Adoption of electronic-cigarette-free,hookah-free and American College Health Association recommended tobacco-free policies among a national sample of postsecondary educational institutions

Abstract

Objective: To examine the prevalence of various types of tobacco-free policies among a US national sample of postsecondary educational institutions (PEIs). Participants: A national sample of US PEIs (N?=?605) attended by the participants of the NEXT Generation Health Study. Methods: Tobacco policies of these PEIs were reviewed to determine if they were e-cigarette-free (yes/no), hookah-free (yes/no), and ACHA-recommended tobacco-free (yes/no) in June–December 2017. Logistic regression models were used to examine the relationships between institutional characteristics and tobacco policies. Results: Overall, 39.2, 26.0, and 20.0% of the sample adopted e-cigarette-free, hookah-free, and ACHA-recommended tobacco-free policies, respectively. Proprietary PEIs (vs. public) were less likely to have ACHA-recommended tobacco-free policies, while PEIs in the South and Midwest (vs. West) were more likely to have ACHA-recommended tobacco-free policies (p?<?0.05). Conclusions: Most sampled PEIs did not have ACHA-recommended tobacco-free polices. Subsequent research needs to investigate how ACHA-recommended tobacco policies influence tobacco use.     

Perceptions of College and University Presidents Regarding Tobacco-Free Campus Policies

Abstract

Objective: To identify college presidents’ support for tobacco-free campus policies (TFCP), perceived barriers and benefits to implementing such policies, and activities that might initiate policy adoption. Participants: Participants were 405 presidents (51% of 796 delivered surveys) from a national sample of eligible 4-year institutions in summer 2012. Methods: A 4-page, 24-item cross-sectional questionnaire was mailed to potential participants in 4 waves to maximize the response rate. Results: The vast majority of presidents support TFCP (84%) and believed they should play a key role in establishing TFCP (80%). A majority agreed advocacy by campus groups was necessary to establishing TFCP. Presidents with an existing policy were twice as likely to believe advocacy was necessary for policy establishment. Presidents most commonly selected creating policy drafts and designating a committee as important to initiating TFCP. Conclusion: Advocates would benefit from focusing on presidential involvement and solutions to personnel barriers in establishing TFCP.     

Going tobacco-free on 24 New York City university campuses: A public health agency's partnership with a large urban public university system

ABSTRACT

The New York City Department of Health and Mental Hygiene partnered with the nation's largest university system, the City University of New York (CUNY), to provide technical assistance and resources to support the development and implementation of a system-wide tobacco-free policy. This effort formed one component of Healthy CUNY—a larger initiative to support health promotion and disease prevention across the university system and resulted in the successful introduction of a system-wide tobacco-free policy on all CUNY campuses. Glassman et al (J Am Coll Health. 2011;59:764–768) published a blueprint for action related to tobacco policies that informed our work. This paper describes the policy development and implementation process and presents lessons learned from the perspective of the Health Department, as a practical case study to inform and support other health departments who may be supporting colleges and universities to become tobacco-free.     

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.     

Online readiness assessment for Smoke- and Tobacco-free campus policies

ABSTRACT

Objective: Develop and test an online survey to assess campus readiness to adopt smoke- and tobacco-free (SF/TF) policies. Participants: Key informants (N = 18) at four campuses in Kentucky without a SF/TF policy recruited April 2015. Methods: Cross-sectional design. The survey assessed six dimensions: knowledge about SF/TF policies; leadership for campus policy; resources for policy development; campus climate surrounding tobacco issues; existing tobacco policies; and political climate for campus policy development. Dimension raw scores were rescaled to range from 0–1 and summed to determine overall stage of readiness (0–6). Results: Political climate was highest dimension across all campuses (0.83–1.0). Knowledge dimension ranked lowest (0.0–0.50). Overall readiness scores ranged from 2.53–3.94; two campuses in preplanning and two in preparation. Conclusions: Development of the online measure is timely considering the impetus to implement SF/TF policies. Findings reinforce that campuses are at varying stages of implementing these policies, and stage-based interventions are necessary.     

Strategies for Implementing a Tobacco-Free Campus Policy

Abstract

This report examines the rationale for creating a tobacco-free campus to utilize in passing antitobacco policies, and recommendations for overcoming barriers. As with any type of advocacy effort, a variety of impediments exist, including lack of administrative and staff support, absence of student involvement, and sparse resources. A variety of potential remedies and advocacy opportunities are explored and delineated.     

Social influences on use of cigarettes,e-cigarettes,and hookah by college students

ABSTRACT

Objectives: (1) Compare social norms and perceived peer use between college student cigarette, e-cigarette, and/or hookah users and nonusers; and (2) determine variables associated with social influences. Participants: Undergraduate students attending a large university in the Southeast United States (N = 511). Methods: An April 2013 online survey assessed use of 3 types of tobacco, social norms, perception of peer use, number of smokers in life, exposure to secondhand smoke, and demographic characteristics. Results: Participants indicated greater acceptance of emerging tobacco products than for cigarettes and consistently overestimated the percent of peers who use various tobacco products. Males and current users had higher social norm scores for all 3 forms of tobacco. Conclusion: To counter marketing of alternative tobacco products, education about the dangers of their use needs to be implemented across college campuses as part of a comprehensive tobacco control strategy that also includes tobacco-free campus policies.     

