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Tan X, Mai J, Lin L, Zhou L, Huang T. Fuzzy-set qualitative comparative analysis of factors affecting the use of e-cigarettes among college students in Guangdong province. Tob Induc Dis 2024; 22:TID-22-93. [PMID: 38813583 PMCID: PMC11135023 DOI: 10.18332/tid/187836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Revised: 04/18/2024] [Accepted: 04/22/2024] [Indexed: 05/31/2024] Open
Abstract
INTRODUCTION In recent years, e-cigarettes as an emerging tobacco product have been favored by college students. Our study aims to explore the factors affecting the use of e-cigarettes among college students and to put forward feasible suggestions for effectively controlling the use of e-cigarettes among college students. METHODS The participating students were from three undergraduate and three specialized colleges in Guangdong Province, surveyed from January to March 2022. The Fuzzy-set Qualitative Comparative Analysis (fsQCA) method was used to analyze the influence mechanism and path of five antecedents: self-efficacy, social environment, cognition, sales environment, and negative outcome expectation, on the use of e-cigarettes. The fsQCA used in this study is a novel research methodology that combines the strengths of qualitative and quantitative analyses, through which we can determine which conditions are essential to the outcomes that lead to e-cigarette use among college students, and which combinations of conditions are more important than others. RESULTS The interaction of self-efficacy, social environment, cognition, sales environment, and negative outcome expectation, affected college students' use of e-cigarettes. Through the fsQCA method, it was found that self-efficacy alone constitutes a necessary condition for college students not to use e-cigarettes. There are four possible pathways for college students not to use e-cigarettes, with higher self-efficacy, correct cognition, and a healthy social environment influencing the most important combination of conditions for college students to use e-cigarettes. CONCLUSIONS The use of e-cigarettes by students in Guangdong Province is the result of the synergistic effect of multiple factors. Tobacco control action suggestions focus on improving students' self-efficacy and paying attention to the combination of different factors to achieve more effective tobacco control.
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Affiliation(s)
- Xiaoyu Tan
- Guangzhou Xinhua University, Guangzhou, China
| | | | - Lina Lin
- Guangzhou Xinhua University, Guangzhou, China
| | - Ling Zhou
- Guangzhou Xinhua University, Guangzhou, China
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Gnonlonfin E, Geindreau D, Gallopel-Morvan K. What are the effects of smoke-free and tobacco-free university campus policies, and how can they be assessed? A systematic review. JOURNAL OF EPIDEMIOLOGY AND POPULATION HEALTH 2024; 72:202520. [PMID: 38579395 DOI: 10.1016/j.jeph.2024.202520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 02/28/2024] [Accepted: 02/28/2024] [Indexed: 04/07/2024]
Abstract
OBJECTIVE This article looks at the evaluation of smoke-free (SF) and tobacco-free (TF) university campus policies that ban smoking (and often vaping) both indoors and outdoors. To assess the effectiveness of these policies, we performed a systematic literature review to answer the following questions: what is the effect of SF/TF policies on campus users' behaviors/norms/perceptions around smoking? Are the SF/TF policies an effective measure for reducing smoking among young adults? What methods and indicators can we use to assess the impact of SF/TF campus policies? What is the theoretical model underpinning the influence of SF/TF policies on the behavior of campus users? METHODS Three databases (PubMed, Scopus, and Web of Science) were searched over the period from January 2005 to December 2022. The article selection process included 54 articles published in scientific journals that analyzed the post-implementation impact of SF/TF campus policies. The quality of these articles was analyzed using six ad hoc indicators based on the Critical Appraisal Skills Program checklist and Joanna Briggs Institute scoping tools. RESULTS Most of the research on SF/TF campus policies has been conducted in the United States using quantitative methodologies. Most of these studies show that SF/TF policies reduce positive beliefs about smoking and its acceptability, influence smoking behavior (reducing smoking initiation and increasing the number of quits and quit attempts), and reduce exposure to passive smoking and pollution from cigarette butts. User acceptability of SF/TF policies is generally high. Limitations of SF/TF campus policies include difficulty for smokers to comply with them, persistence of passive smoking around campuses, and limited uptake of on-campus cessation support services provided to smokers. DISCUSSION The various mediating and moderating variables identified in the literature have made it possible to propose a model of the potential influence of SF/TF policy on campus users, based on the theory of planned behavior. Based on this review, we provide health professionals and higher education institutions wishing to implement a SF/TF campus policy with a set of indicators that can serve to assess the impact of a SF/TF campus policy (attitudes, acceptability, beliefs, norms, exposure to passive smoking and pollution, changes in smoking behavior). CONCLUSION Based on scientific evidence, the implementation of SF/TF campus policies in France is an important measure to help combat smoking in young adults.
