| | - Sharyn Burns
- Collaboration for Evidence, Research, and Impact in Public Health, Curtin University, GPO Box U1987, Perth, WA 6845, Australia
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18
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Braverman MT, Hoogesteger LA, Johnson JA, Aarø LE. Supportive of a smoke-free campus but opposed to a 100% tobacco-free campus: Identification of predictors among university students, faculty, and staff. Prev Med 2017; 94:20-26. [PMID: 27784635 DOI: 10.1016/j.ypmed.2016.10.021] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Revised: 10/20/2016] [Accepted: 10/21/2016] [Indexed: 10/20/2022]
Abstract
Many universities are adopting campus tobacco policies, but little research has explored factors influencing the choice between the policy options of smoke-free versus 100% tobacco-free. Students, faculty, and staff at a U.S. state university participated in a web-based survey in 2013, approximately one year after adoption of a smoke-free policy. Respondents who expressed support for the policy were included in an analysis to examine their opinions regarding a 100% tobacco-free policy. The samples included 4138 students and 1582 faculty/staff. Bivariate analyses and multivariate logistic regression were used to identify predictors of opposition to a tobacco-free campus. Independent variables included strength of support for a smoke-free campus, past-month tobacco use (cigarettes, smokeless tobacco, e-cigarettes, non-cigarette combustible tobacco products), campus exposure to secondhand smoke, perceptions of tobacco-related behaviors and norms, and demographics. Of these supporters of a smoke-free campus, 14.3% of students and 10.2% of faculty/staff were opposed to a tobacco-free campus. In the multivariate analyses, in both samples, smokeless tobacco use predicted opposition while smoke-free policy support and female gender predicted support. In addition, among students, current or former cigarette smoking and non-cigarette combustible tobacco use predicted opposition; international student status and secondhand smoke exposure predicted support. Among faculty/staff, age over 55 predicted support. Future research should examine why current and former smokers might oppose policies restricting non-combustible tobacco products, even when they support smoke-free policies. In policy planning, campus administrators should communicate actual tobacco usage levels. International students who do not use tobacco may be a source of policy support.
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Affiliation(s)
- Marc T Braverman
- School of Social and Behavioral Health Sciences, Oregon State University, Corvallis, OR 97331, USA.
| | - Lisa A Hoogesteger
- Advising Services, Linn-Benton Community College, Albany, OR 97321, USA.
| | - Jessica A Johnson
- Southern Nevada Health District, Office of Chronic Disease Prevention and Health Promotion, 280 S. Decatur Blvd., Las Vegas, NV 89107, USA.
| | - Leif Edvard Aarø
- Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway.
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19
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Cooper TV, Cabriales JA, Hernandez N, Law J. A baseline assessment of attitudes toward tobacco free campus policies in a U.S./México border university. Addict Behav 2016; 60:223-7. [PMID: 27174217 DOI: 10.1016/j.addbeh.2016.04.023] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2016] [Revised: 04/04/2016] [Accepted: 04/20/2016] [Indexed: 10/21/2022]
Abstract
In recent years there has been an increase in the number of smoke/tobacco free settings, including university campuses. Given the benefits associated with the implementation of smoke and tobacco free campus policies, it is important to study attitudes toward these due to their potential association with subsequent implementation issues. The present study assessed potential predictors of attitudes toward tobacco free campus (TFC) policies, tobacco use risk perception, and perceived problematic campus tobacco use at a university located on the U.S./México border. University faculty, staff, and students (N=3002; Mage=30.4; 60% female; 67.1% Hispanic) completed an online survey regarding tobacco use history, attitudes toward TFC policies, tobacco use risk perception, perception of problematic tobacco use on campus, and awareness of the current tobacco use campus policy. Male gender, non Hispanic white ethnicity, smoking behavior (history/current), and identifying the current tobacco use policy were associated with less positive attitudes toward TFC policies and lower tobacco use risk perception. Non Hispanic white ethnicity and current smoking were associated with a lower perception of problematic campus tobacco use. Attitudes toward TFC policies and perceptions were generally positive, yet educating about the risks associated with tobacco use and addressing misconceptions about the dangers of secondhand smoke to potentially promote TFC policies seem warranted.
