Trial and Lifetime Smoking Risks Among African American College Students

Abstract

The authors surveyed 614 African American university students to determine the magnitude of cigarette use, identify risk factors, and develop models to predict smoking. More than half (58.3%) of the participants had smoked at least once, and 9.3% of that group were lifetime smokers. Among the lifetime smokers, 71.3% had smoked during the 30 days preceding the survey. More women (66.8%) than men (56.1%) had tried smoking and were classed as lifetime smokers. Residence, parental, and peer smoking (current and childhood) were associated with trying smoking; age, race/ethnicity, and marital status were additional factors for becoming a lifetime smoker. The risk of being a lifetime smoker was reduced when neither friends nor parents of the student smoked and the student viewed spirituality as important. The results of this study add to the growing understanding of health risk behaviors among African Americans and can be useful in reducing smoking.     

Attitudinal and behavioral differences between cigarette users who do and do not identify as “smokers”

Objective: The current research aimed to understand differences in smoking-related identity among college students and to illustrate the distinct characteristics of nonidentified smokers (NIS). Participants: Students from 2 colleges in Massachusetts (N = 538; April 2016). Methods: Respondents reported by online survey whether or not they had smoked a cigarette in the past 30 days and if they self-identified as smokers. Nonsmokers (NIS) and identified smokers (IS) were then compared on their smoking attitudes and behavior. Results: NIS made up 12.5% of the sample and 64% of all tobacco users. NIS perceived themselves as less addicted and were more confident in their ability to quit smoking. They also were less likely to smoke alone, buy their own cigarettes, or have friends who smoked. Conclusions: College health officials can best motivate NIS to quit smoking by focusing on peer norms and the potential of long-term addiction.     

Assessing College Students' Autonomy Over Smoking With the Hooked on Nicotine Checklist

Objective, Participants, and Methods: In this study, the authors explored the psychometric properties of the Hooked on Nicotine Checklist (HONC) among 300 college students who were current smokers. The HONC is a 10-item survey instrument designed to measure diminished autonomy over smoking, a key aspect of dependence. Autonomy is diminished when symptoms present a barrier to cessation. Results: Internal consistency was high (α = .89), as was concurrent validity. Students who began smoking earlier and heavier smokers reported more symptoms than did those who started later and smoked less. After controlling for smoking frequency, the HONC was predictive of the likelihood of a failed cessation attempt, with each additional symptom doubling that likelihood. Conclusions: College health professionals could use the HONC to help new smokers recognize their symptoms of diminished autonomy. The HONC may serve as a recruiting tool for cessation programs, which could benefit such early-phase smokers.     

Cigarette Smoking and Cessation Among Trade or Technical School Students in Texas

Although students enrolled in trade or technical colleges are at an elevated risk for tobacco use, virtually no information exists regarding their smoking behaviors. Objective and Participants: In the present study, the authors examined (1) the prevalence of smoking and quitting among 617 students in 2 trade or technical colleges in East Texas and (2) on-campus media exposure to antitobacco messages. Methods: Students voluntary completed the 42-item Texas Trade and Technical School Tobacco Survey during a required introductory-level class. Results: Of the participating students, 34% reported past-30-day smoking (current smoking). Of current smokers, 74% reported a previous quit attempt and 64% wanted to quit before graduation. Although most current smokers expressed a desire to quit smoking, the antitobacco message they were least likely to see on campus was that regarding how to quit. Current smokers cited their own health as the most likely reason to quit smoking, and most reported wanting to quit on their own, without the use of resources. However, of the 9 listed resources, students were most likely to report the possible use of medication. Conclusions: Given that most smoking students desire to quit smoking—and that they are enrolled in trade or technical schools for an extended period of time—additional research should examine how successful interventions can be delivered at the trade or technical school itself.     

Screening and Brief Intervention for Tobacco Use by Student Health Providers on College Campuses

Abstract

Objective: This study assessed college students’ reports of tobacco screening and brief intervention by student health center providers. Participants: Participants were 3,800 students from 8 universities in North Carolina. Methods: Web-based survey of a stratified random sample of undergraduates. Results: Fifty-three percent reported ever visiting their student health center. Of those, 62% reported being screened for tobacco use. Logistic regression revealed screening was higher among females and smokers, compared to nonsmokers. Among students who were screened and who reported tobacco use, 50% reported being advised to quit or reduce use. Brief intervention was more likely among current daily smokers compared to current nondaily smokers, as well as at schools with higher smoking rates. Screening and brief intervention were more likely at schools with lower clinic caseloads. Conclusions: Results highlight the need to encourage college health providers to screen every patient at every visit and to provide brief intervention for tobacco users.     

