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.     

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.     

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.     

Sexual Violence on the College Campus: A Template for Compliance With Federal Policy

Objective: The author introduces a template, the Model Policy for the Prevention and Response to Sexual Assault, to assist institutions of higher education to benchmark campus policy compliance with federal laws directed at sexual assault. The author presents a detailed review of policy criteria recommended by the National Institute of Justice. The author proposes 2 unique criteria not found in the National Institute of Justice report for consideration for a comprehensive campus sexual assault policy. Conclusion: The template provides an inclusive system to benchmark campus sexual assault policies. Conforming to the template provides compliance with federal laws and demonstrates that the campus fosters a climate that does not tolerate sexual violence.     

A Systematic Analysis of College Substance Use Policies

College substance use policies provide guidelines for student behavior and influence campus culture. Although they are the primary environmental strategy to address campus substance use, policies have not been systematically compared and studied. We constructed a systematic review method to examine the accessibility, comprehensiveness, enforcement procedures, and clarity of college substance use policies. We developed an objective evaluation scheme for each of these 4 dimensions and then applied it to documented substance use policies from a sample of colleges and universities (N = 24). Policies were found to vary considerably but tended to specify compliance with local laws and emphasize student health and well-being. The next stage of campus policy review should examine actual implementation, evaluate potential differentiating factors among institutions, and assess the influence of policy on campus climate and student outcomes.     

Nonmedication Treatments for Adult ADHD: Evaluating Impact on Daily Functioning and Well-Being

Abstract

Professor J. Russell Ramsey has written a short book aimed at practicing mental health clinicians, describing various non-medication approaches to the treatment of adult attention-deficit/hyperactivity disorder (ADHD). It includes a variety of strategies, some of which are validated and others of which are currently being developed but do not yet demonstrate effectiveness, alongside the documented effectiveness of medications for the treatment of core symptoms of ADHD, especially inattention, hyperactivity and impulsivity. He includes an up-to-date bibliography and critical evaluations of effectiveness for each treatment, especially functional outcomes. Given the high rate of postsecondary students with ADHD, the book should be helpful for college health professionals who are trying to assist such students.     

Predictors of Smoking and Smokeless Tobacco Use in College Students: A Preliminary Study Using Web-Based Survey Methodology

Cigarette smoking and smokeless tobacco (SLT) use are associated with numerous health hazards and economic costs, and rates of tobacco use have recently increased among young adults. In this study, the authors compared predictors of smoking and SLT use among college students (N = 21,410) from 13 Texas universities using a Web-based survey. Results revealed that sex, belonging to a fraternity or sorority, participation in intercollegiate sports, peer influences, and ethnicity predicted smoking and SLT use. Although common factors predicted both lifetime and current smoking and SLT use, patterns of prediction differed across dependent variables. The authors discuss implications for developing tobacco prevention programs targeting specific risk factors salient to the young adult population.     

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.     

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.     

Differences in Tobacco Use Among Two-Year and Four-Year College Students in Minnesota

Abstract

Objective: This study compares tobacco use rates among two-year and four-year college students and explores the demographic variables that predicted that behavior. Participants: 9,931 students at 14 two-year and four-year colleges in Minnesota participated. Methods: Students at 11 schools completed an online survey, and students at 3 schools completed a paper survey in 2007. Results: After controlling for sex, age, ethnicity, relationship status, hours of work per week, and number of school credits, attending a two-year college predicted current and daily smoking (odds ratio [OR]) = 1.70, 95% confidence interval [CI] = 1.52–1.89; OR = 3.47, 95% CI = 2.94–4.11) and smokeless tobacco use (OR = 1.65, 95% CI = 1.32–2.06; OR = 1.64, 95% CI = 1.06–2.53). Conclusions: Although two-year college students comprise approximately two fifths of the college student population, surveys of college student tobacco use have focused nearly exclusively on four-year college students. Two-year college students should represent a priority population for tobacco control because attending a two-year college predicts increased tobacco use.     

Electronic Cigarette Use Among College Students: Links to Gender,Race/Ethnicity,Smoking, and Heavy Drinking

Abstract

Objective: Electronic cigarette (e-cigarette) use continues to rise, and current data regarding use of e-cigarettes among college students are needed. The purpose of this study was to examine e-cigarette use and the relation of such use with gender, race/ethnicity, traditional tobacco use, and heavy drinking. Participants and Methods: A sample of 599 college students enrolled in General Psychology at a state university completed a self-report questionnaire. Results: Twenty-nine percent of students reported prior use of e-cigarettes, with 14% reporting use in the past 30 days. E-cigarette use was linked to male gender but not to race/ethnicity. Dual use (ie, concurrent use of both traditional and e-cigarettes) was related to heavier use of traditional and e-cigarettes, and nicotine use was linked to pronounced rates of heavy drinking. Conclusions: E-cigarette use among college students is exponentially on the rise, and its co-use with alcohol may contribute to negative outcomes in this population.     