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20
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Burns S, Jancey J, Crawford G, Hallett J, Portsmouth L, Longo J. A cross sectional evaluation of an alcohol intervention targeting young university students. BMC Public Health 2016; 16:610. [PMID: 27439308 PMCID: PMC4955165 DOI: 10.1186/s12889-016-3314-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2015] [Accepted: 07/15/2016] [Indexed: 11/23/2022] Open
Abstract
Background Hazardous drinking has been found to be higher among young university students compared to their non-university peers. Although young university students are exposed to new and exciting experiences, including greater availability and emphasis on social functions involving alcohol there are few multi strategy comprehensive interventions aimed at reducing alcohol-related harms. Methods Random cross sectional online surveys were administered to 18–24 year old students studying at the main campus of a large metropolitan university in Perth, Western Australia. Prior to the completion of the second survey an alcohol intervention was implemented on campus. Completed surveys were received from 2465 (Baseline; T1) and 2422 (Post Year 1: T2) students. Students who consumed alcohol in the past 12 months were categorised as low risk or hazardous drinkers using the Alcohol Use Disorders Identification Test (AUDIT). Due to the cross sectional nature of the two samples two-tailed two-proportion z-test and two sample t-tests were employed to determine statistical significance between the two time periods for categorical and continuous variables respectively. Results At T1 and T2 89.1 % and 87.2 % of the total sample reported drinking alcohol in the past month respectively. Hazardous levels of alcohol consumption reduced slightly between T1 (39.7 %) and T2 (38 %). In both time periods hazardous drinkers reported significantly higher mean scores for experienced harm, second-hand harm and witnessed harm scores compared to low risk drinkers (p <0.001). Hazardous drinkers were significantly more likely to experience academic problems due to their alcohol consumption and to report more positive alcohol expectations than low risk drinkers at both time periods (p <0.001). Conclusions Harms and problems for students who report hazardous drinking are of concern and efforts should be made to ensure integrated and targeted strategies reach higher risk students and focus on specific issues such as driving while intoxicated and alcohol related unplanned sexual activity. However there is also a need for universal strategies targeting all students and low risk drinkers as they too are exposed to alcohol harms within the drinking and social environment. Changing the culture of the university environment is a long term aim and to effect change a sustained combination of organisational actions, partnerships and educational actions is required.
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Affiliation(s)
- Sharyn Burns
- School of Public Health, Curtin University, GPO Box U1987, Perth, WA, 6845, Australia.
| | - Jonine Jancey
- School of Public Health, Curtin University, GPO Box U1987, Perth, WA, 6845, Australia
| | - Gemma Crawford
- School of Public Health, Curtin University, GPO Box U1987, Perth, WA, 6845, Australia
| | - Jonathan Hallett
- School of Public Health, Curtin University, GPO Box U1987, Perth, WA, 6845, Australia
| | - Linda Portsmouth
- School of Public Health, Curtin University, GPO Box U1987, Perth, WA, 6845, Australia
| | - Janelle Longo
- South Metropolitan Population Health Unit, Department of Health, PO Box 546, Fremantle, WA, 6959, Australia
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21
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Feldman I, Donchin M, Levine H. A smoke-free medical campus in Jerusalem: data for action. Isr J Health Policy Res 2016; 5:20. [PMID: 27274394 PMCID: PMC4895807 DOI: 10.1186/s13584-016-0080-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Accepted: 05/20/2016] [Indexed: 11/15/2022] Open
Abstract
Background Establishing smoke-free environments is a major component of tobacco control policy. The introduction of a smoke-free policy in medical campuses may serve as a role model for other educational and health institutions but little has been published about their prevalence or impact. In 2012, the Faculty of Medicine at Hebrew University–Hadassah in Jerusalem, Israel launched a smoke-free Medical Campus initiative. This study examined smoking behaviours, cigarette smoke exposure and attitudes towards the smoke-free campus policy among students and employees. Methods Using a self-administered questionnaire, data was collected from medical, dental and pharmacy students, as well as employees of the school of pharmacy. We approached the entire target population in 2013 (N = 449), with a response rate of 72.5 % (N = 313). Results The rate of smoking was 8.3 % (95 % CI 5.5–11.9 %). Most participants reported daily exposure or exposure several times a week to cigarette smoke (65.8 %). Overall, 98.0 % had reported seeing people smoke in open campus areas and 27.2 % indoors. Most participants supported the smoking ban inside buildings (94.2 %) but fewer supported (40.8 %) a complete ban of smoking throughout the campus, including outside areas. Only 18.4 % agreed that a policy prohibiting smoking was unfair to smokers. A multivariable analysis showed that support for a complete ban on smoking on campus was higher among non-smokers than for smokers (OR = 9.5, 95 % CI 2.2–31.5, p = 0.02). Conclusions The smoke-free policy does not have total compliance, despite the strong support among both students and employees for a smoke-free medical campus. The data collected will assist policy makers move towards a total smoke-free medical campus and will aid tobacco control efforts in Israel and other countries.