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.     

Impact of the Adoption of Tobacco-Free Campus Policies on Student Enrollment at Colleges and Universities,North Carolina, 2001–2010

Abstract

Objective: College and university administrators have expressed concern that adoption of tobacco-free policies may reduce applications and enrollment. This study examines adoption and implementation of 100% tobacco-free campus policies by institutions of higher education on applications and enrollment. Participants: North Carolina private colleges and universities and public community colleges. Analysis was conducted in 2011. Methods: Student enrollment and application data were analyzed by campus type to determine (a) if there was a difference in student applications and enrollment before and after policy implementation, and (b) if there was a difference in student applications and enrollment for campuses with versus without a policy. Results: No significant differences were found in student enrollment or applications when comparing years prior to and following policy implementation or when comparing with institutions without 100% tobacco-free campus policies. Conclusions: The authors found no evidence that 100% tobacco-free policy adoption had an impact on student enrollment or applications.     

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.     

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.     

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.     

US Public Universities' Compliance With Recommended Tobacco-Control Policies

Abstract

To address the rise in tobacco use among college students, several national health organizations, including the American College Health Association, recommend that colleges enact smoking bans in and around all campus buildings, including student housing, and prohibit the sale, advertisement, and promotion of tobacco products on campus. Key informants at 50 US public universities, one from each state, were interviewed during the 2001/2002 academic year to assess the prevalence of these recommended policies. More than half (54%) of the colleges banned smoking in all campus buildings and student residences, 68% had no tobacco sales on campus, and 32% of the schools' newspapers did not accept tobacco advertising. Regional differences in adoption of these campus tobacco-control policies were present. Although this national sample of public universities had implemented some of the recommended policies, they must take further actions to comply fully with campus tobacco-control guidelines.     

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.     

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.     

Perceived Continuing Education Needs and Job Relevance of Health Education Competencies Among Health Education and Promotion Practitioners in College Health Settings

Objective and Participants: The author conducted this study to determine college health education and promotion practitioners' perceived continuing education needs and perceived job relevance in relation to national health education responsibilities and competencies. Methods: In Spring 2006, the author invited college health education and promotion professionals to participate in an online survey, using 3 listservs. Of 276 individuals visiting the Web site, 141 participants completed the survey (51%). Participants rated their perceived training needs and job relevance for the 35 National Commission for Health Education Credentialing (NCHEC) competencies as well as preferred training formats. Results: Participants identified the following competencies as those in which they needed additional training: designing data-collection instruments, securing fiscal resources, interpreting evaluation and research results, carrying out evaluation and research plans, and developing plans for evaluation and research. They identified the following competencies as being the most relevant to their jobs: demonstrating a variety of skills in delivering strategies, interventions, and programs; using a variety of methods to implement strategies, interventions, and programs; initiating a plan of action; and using health-related information resources. The most preferred methods of obtaining additional continuing education were attending the American College Health Association annual meeting (67%) and completing home self-study print materials (67%). Conclusions: Collegiate professional organizations should offer a variety of continuing education opportunities centering on NCHEC competencies, specifically those perceived as needed by study participants.     

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.     

Varicella immunization requirements for US colleges: 2014–2015 academic year

ABSTRACT

Objective: To obtain information on varicella prematriculation requirements in US colleges for undergraduate students during the 2014–2015 academic year. Participants: Health care professionals and member schools of the American College Health Association (ACHA). Methods: An electronic survey was sent to ACHA members regarding school characteristics and whether schools had policies in place requiring that students show proof of 2 doses of varicella vaccination for school attendance. Results: Only 27% (101/370) of schools had a varicella prematriculation requirement for undergraduate students. Only 68% of schools always enforced this requirement. Private schools, 4-year schools, northeastern schools, those with <5,000 students, and schools located in a state with a 2-dose varicella vaccine mandate were significantly more likely to have a varicella prematriculation requirement. Conclusions: A small proportion of US colleges have a varicella prematriculation requirement for varicella immunity. College vaccination requirements are an important tool for controlling varicella in these settings.     

Peer support and food security in deaf college students

Abstract

Objective: The purpose of the study was to investigate whether peer support and demographic characteristics predicted food security among deaf college students. Participants: The sample included 166 deaf college students at Gallaudet University. Methods: Participants completed a bilingual online survey in American Sign Language (ASL) and English. This survey included USDA’s 6-item food security survey, questions about peer support and socio-demographic characteristics. Results: Out of 166 students (mean age =23; SD?=?6), 60.7% were food secure. About 26.4% were at-risk for low food security and another 12.9% had very low food security. The sample included respondents who identified as people of color (54%) and women (52%). Binary logistic regression revealed that compared to people who reported always receiving peer support, people who never received peer support were 16.3 times more likely to experience food insecurity (adj OR: 16.325, 95% CI 1.824–146.107). Conclusions: This study demonstrates a strong relationship between peer support and deaf college students' food security experiences.