College and University Compliance With a Required Meningococcal Vaccination Law

Objective: Maryland became the first state to pass a vaccination law requiring college and university students living on campus to obtain a meningococcal vaccination or to sign a waiver refusing vaccination because college students are at increased risk for disease. The authors sought to identify how Maryland colleges addressed the law and determine whether schools were in full compliance. Participants: The authors surveyed 32 college/university administrators via a self-administered questionnaire. Methods: The authors calculated vaccination and waiver rates and assessed compliance with the law overall and with specific law components. Results: Among 28 participating schools, annual vaccination rates and waiver rates among students during 2000-2004 ranged from 66%-76% and 12%-17%, respectively. Two (7%) schools were compliant with all components of the law. Conclusions: Mandatory vaccination laws do not ensure compliance at the college and university level. Mandatory reporting, increased education, and collaboration between colleges and universities and public health agencies are needed.     

An Assessment of America's Tobacco-Free Colleges and Universities

Abstract

Objective: This study examined the extent to which US campuses identified as “100% tobacco-free” by the American Lung Association of Oregon adhered to the American College Health Association's the most recent guidelines and recommendations promoting tobacco-free environments in colleges and universities. Participants: A key informant from 162 of 175 institutions (92.6% response rate) completed an online survey between January 2010 and February 2010. Methods: The variables under study were assessed via a cross-sectional research design. Participants completed a 35-item survey regarding their school's tobacco policies, procedures, and enforcement practices. Results: Although the vast majority of schools had written policies and procedures in place, schools with current policies were the most compliant. Numerous opportunities for improved adherence were identified in the results. Conclusions: Findings from this study may help institutions in the development and implementation of a new tobacco policy, as well as strengthen policies among existing tobacco-free schools.     

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.     

Support for Alcohol-Control Policies and Enforcement Strategies Among US College Students at 4-Year Institutions

Objective: The authors examined college student support for policies and enforcement strategies to reduce alcohol problems on campus. Participants: A random sample of students from each of 32 four-year colleges and universities participated. Methods: Students completed an anonymous mail survey. Results: A majority of students supported 5 of the 12 policy proposals. Whatever percentage of students indicated support for a policy, a far smaller percentage reported that other students supported it. The majority at all 32 schools supported using stricter disciplinary sanctions for students who engage in alcohol-related violence and repeatedly violate campus alcohol policy. The majority at more than half of the schools supported applying stricter penalties for the use of false IDs to purchase alcohol illegally and prohibiting kegs on campus. Conclusions: Higher-education administrators should survey students to learn which policies a majority of their students will endorse.     

Public Policies and Father Involvement

SUMMARY

The last two decades have been marked by a series of social and policy developments that are changing both how men see themselves as fathers and how policies conceptualize and encourage their involvement in the lives of children and families. This paper focuses on several areas of intersection between research on fathers and policy. The paper first summarizes the research that led to the current political and social interest in fathers. The paper then describes the Fatherhood Initiative, a set of activities that stemmed from a 1995 memorandum from President Clinton. This Initiative led to coordinated efforts by U.S. Federal Statistical agencies to collect better data about fathers. The paper concludes with a discussion of what we know about the effects on father involvement of policies such as welfare reform, child support, work place policies, responsible fatherhood programs, and other fatherhood interventions. Examples of new programs and initiatives on father involvement are also given.     

Challenges and Recommendations to Enforcement of Alcohol Policies on College Campuses: An Administrator's Perspective

Abstract

Objective: The purpose of this study was to examine challenges and recommendations (identified by college administrators) to enforcing alcohol policies implemented at colleges in the southeastern United States. Methods: Telephone interviews were conducted with 71 individuals at 21 institutions. Results: Common challenges included inconsistent enforcement, mixed messages received by students, and students’ attitudes toward alcohol use. The most common recommendations were ensuring a comprehensive approach, collaboration with members of the community, and enhanced alcohol education.     

Attitude Change among College Students toward Homosexuality

Abstract

Although audio-visual materials are commonly used on college and university campuses, frequently those materials are not evaluated to determine what impact they may have on students' attitudes. The present research compared the effect of three audio-visual programs on attitudes of college students toward homosexuality. The three programs included a film that dealt with prejudice towards numerous groups but not towards homosexuals; a video-tape of a homosexual clergyman who discussed sexual variance with particular emphasis on homosexuality; and two films in which couples were explicitly engaging in homosexual behavior. A control group was used. All groups received a lecture about homosexuality.

Using a two-way analysis of covariance, significant differences were found among the groups. Subjects that watched the film on prejudice and the video-tape of a discussion of homosexuality, as well as the control group, were all significantly more tolerant toward homosexuality than subjects who watched the explicit films. The difference among groups was immediate only. Five weeks after exposure to audio-visual programs, there were no significant differences. There was no significant difference between males and females, either immediately after seeing the programs or five weeks later. Thus, attitudes of college students toward homosexuality can be altered and were not gender specific.     

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.     

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.