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Affiliation(s)
- Itamar Feldman
- Hebrew University-Hadassah Faculty of Medicine, Ein Kerem, 17 Habanai Street, Entrance A, Jerusalem, 9626430 Israel
| | - Milka Donchin
- Hebrew University-Hadassah Braun School of Public Health and Community Medicine, Ein Kerem, Jerusalem, Israel
| | - Hagai Levine
- Hebrew University-Hadassah Braun School of Public Health and Community Medicine, Ein Kerem, Jerusalem, Israel
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22
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Burns S, Hart E, Jancey J, Hallett J, Crawford G, Portsmouth L. A cross sectional evaluation of a total smoking ban at a large Australian university. BMC Res Notes 2016; 9:288. [PMID: 27230617 PMCID: PMC4882868 DOI: 10.1186/s13104-016-2090-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2016] [Accepted: 05/15/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Total smoking bans have been found to contribute positively to the health of non-smokers by reducing exposure to second-hand smoke, and to enhance the likelihood of cessation among smokers. METHODS Two cross-sectional electronic surveys of staff and students at a large Australian university were conducted prior (n = 969) and 1 year post (n = 670) the implementation of a smoke free campus policy. Demographics, tobacco use, intention to quit, attitudes towards smoking and smoking restrictions and awareness of and attitudes towards the campus smoking policy were measured. RESULTS Exposure to second-hand smoke (SHS) reduced significantly (p < 0.001) one year after policy implementation. Smoking prevalence was similar at both time periods (T1 9.3 %; T2 8.4 %) and over half of smokers indicated they were planning to quit smoking in the future (T1 65.5 vs T2 62.3 %). There was a significant increase in positive responses to the statement the campus should be totally smoke free including all outdoor areas at T2 compared to T1 (T1 60.8 vs T2 71.4 %; p < 0.001), however respondents felt there should be places on campus for smokers to smoke (T1 53.6 vs T2 47 %; p < 0.05). CONCLUSIONS This study found a significant positive difference in exposure SHS after implementation of the total ban. Although prevalence of smoking in this study was low, the proportion of respondents who were contemplating smoking cessation suggests support for smokers would be beneficial. Continued awareness raising, education and enforcement is likely to enhance the long term outcomes of the total ban.
