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.     

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.     

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.     

Clearing the air: American Indian tribal college students' exposure to second hand smoke & attitudes towards smoke free campus policies

Objective: The purpose of this study was to examine knowledge, awareness, and support for campus smoke-free policies. Participants: 1,256 American Indian tribal college students from three tribal colleges in the Midwest and Northern Plains. Methods: Data are from an observational cross-sectional study of American Indian tribal college students, collected through a web-based survey. Results: Only 40% of tribal college students reported not being exposed to second hand smoke in the past 7 days. A majority of nonsmokers (66%) agreed or strongly agreed with having a smoke-free campus, while 34.2% of smokers also agreed or strongly agreed. Overall, more than a third (36.6%) of tribal college students were not aware of their campus smoking policies. Conclusions: Tribal campuses serving American Indian students have been much slower in adopting smoke-free campus policies. Our findings show that tribal college students would support a smoke-free campus policy.     

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.     

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.     

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.     

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.     

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.     

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.     

Flourishing: Exploring Predictors of Mental Health Within the College Environment

Abstract

Objective: To explore the predictive factors of student mental health within the college environment. Participants: Students enrolled at 7 unique universities during years 2008 (n = 1,161) and 2009 (n = 1,459). Methods: Participants completed survey measures of mental health, consequences of alcohol use, and engagement in the college environment. Results: In addition to replicating previous findings related to Keyes’ Mental Health Continuum, multiple regression analysis revealed several predictors of college student mental health, including supportive college environments, students’ sense of belonging, professional confidence, and civic engagement. However, multiple measures of engaged learning were not found to predict mental health. Conclusions: Results suggest that supportive college environments foster student flourishing. Implications for promoting mental health across campus are discussed. Future research should build on exploratory findings and test confirmatory models to better understand relationships between the college environment and student flourishing.     

The Community College Nurse as an Occupational Health Nurse

Abstract

Objective: This multisite study assessed college student's perceptions and practices regarding carrying concealed handguns on campus. Participants: Undergraduate students from 15 public midwestern universities were surveyed (N = 1,800). Methods: Faculty members distributed the questionnaire to students in general education classes or classes broadly representative of undergraduate students. Results: Useable questionnaires were returned by 1,649 students (92%). The majority (78%) of students was not supportive of concealed handguns on campuses, and 78% claimed that they would not obtain a permit to carry a handgun on campus, if it were legal. Those who perceived more disadvantages to carrying handguns on campus were females, who did not own firearms, did not have a firearm in the home growing up, and were not concerned with becoming a victim of crime. Conclusions: The majority of students was not supportive of concealed handguns on campus and claimed that they would not feel safer if students and faculty carried concealed handguns.     

College Smoking Policies and Smoking Cessation Programs: Results of a Survey of College Health Center Directors

Abstract

College students' cigarette smoking rose dramatically during the 1990s. Little is known about what colleges do to address the problem. Health center directors at 393 4-year US colleges provided information (response rate: 65.1%) about college policies addressing smoking and the availability of smoking cessation programs. Of the health center directors surveyed, 85% considered students' smoking a problem; yet only 81% of colleges prohibit smoking in all public areas and only 27% ban smoking in all indoor areas, including students' rooms in dormitories and in private offices. More than 40% of the respondents reported that their schools did not offer smoking cessation programs and that the demand for existing program was low. Colleges need to do more to discourage student tobacco use. Recommended actions include campus-wide no-smoking policies that apply to student residences and identification of new ways of providing smoking prevention and cessation services.     

Alcohol Use in Students Seeking Primary Care Treatment at University Health Services

Abstract

Objective: Given the high rate of at-risk drinking in college students, the authors examined drinking behaviors and associated factors in students being seen in student health services for primary care visits from October 30, 2004, to February 15, 2007. Methods: Analyses were based on a Health Screening Survey completed by 10,234 college students seeking general medical treatment. Results: Alcohol use was similar to other studies with 57% (n = 5,840) meeting the National Institute on Alcohol Abuse and Alcoholism criteria for at-risk drinking. Twenty-six percent of the students reported smoking at least once in the last 3 months. Risk factors for at-risk drinking included young age, white males, drinking at a fraternity/sorority house, and use of tobacco. Conclusions: These findings support the widespread implementation of alcohol screening and intervention in university health services.     

Community health workers on a college campus: Effects on influenza vaccination

Objective: To assess the impact of a campus community health worker program (HealthPALs) on student influenza vaccination. Participants: Undergraduate students at a northeastern US university (enrollment 6650), influenza seasons 2011–2012 through 2015–2016. Methods: Study design: Difference-in-differences analysis of student vaccination at campus dormitory influenza clinics during intervention vs. baseline. Intervention: In the first intervention year, HealthPALs conducted in-person peer outreach at several campus dormitory flu clinics. Subsequent years, HealthPALs conducted an enhanced intervention, with the addition of a personalized, dormitory-specific social media campaign appealing to students' community identity. Results: The initial intervention increased vaccinations by 66% (IRR = 1.66, 95%CI 1.39-1.97) at intervention clinics relative to control. The enhanced intervention increased vaccinations by 85% (IRR = 1.85, 95%CI 1.75-1.96).

Conclusion: Community health workers can be a highly effective, low-cost strategy for increasing influenza vaccination among college students. This model could also be used to address other campus health challenges where student engagement is key.     

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.     

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.     

College Student Smokers' Cognitive Appraisal of High-Risk Activities

Abstract

Objective: Students who smoke are more likely to engage in risky behaviors such as binge drinking and unprotected sex (Schnieder and Morris, Environ Behav. 1999; 23:575–591). The goals of the present study were to determine whether smokers assess these behaviors as lower risk than nonsmokers, and if smoking rate influences risk perceptions. Methods: Participants were 303 college students. Cognitive Appraisal of Risky Activities (Fromme et al., Cognit Ther Res. 1997; 21:421–442) and smoking were assessed August–November, 2006. Results: Smokers reported significantly less risk, more benefit, and more involvement in risky behaviors than nonsmokers (p < .01). In hierarchical linear regression, risk perceptions moderated the association between smoking and (a) expected benefit from risky sexual behaviors (β = ?1.121, p < .05); and (b) expected involvement with illicit drugs (β = ?.313, p < .01). Conclusions: College smokers’ assessment of high-risk behaviors influenced their intended involvement. Risk perception change may therefore alter their involvement in high-risk behaviors.     

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.