A Smoking and Health Fair: Implementation and Evaluation

Abstract

A two-day health fair that focused entirely on the tobacco smoking habit was organized. Participating agencies offered information on smoking effects, cessation programs, and health screening to fair visitors. A visitor questionnaire indicated that the fair was successful in attracting both smokers and nonsmokers and that each group found information that was perceived as helpful. Issues involved in coordinating the project are discussed and suggestions for future smoking and health fairs are offered.     

Actual Versus Perceived Risk of Cervical Cancer Among College Women Smokers

Cervical cancer is a well-established smoking-related illness, but many at-risk women are unaware of this link. Objective: The authors designed this study to (1) investigate the relationship of smoking behavior with the history of abnormal Pap test results, sexual history, and perceived risk of cervical cancer and (2) determine whether self-classified smoking status (and hence perceived risk) corresponds with actual smoking behavior in a college student population. Participants and Method Summary: College women students (N = 135) completed a survey assessing smoking history, health history, sexual risk behavior, and risk awareness. Results: Relative to those who had not smoked in the past month, current smokers (n = 36, or 27% of the total sample) perceived themselves to be at higher risk for developing cervical cancer, but did not demonstrate increased awareness of specific cervical cancer risk factors, including smoking. Twenty-eight percent (10 of 36) of past-month smokers did not define themselves as current smokers. Conclusion: The authors conclude that antismoking and health-related messages targeting smokers may misfire for individuals who do not define themselves as smokers but are nonetheless at risk for smoking-related consequences and escalating use.     

Socioeconomic Correlates of Current and Regular Smoking Among College Students in Rhode Island

Objective: The objective of this study was to determine how sociodemographic variables, in particular socioeconomic status, correlate with current and regular smoking among college students in Rhode Island. Participants and Methods: Over a 4-year period (academic year 2000-2001 to 2003-2004), the authors examined sociodemographic correlates of cigarette use among 3,984 students aged 17 to 24 years from 10 colleges and universities in Rhode Island. Results: One-third of participants (32.0%) had smoked a cigarette in the 30 days preceding the questionnaire. Findings from a pair of logistic regression models indicated that participants from upper-income families were more likely to be current smokers—although not regular smokers—suggesting that the effect of socioeconomic status on smoking is partly dependent on the level of addiction. In addition, freshmen were more likely to be current and regular smokers than were upperclassmen, and white students were most likely to be regular smokers. Conclusions: The frequency of college students who reported that they first tried smoking and first smoked regularly while in college increased from freshman to senior year, indicating that the college years are a vulnerable period for smoking initiation and habituation.     

Concurrent alcohol and cigarette use among school-going adolescents in Korea

BackgroundConrurrent alcohol and tobacco use may increase the risk for substance abuse in adolescents. The aim of this study was to investigate concurrent alcohol and cigarette use and the co-occurrence risks of each substance in school-going adolescents in Korea.MethodsIn a cross-sectional nationally representative survey in 2016, 65,528 students (Mean age = 15.1 years, SE = 0.02) responded to a questionnaire that included measures of substance use and substance use exposure.ResultsIn all, 13.3% of the students were concurrent lifetime smokers and drinkers (19.3% among boys and 6.7% among girls), 25.5% lifetime alcohol users only (24.2% among boys and 26.9% among girls), 3.0% lifetime smokers only (4.7% among boys and 1.1% among girls) and 58.3% never smoked and never used alcohol (52.2% among boys and 47.8% among girls). All measures of more intensive smoking pattern and smoking exposure and more intensive drinking pattern and drinking exposures, respectively, were associated with consistently increased risk of lifetime alcohol use and lifetime smoking, respectively, compared to lifetime never smokers and abstainers. In multinomial logistic regression, compared to students who neither had used alcohol nor tobacco, concurrent lifetime smokers and drinkers were more likely to be male, mixed or boys school, higher school grade, lower paternal and maternal educational level, perceived lower socio-economic status, ever drug user, perceived stress above average, depressive mood, experience of violence victimization, and living in a rural area or medium sized city.ConclusionPrevention and treatment strategies should better incorporate the comorbidity of cigarette smoking and alcohol use in their intervention programmes.     

