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.     

Cigarette Smoking Among Korean International College Students in the United States

Abstract

Objective and Participants: This study explored (1) the prevalence of cigarette smoking among South Korean international college students in the United States, (2) differences in smoking between on- and off-campus living arrangements, and (3) predictors of an increase in smoking over time in the United States Methods: An online survey was completed by 1,201 students at 52 4-year US universities (34% response rate). Results: The overall smoking prevalence was 43.5%. The smoking rate (29.0%) of female students was higher than that (4%) of female college students in South Korea. Sex, living place, living situation, length of stay as a student in the United States, home smoking rules, campus-wide tobacco-free policies, and levels of acculturative stress, anxiety, and depression were significantly associated with an increase in smoking (p < .05). Conclusions: Given the high smoking prevalence among the South Korean students on US college campuses, targeted prevention efforts for these students may be warranted.     

Adoption of an Outdoor Residential Hall Smoking Policy in a California Public University: A Case Study

Abstract

Objective: Because secondhand smoke is a public health concern, many colleges have adopted bans to ensure healthier environments. This study demonstrates how outdoor smoking policy change can be accomplished at a large public university. Participants: The participants were 1,537 students housed in residential communities at the University of California, Berkeley, who completed an online survey. Methods: A proposal for smoke-free residential communities that included student resident survey data was prepared. Results: The survey data indicated that most students (77%) were bothered by secondhand smoke, and most (66%) favored smoke-free environments. The data were used to advocate for a change in the residential community smoking policy. Conclusion: The survey data and institutional comparisons played a key role in administrators’ decision-making about campus smoking policy. Despite administrators’ concerns about students’ safety and freedom of choice, student-led advocacy was able to influence policy change.     

Depressive Symptoms and Cigarette Smoking in a College Sample

Objective and Participants: The authors examined (1) the relationship between depressive symptoms and cigarette smoking in a college sample and (2) the role of smoking self-efficacy (one's perceived ability to abstain from smoking) in explaining the relationship between depressive symptoms and cigarette smoking. Methods: Predominantly first-year college students at a large public university completed a self-report inventory indexing depressive symptoms, cigarette smoking, and smoking self-efficacy. Results: Findings indicated that students high in depressive symptoms smoked significantly more cigarettes per day than did those with low depressive symptoms. Further, among current smokers, smoking self-efficacy explained the relationship between depressive symptoms and cigarette smoking. Conclusions: These findings add to accumulating evidence that depressive symptoms are a risk factor for increased cigarette smoking in college students. The authors discuss implications for university-based smoking cessation and prevention programs.     

Social Facilitation Expectancies for Smoking: Psychometric Properties of a New Measure

Abstract

Objective: Expectancies about social outcomes for smoking are relevant to college student smokers, who frequently report “social smoking.” A new measure, the Social Facilitation Expectancies (SFE) scale, was developed to assess these beliefs. Participants: The SFE was administered to undergraduate college student smokers (N = 1,096; study completed in May 2011). Methods: Items were scored on a 5-point scale with a summed total score. The sample was randomly split and principle axis factoring and confirmatory factor analysis applied to determine scale structure. The structure was tested across sex and smoking groups and validation analyses were conducted. Results: A 9-item, 1-factor scale was replicated within each group. Higher SFE scores were observed among those with greater smoking experience and higher scores were associated with greater endorsement of other smoking-related beliefs. Conclusions: These preliminary findings provide support for the sound psychometric properties of this measure for use with young adult college students.     

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.     

Canadian Campus Smoking Policies: Investigating the Gap Between Intent and Outcome From a Student Perspective

Abstract

Background: Young adults remain the earliest legal target for the tobacco industry. Against this, the existence of smoking policies would appear to offer some protection to students on campus. However, little research has been conducted into the outcomes of such policies from a student perspective. Methods: The authors conducted 8 focus groups at 4 selected Canadian undergraduate campuses to investigate student perceptions and behaviors resulting from campus smoking policies. Results: Results indicated that student smoking behaviors are minimally impacted by campus smoking policies due to seriously compromised implementation and enforcement. Conclusions: These findings imply that the presence of campus smoking policies and claims of “smoke-free” campuses should not be misinterpreted as achievement and without renewed focus and adequate tobacco control infrastructure, it will remain possible for young adults to initiate and maintain tobacco smoking on campus.     

Waterpipe Smoking Among College Students in the United States: A Review of the Literature

Abstract

Objective: To review the literature on college student waterpipe use with a focus on undergraduates in the United States. Participants: Undergraduate students. Methods: Studies were accessed using the databases PubMed, MEDLINE, PsycINFO, and Academic Search Premier. Searches included combinations of the following keywords: “waterpipe,” “hookah,” “shisha,” “nargila,” “argileh,” “hubble bubble,” “college,” “university,” and “student.” Results: Results demonstrate that approximately 1 in 5 American college students report past-year waterpipe use. Results also suggest that there are a number of established correlates of waterpipe smoking, including male gender, Arab ethnicity, cigarette smoking, and the belief that waterpipe smoking is less harmful than cigarette smoking. Conclusions: Despite its harmful health effects, waterpipe smoking is quite common among college students. Future research with better methodologies and theoretical frameworks are needed to advance the field.     

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.     