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Affiliation(s)
- Sharyn Burns
- Collaboration for Evidence, Research and Impact in Public Health, School of Public Health, Curtin University, GPO Box U1987, Perth, WA 6845 Australia
| | - Ellen Hart
- Collaboration for Evidence, Research and Impact in Public Health, School of Public Health, Curtin University, GPO Box U1987, Perth, WA 6845 Australia
| | - Jonine Jancey
- Collaboration for Evidence, Research and Impact in Public Health, School of Public Health, Curtin University, GPO Box U1987, Perth, WA 6845 Australia
| | - Jonathan Hallett
- Collaboration for Evidence, Research and Impact in Public Health, School of Public Health, Curtin University, GPO Box U1987, Perth, WA 6845 Australia
| | - Gemma Crawford
- Collaboration for Evidence, Research and Impact in Public Health, School of Public Health, Curtin University, GPO Box U1987, Perth, WA 6845 Australia
| | - Linda Portsmouth
- Collaboration for Evidence, Research and Impact in Public Health, School of Public Health, Curtin University, GPO Box U1987, Perth, WA 6845 Australia
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23
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Sureda X, Fernández E, Martínez-Sánchez JM, Fu M, López MJ, Martínez C, Saltó E. Secondhand smoke in outdoor settings: smokers' consumption, non-smokers' perceptions, and attitudes towards smoke-free legislation in Spain. BMJ Open 2015; 5:e007554. [PMID: 25854974 PMCID: PMC4390691 DOI: 10.1136/bmjopen-2014-007554] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To describe where smokers smoke outdoors, where non-smokers are exposed outdoors to secondhand smoke (SHS), and attitudes towards smoke-free outdoor areas after the implementation of national smoke-free legislation. DESIGN This cross-sectional study was conducted between June 2011 and March 2012 (n=1307 participants). SETTING Barcelona, Spain. PARTICIPANTS Representative, random sample of the adult (≥16 years) population. PRIMARY AND SECONDARY OUTCOMES Proportion of smoking and prevalence of exposure to SHS in the various settings according to type of enclosure. Percentages of support for outdoor smoke-free policies according to smoking status. RESULTS Smokers reported smoking outdoors most in bars and restaurants (54.8%), followed by outdoor places at work (46.8%). According to non-smokers, outdoor SHS exposure was highest at home (42.5%) and in bars and restaurants (33.5%). Among non-smoking adult students, 90% claimed exposure to SHS on university campuses. There was great support for banning smoking in the majority of outdoor areas, which was stronger among non-smokers than smokers. Over 70% of participants supported smoke-free playgrounds, school and high school courtyards, and the grounds of healthcare centres. CONCLUSIONS Extending smoking bans to selected outdoor settings should be considered in further tobacco control interventions to protect non-smokers from SHS exposure and to establish a positive model for youth. The majority of public support for some outdoor smoke-free areas suggests that it is feasible to extend smoking bans to additional outdoor settings.
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Affiliation(s)
- Xisca Sureda
- Tobacco Control Unit, Cancer Control and Prevention Programme, Institut Català d'Oncologia-ICO, L'Hospitalet de Llobregat, Barcelona, Spain
- Cancer Control and Prevention Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
- Department of Clinical Sciences, School of Medicine, Universitat de Barcelona, L'Hospitalet del Llobregat, Barcelona, Spain
| | - Esteve Fernández
- Tobacco Control Unit, Cancer Control and Prevention Programme, Institut Català d'Oncologia-ICO, L'Hospitalet de Llobregat, Barcelona, Spain
- Cancer Control and Prevention Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
- Department of Clinical Sciences, School of Medicine, Universitat de Barcelona, L'Hospitalet del Llobregat, Barcelona, Spain
- Catalan Network of Smoke-free Hospitals, Insitut Català d'Oncologia, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Jose M Martínez-Sánchez
- Tobacco Control Unit, Cancer Control and Prevention Programme, Institut Català d'Oncologia-ICO, L'Hospitalet de Llobregat, Barcelona, Spain
- Cancer Control and Prevention Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
- Biostatistic Unit, Department of Basic Science, School of Medicine and Health Sciences, Universitat Internacional de Catalunya, Satn Cugat del Valles, Spain
| | - Marcela Fu
- Tobacco Control Unit, Cancer Control and Prevention Programme, Institut Català d'Oncologia-ICO, L'Hospitalet de Llobregat, Barcelona, Spain
- Cancer Control and Prevention Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
- Department of Clinical Sciences, School of Medicine, Universitat de Barcelona, L'Hospitalet del Llobregat, Barcelona, Spain
| | - María J López
- Evaluation and Interventions Methods Service, Agència de Salut Pública de Barcelona, Barcelona, Spain
- Biomedical Research Centre Network for Epidemiology and Public Health (CIBERESP), Agència de Salut Pública de Barcelona, Barcelona, Spain
- Institut d'Investigació Biomèdica-IBB Sant Pau, Sant Antoni Maria Claret, Barcelona, Spain
| | - Cristina Martínez
- Tobacco Control Unit, Cancer Control and Prevention Programme, Institut Català d'Oncologia-ICO, L'Hospitalet de Llobregat, Barcelona, Spain
- Cancer Control and Prevention Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
- Catalan Network of Smoke-free Hospitals, Insitut Català d'Oncologia, L'Hospitalet de Llobregat, Barcelona, Spain
- Department of Nursing, School of Medicine and Health Sciences, Universitat Internacional de Catalunya, Sant Cugat del Valles, Spain
| | - Esteve Saltó
- Cancer Control and Prevention Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
- Direcció General de Planificació i Recerca en Salut, Generalitat de Catalunya, Travessera de les Corts, Barcelona, Spain
- Department of Public Health, School of Medicine, Universitat de Barcelona, Barcelona, Spain
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Braverman MT, Hoogesteger LA, Johnson JA. Predictors of support among students, faculty and staff for a smoke-free university campus. Prev Med 2015; 71:114-20. [PMID: 25542670 DOI: 10.1016/j.ypmed.2014.12.018] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2014] [Revised: 10/25/2014] [Accepted: 12/18/2014] [Indexed: 11/15/2022]
Abstract
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.