Smoking and Membership in a Fraternity or Sorority: A Systematic Review of the Literature

Abstract

Objective: Fraternity and sorority members have higher rates of smoking than other college students. This systematic review examines studies that included fraternity/sorority membership in their investigation of smoking behaviors. Participants/Methods: Studies identified in MEDLINE, PsychInfo, JSTOR, CINAHL, ERIC, and Google Scholar published between 2003 and 2013 were included if they included fraternity and/or sorority membership, were written in English, published in a peer-reviewed journal, and had smoking as an outcome variable. Nineteen studies were identified for the review. Results: Fraternity/sorority members were more likely to be nondaily smokers. Members who lived in the fraternity/sorority house had higher rates of smoking than members who lived elsewhere. Fraternity/sorority member smoking was associated with alcohol and other substance use. The influence of no-smoking policies on fraternity/sorority member smoking was also examined. Conclusions: Fraternity/sorority membership was associated with higher rates of smoking, but this association was influenced by other substance use and environmental factors.     

The Relationship of Smoking Status to Alcohol Use,Problems, and Health Behaviors in College Freshmen

Differences in drinking, consequences, and perceptions were examined between alcohol‐using college students by smoking status (current, past, and lifetime nonsmoker). Entering freshmen (N = 558: 45% male, 72% Caucasian, age M = 18) completed a questionnaire assessing smoking, drinking and current health perceptions. Results indicated current smokers drank more frequently, were more likely to drink to intoxication, and had more physiological consequences (e.g., blackouts, coordination problems) than past or lifetime nonsmokers, but past smokers also reported riskier drinking than lifetime nonsmokers. Despite a higher prevalence of alcohol‐related health problems in both current and past smokers, no current health differences were found. Results replicate findings that current smokers are at increased risk for problematic drinking and identify past smokers as another risk group.     

Preliminary Results of a Longitudinal Study of Collegiate Alcohol Abuse

Abstract

Objective: Hookah smoking is a popular form of tobacco use on university campuses. This study documented use, attitudes, and knowledge of hookah smoking among college students. Participants: The sample included 943 university students recruited between February 2009 and January 2010. Respondents (M age = 20.02) included 376 males, 533 females, and 34 who did not report sex. Methods: An anonymous online questionnaire was completed by respondents. Results: In this sample, 42.9% of college students had tried hookah, and 40% of those individuals had used it in the past 30 days. Students perceived fewer negative consequences of hookah smoking compared with cigarette smoking. Age, sex, racial background, marijuana/cigarette use, and perceptions of side effects were significantly associated with hookah use. Conclusions: University students are misinformed regarding the health consequences of hookah smoking. Programs aimed at education, prevention, and intervention for hookah use are needed to address this growing public health concern.     

Internet and Mobile Phone Text Messaging Intervention for College Smokers

Objective: The authors developed a smoking cessation program using mobile phone text messaging to provide tailored and stage-specific messages to college smokers. Participants and Methods: The authors recruited 31 daily smokers who desired to quit from a college campus and asked them to use an Internet and mobile phone text messaging program to quit smoking. Results: Six weeks after program initiation, 45% reported abstinence with 42% abstinent based on cotinine verification. Continued smokers reported significantly reduced smoking rates and dependence. Overall, participants accepted the text messages. Conclusions: These results replicate findings from an earlier study and indicate that mobile phone text messaging is a potentially efficacious and easily disseminated method for providing cessation interventions to young adult smokers.     

Understanding factors related to nonsmoking intention among college students

Abstract

Objective: While cigarette smoking in the United States has declined, the age range of smoking initiation has risen to include young adults. This study investigated the relationship of Theory of Planned Behavior constructs (TPB; attitudes, subjective norms, and perceived behavioral control [PBC]) to nonsmoking intention among college students. Participants: Participants were 619 students at a Southeastern US university (69.8% female, 70.8% ≤ age 21, and 73.5% white). Methods: Students were recruited by email in March 2013 to participate in an online TPB-based questionnaire. Results: Future-oriented attitudes and PBC predicted higher nonsmoking intention; subjective norms did not. Moderator analyses indicated injunctive norms were more influential for occasional smokers and PBC was less influential. Conclusions: Findings suggest TPB is useful in predicting nonsmoking intention, but differentially for nonsmokers and occasional smokers. Future work should consider the health-related utility of future-oriented attitudes toward nonhealth domains and the differing beliefs of occasional smokers.     