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Affiliation(s)
- Etienne Gnonlonfin
- Univ Rennes, EHESP, CNRS, Inserm, Arènes - UMR 6051, RSMS - U 1309, 35000, Rennes, France.
| | - Diane Geindreau
- Univ Rennes, EHESP, CNRS, Inserm, Arènes - UMR 6051, RSMS - U 1309, 35000, Rennes, France
| | - Karine Gallopel-Morvan
- Univ Rennes, EHESP, CNRS, Inserm, Arènes - UMR 6051, RSMS - U 1309, 35000, Rennes, France
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Cabriales JA, Hernandez N, Taylor T, Cooper TV. A three wave assessment of a tobacco free campus policy within a minority serving institution. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2022:1-8. [PMID: 36260809 DOI: 10.1080/07448481.2022.2129978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 09/01/2022] [Accepted: 09/25/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVE This study assessed changes (in relation to smoking status) in tobacco use, attitudes toward TFC policies, and tobacco use risk knowledge by applying a three Wave repeated cross-sectional assessment. PARTICIPANTS Participants were students at Wave 1 (n = 2,169), Wave 2 (n = 2,576), and Wave 3 (n = 2,169) and faculty at Wave 1 (n = 256), Wave 2 (n = 204), and Wave 3 (n = 180). METHODS Measures regarding sociodemographics, tobacco use, attitudes toward TFC policies, and tobacco use risk knowledge were completed. RESULTS Compared with Wave 1, more students reported having quit smoking within the last six months at Waves 2 and 3. The negative attitudes toward TFC policies of those who reported quitting in the last six months aligned with those of nonsmokers. CONCLUSIONS Study findings suggest smoking status as a relevant covariate to focus on to further strengthen and refine existing TFC policies.
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Affiliation(s)
- José Alonso Cabriales
- Fine Arts, Humanities & Social Sciences, The University of New Mexico-Gallup, Gallup, New Mexico
| | - Nora Hernandez
- Office of Research and Sponsored Projects, The University of Texas at El Paso, El Paso, Texas, USA
| | - Thom Taylor
- Department of Psychology, The University of Texas at El Paso, El Paso, Texas, USA
| | - Theodore V Cooper
- Department of Psychology, The University of Texas at El Paso, El Paso, Texas, USA
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Nyman AL, Jivani S, Jazwa A, Heath E, Redmon PB, Sinha B, Hayat MJ, Eriksen MP. Student tobacco use, secondhand smoke exposure, and policy beliefs before and after implementation of a tobacco-free campus policy: Analysis of five U.S. college and university campuses. Prev Med 2022; 163:107238. [PMID: 36057391 DOI: 10.1016/j.ypmed.2022.107238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 07/12/2022] [Accepted: 08/28/2022] [Indexed: 11/26/2022]
Abstract
The adoption of comprehensive tobacco policies by colleges and universities may help reduce student tobacco use. To this end, The American Cancer Society's Tobacco-Free Generation Campus Initiative (TFGCI) awarded grants to 106 higher learning institutions to adopt 100% tobacco-free campus policies. This study measured changes in student tobacco use, reported exposure to secondhand smoke, and support for types of tobacco policies among five TFGCI grantee institutions who implemented 100% tobacco-free policies. Students at five U.S. TFGCI grantee institutions completed two independent cross-sectional online surveys regarding tobacco use, exposure to secondhand smoke, and policy attitudes, once before (n = 2499) and once after (n = 1667) their campuses adopted a tobacco-free policy. Students were less likely to report current cigarette smoking (aOR: 0.73, 95% C.I.: 0.63, 0.85) and exposure to secondhand smoke on campus (aOR: 0.42, 95% C.I.: 0.23, 0.76) following the policy change. In contrast, students were more likely to report past 30-day use of electronic nicotine delivery systems (ENDS) (aOR: 2.16, C.I.: 1.77, 2.63) following the policy change, despite the policy's inclusion of all tobacco and nicotine products. Tobacco-free campus policies can be associated with decreases in tobacco product use and environmental smoke exposure. The extent of their effectiveness may vary by product and the inclusion of tailored messaging, cessation support, and enforcement approaches. To discourage use of these products among students, colleges and universities should adopt 100% tobacco-free policies, monitor product use trends, offer cessation support and messaging customized for specific groups and products, and utilize a comprehensive enforcement strategy.