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Affiliation(s)
- Marc T Braverman
- School of Social and Behavioral Health Sciences, Oregon State University, Corvallis, OR 97331, USA.
| | - Lisa A Hoogesteger
- Office of Healthy Campus Initiatives, Oregon State University, Corvallis, OR 97331, USA.
| | - Jessica A Johnson
- Nellis Family Medicine Clinical Investigation Programs, Nellis Air Force Base, NV 89191, USA.
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Burns S, Crawford G, Hallett J, Jancey J, Portsmouth L, Hunt K, Longo J. Consequences of Low Risk and Hazardous Alcohol Consumption among University Students in Australia and Implications for Health Promotion Interventions. ACTA ACUST UNITED AC 2015. [DOI: 10.4236/ojpm.2015.51001] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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26
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Burns S, Bowser N, Smith J, Jancey J, Crawford G. An exploratory study of smokers' and stakeholders' expectations of the implementation of a smoke-free policy in a university setting. Health Promot J Austr 2014; 25:129-35. [PMID: 24987909 DOI: 10.1071/he13044] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2013] [Accepted: 04/12/2014] [Indexed: 11/23/2022] Open
Abstract
ISSUES ADDRESSED Smoke-free policies restricting tobacco use in public places are common in many middle- and high-income countries. Implementation of a smoke-free policy does not automatically result in a smoke-free environment, and appropriate enforcement procedures must be clearly communicated and implemented. Safety and restrictions in private spaces, especially student housing, are also issues that need to be explored. This research explored perceptions and attitudes of staff and student smokers and key stakeholders before the implementation of a complete campus ban on smoking at a large Australian university. METHODS Interviews were conducted with staff and student smokers (n=9) and stakeholders (n=9). The interviews explored attitudes towards a completely smoke-free policy in the university environment, perceptions relating to enforcement of and compliance with a completely smoke-free policy, and support needed from the university for smokers. RESULTS Participants generally supported a complete smoke-free policy. Key themes associated with the policy implementation included health implications, stigmatisation and labelling, liberty, and enforcement. CONCLUSION Smoke-free policies require careful planning, evaluation, and appropriate enforcement to ensure maximum impact. Further research is needed to improve compliance with smoke-free policies in outdoor environments and diverse spaces. SO WHAT? A better understanding of attitudes and intentions towards a smoke-free policy before implementation may provide useful insight into the potential challenges and provide guidelines for the development of strategies to improve policy readiness and adherence. University support for smokers to quit is essential when implementing a smoke-free policy.
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Affiliation(s)
- Sharyn Burns
- Western Australian Centre for Health Promotion Research, School of Public Health, Curtin University, Kent Street, Bentley, WA 6102, Australia
| | - Nicole Bowser
- Western Australian Centre for Health Promotion Research, School of Public Health, Curtin University, Kent Street, Bentley, WA 6102, Australia
| | - Jenny Smith
- School of Public Health, Curtin University, Kent Street, Bentley, WA 6102, Australia
| | - Jonine Jancey
- Western Australian Centre for Health Promotion Research, School of Public Health, Curtin University, Kent Street, Bentley, WA 6102, Australia
| | - Gemma Crawford
- Western Australian Centre for Health Promotion Research, School of Public Health, Curtin University, Kent Street, Bentley, WA 6102, Australia
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