Characteristics of university students who mix alcohol and energy drinks

Objective: Research has identified correlates (eg, drug use, risky sex, smoking) of using alcohol mixed with energy drinks (AMEDs). Few studies have investigated common mental health-related concerns (eg, depression, sleep). Participants: Alcohol-using college students (n = 380 never used AMEDs, n = 180 used AMEDs) were recruited in the study during the fall 2011 semester. Methods: The study examined demographics, substance use, depressive symptoms, and sleep problems in association with AMED use. Results: Multivariable logistic regression indicated that alcohol use severity (AOR = 1.24; 95% CI = 1.14+1.34), drug use severity (AOR = 1.20; 95% CI = 1.04–1.39), depressive symptoms (AOR = 1.06; 95% CI = 1.01–1.12), and smoking (AOR = 2.12; 95% CI = 1.22–3.68) were independently associated with AMED use; sleep problems were non-significant. Conclusions: Administrators may consider policies regarding energy drink availability on campus, and campus health personnel may increase screening and education surrounding AMED use to reduce risks among students.     

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.     

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.     

The Role of Depression and Negative Affect Regulation Expectancies in Tobacco Smoking Among College Students

Objective: Expectancies about nicotine's ability to alleviate negative mood states may play a role in the relationship between smoking and depression. The authors examined the role of negative affect regulation expectancies as a potential mediator of depression (history of depression and depressive symptoms) and smoking among college students. Participants and Methods: As part of a larger study, 315 undergraduate smokers completed a 296-item survey from January to May of 2001 and 2002. Results: Cross-sectional analyses revealed that negative affect regulation expectancies fully mediated the positive relationship between depressive symptoms and level of smoking. Conclusions: Although depressive symptoms are associated with higher levels of tobacco smoking, the expectation that smoking will reduce negative emotions is 1 factor that accounts for this relationship.     

University Binge Drinking Patterns and Changes in Patterns of Alcohol Consumption Among Chinese Undergraduates in a Hong Kong University

Abstract

Objective: To examine patterns of binge drinking and changes in drinking patterns among Chinese university students. Participants and Methods: Responses to an anonymous questionnaire were compared between a random sample of 411 second year Chinese undergraduate students in 2006 and 2,630 first year students from the previous year. Students reporting any symptoms of alcohol abuse were classified as alcohol abusers whereas those reporting repeated inability to curtail use were categorized as alcohol dependent. Results: After 1 year of university, greatly increased rates of past-month drinking of different degrees were found in both genders. Binge drinking among second year undergraduates was significantly correlated with male gender, living in a student residence hall, smoking, drinking to relieve stress, and having friends who frequently drank. Conclusions: Alcohol misuse is a health hazard to Chinese students in a university environment. Proactive policies aimed at preventing harmful alcohol use should be considered by university authorities.     

Relations Between Physical Activity and Behavioral and Perceptual Correlates Among Midwestern College Students

Objective Given ‘the inconsistent findings in the literature, the authors’ purpose in this study was to examine the associations between physical activity and behavioral and perceptional correlates, such as binge drinking, cigarette smoking, fruit or vegetable consumption, and weight perceptions, among midwestern college students. Participants and Methods The authors invited a convenience sample of 1,200 undergraduate college students enrolled in the 2004-2005 academic year in 4 different midwestern universities to participate in a survey. Of the 1,163 students who participated in the survey, a total of 1,134 usable surveys were received (response rate of 94.5%). Results Hierarchical multiple logistic regression analyses indicated that smoking, perceived weight, and consumption of fruit were independent predictors of physical activity when controlling for other variables. Conclusions Physical activity promotion requires tailored approaches that are dependent on the target segment of the college student populations.     

Hookah and Cigarette Smoking Among African American College Students: Implications for Campus Risk Reduction And Health Promotion Efforts

ABSTRACT

Objective: To identify individual and institutional risks and protections for hookah and cigarette smoking among African American (AA) college students. Participants: AA college students (N = 1,402; mean age = 20, range = 18–24 years; 75% female) who completed the Fall 2012 American College Health Association–National College Health Assessment II. Methods: Respondents were stratified into 4 mutually exclusive groups by last-30-day smoking status: cigarette-only use (5.1%), hookah-only use (5.9%), dual use (2.4%), and nonuse (86.6%). Multinomial logistic regression models identified the relative odds of exclusive and dual hookah and cigarette smoking. Results: Current hookah and cigarette smoking rates were comparably low. Age, gender identity, current substance use, interest in tobacco use information, and student population prevailed as risks and protections for hookah and cigarette smoking. Conclusions: Campus health promotion campaigns may need to tailor messages to AA students, particularly those who use substances, to underscore the health risks of hookah and cigarette smoking.     

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.     

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.     

Improving Tobacco-Free Advocacy on College Campuses: A Novel Strategy to Aid in the Understanding of Student Perceptions About Policy Proposals

Abstract

Objective: Tobacco-control policy proposals are usually met with opposition on college campuses. Research to understand students’ viewpoints about health-related policy proposals and messaging strategies, however, does not exist. This study investigated students’ perceptions about a smoke-free policy proposal to help understand their positions of support and opposition and to inform the development of effective messaging strategies. Participants: In January 2012, 1,266 undergraduate students from a midwestern university completed an online questionnaire about smoke-free campus policies. Methods: Responses were coded and analyzed using Linguistic Inquiry and Word Count software and chi-square, independent-samples t tests, and binary logistic models. Results: Most students who supported a smoke-free policy considered environmental or aesthetic conditions, whereas most opponents used personal freedom frames of thought. Supporters viewed smoking policies in personal terms, and opponents suggested means-ends policy reasoning. Conclusions: Taken together, points of reference and emotions about proposed policies provided insight about participants’ perspectives to help inform effective policy advocacy efforts.     

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.