Social Smoking: An Untenable Position

Abstract

Social smokers manage the conflicting aspects of their liminal identities by negotiating complex roles of performance and exchange. Using a combination of methods, including both participant observation of cultural performances and informal interviews, to elicit lay theories and accounts of self-conscious practices, this project examines social actors, self-defined as nonsmokers (or reformed smokers), who engage in recreational tobacco use. Through in-depth interviews and observations of self-identified female social smokers, we document general characteristics of this subpopulation, sampled from a large Midwest capital and its surrounding areas. Social smokers occupy an untenable social space; as neither smokers nor nonsmokers, they use both practices and discourses about those practices to stake their claim to an untenable social position. We conclude with a theoretical discussion that compares our findings with other discourses on smoking, especially the discourse of addiction narratives. In an age of increasing awareness of the health consequences, smoking has become a culturally unavailable category producing “disconfirming realities” in which social smokers constantly renegotiate their status.     

The Receptlveness of Health Risk Appraisals in Health Instruction

Abstract

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 (χ² (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.     

Urban college student self-report of hookah use with health care providers

Objective: This study's purpose was to describe urban college students’ communication about hookah with health care providers. Participants: Participants included a random sample of undergraduate urban college students and health care providers. Methods: Students surveyed determined the epidemiology of hookah use in this population, how many health care providers asked about hookah, and how many students admitted hookah use to a physician. Results: Of 375 students surveyed, 78 (20.8%) had never tried it, 284 (75.7%) had smoked hookah at least once, and 64 students (22.6%) were classified as frequent hookah smokers. Only 15 (4.7%) reported a health care provider asking about hookah during visits, whereas 36 (12.7%) admitted their hookah use to a health care provider. Conclusion: Hookah use was found to be highly prevalent among students in one urban university. This study supports the hypothesis that few health care providers broach the topic with patients. Additional research on health consequences of hookah use, education, and improved screening is warranted.     

Styles of Physician Advice About Smoking Cessation in College Students

Abstract

Objective: To examine whether young adult cigarette smokers who were in the precontemplation and contemplation stages of change for smoking cessation would differ in their evaluations of vignettes depicting 2 types of physician advice. Participants: Fifty-seven young adult cigarette smokers who were undergraduate students (49.1% female, mean age = 20.4 years) attending an urban university. Methods: Participants evaluated 2 written vignettes. Both vignettes depicted physicians using patient-centered communication styles. One vignette depicted a physician giving a patient direct advice to quit smoking and the other a physician using a motivational style of advice. Data were collected from September 2004 through May 2005. Results: Participants rated the motivational advice vignette as significantly more favorable compared to the direct advice vignette on all assessed dimensions (global satisfaction, general satisfaction, physician affective style, physician technical style, and physician communication style). Conclusion: Smokers preferred the motivational advice style to simple patent-centered advice.     

Use of and Interest in Smoking Cessation Strategies Among Daily and Nondaily College Student Smokers

Abstract

Objective: To examine use of and interest in cessation strategies among nondaily and daily college student smokers. Participants: 800 undergraduate student smokers aged 18 to 25. Methods: The authors examined nondaily versus daily smoking in relation to use of and interest in cessation strategies using an online survey. Results: Nondaily (65.8%) versus daily smokers (34.3%) were more likely to have made a quit attempt (p = .01) but less likely to have used any assistance (p < .001). Nondaily smokers were less interested in pharmacotherapy and traditional behavioral interventions; however, there was no difference in interest in technology-based interventions among nondaily versus daily smokers. Controlling for covariates, there were no significant differences in interest in traditional or technology-based behavioral interventions. Higher motivation, lower confidence, and depressive symptomatology were related to interest in each intervention. Smoking for social reasons was related to interest in technology-based interventions. Conclusions: Different intervention strategies may be appropriate for nondaily and daily smokers.     

Trial and lifetime smoking risks among African American college students

The authors surveyed 614 African American university students to determine the magnitude of cigarette use, identify risk factors, and develop models to predict smoking. More than half (58.3%) of the participants had smoked at least once, and 9.3% of that group were lifetime smokers. Among the lifetime smokers, 71.3% had smoked during the 30 days preceding the survey. More women (66.8%) than men (56.1%) had tried smoking and were classed as lifetime smokers. Residence, parental, and peer smoking (current and childhood) were associated with trying smoking; age, race/ethnicity, and marital status were additional factors for becoming a lifetime smoker. The risk of being a lifetime smoker was reduced when neither friends nor parents of the student smoked and the student viewed spirituality as important. The results of this study add to the growing understanding of health risk behaviors among African Americans and can be useful in reducing smoking.