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Affiliation(s)
- Amy L Nyman
- School of Public Health, Georgia State University, Atlanta, GA, USA.
| | - Saiza Jivani
- School of Public Health, Georgia State University, Atlanta, GA, USA
| | - Amelia Jazwa
- School of Public Health, Georgia State University, Atlanta, GA, USA
| | - Erica Heath
- School of Public Health, Georgia State University, Atlanta, GA, USA
| | - Pamela B Redmon
- School of Public Health, Georgia State University, Atlanta, GA, USA
| | | | - Matthew J Hayat
- School of Public Health, Georgia State University, Atlanta, GA, USA
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Pulvers K, Rice M, Stewart SL, Tong E. Tobacco Tracker: A New Tool to Support College Smoke and Tobacco Free Policies. Nicotine Tob Res 2022; 24:241-249. [PMID: 34671812 DOI: 10.1093/ntr/ntab187] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 09/11/2021] [Indexed: 11/12/2022]
Abstract
INTRODUCTION University community members are critical to the success of their smoke and tobacco free (STF) policies. The present study evaluates changes in social enforcement-related attitudes and behaviors following introduction of a new online Tobacco Tracker tool in two university settings. METHODS Campus wide surveys were administered to current students, faculty, and staff at two California public universities with 100% STF policies before (November 2018; N = 5078) and after (December 2019-January 2020; N = 4853) introduction of Tobacco Tracker in February 2019. Prospective surveillance reports over 12 months from Tobacco Tracker, a GIS tool for the campus community to report tobacco use and related litter that displays crowdsourced maps of hotspots, were analyzed. Outcomes included awareness and self-reported use of a tobacco reporting tool, readiness for policy social enforcement, an Intellectual Social Affective (ISA) Engagement scale, and environmental surveillance reports from Tobacco Tracker. RESULTS In campus surveys, awareness of a tobacco reporting tool doubled (8.0%-16.9%, p < .0001), use of an online reporting tool tripled (1.1%-3.2%, p < .0001), and readiness to enforce the policy increased (p = .0008). ISA engagement did not change (p = .72). In Tobacco Tracker campus reports (N = 1163), active tobacco use was reported more frequently than tobacco-related litter. CONCLUSIONS Tobacco Tracker is a promising tool for college communities to support STF policy. Introduction of Tobacco Tracker was associated with an increase in campus awareness and utilization of a reporting tool, readiness to enforce policy, and campus tobacco surveillance. Future research should determine how Tobacco Tracker may improve policy compliance. IMPLICATIONS Tobacco Tracker is a promising tool for college communities to support smoke and tobacco free (STF) policy through active surveillance of smoking, vaping, and related litter on campus. Introduction of Tobacco Tracker was associated with changes in social enforcement-related attitudes and behaviors critical to realizing the preventive potential of STF policies. A crowdsourcing-based tool for monitoring tobacco use on college campuses can address a major barrier to social enforcement: discomfort confronting tobacco users. Further, it provides an alternative to punitive enforcement approaches and promises a sustainable solution to an infrastructure issue faced by many universities lacking resources to collect data on campus tobacco use and related litter.
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Affiliation(s)
- Kim Pulvers
- Department of Psychology, California State University San Marcos, San Marcos, CA, USA
| | - Myra Rice
- Department of Psychology, California State University San Marcos, San Marcos, CA, USA
| | - Susan LeRoy Stewart
- Department of Public Health Sciences, University of California, Davis, Sacramento, CA, USA
| | - Elisa Tong
- Department of Internal Medicine, University of California, Davis, Sacramento, CA, USA
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Glasgow TE, Miller CA, Barsell DJ, Do EK, Fuemmeler BF. Assessing how a tobacco-free campus leads to attitude change and support among students, faculty, and staff. Tob Prev Cessat 2021; 7:53. [PMID: 34307968 PMCID: PMC8283972 DOI: 10.18332/tpc/138224] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 05/21/2021] [Accepted: 05/26/2021] [Indexed: 12/28/2022]
Abstract
INTRODUCTION Universities are increasingly considering tobacco-free campus policies to help promote a healthy learning and working environment. We assessed attitudes of students, faculty, and staff, before and after the implementation of a tobacco-free campus policy at a large, urban university. We also examined individual factors associated with these attitudes. METHODS An independent panel design method was used to assess students, faculty and staff about their tobacco product use, attitudes towards tobacco policies, and support for cigarette and e-cigarette bans 3 months before and 7 months after a university-wide policy change to ban tobacco and e-cigarettes on campus. Survey participants before the policy change included 636 students and 1356 faculty/ staff. Survey participants after the policy change included 1000 students and 574 faculty/staff. We conducted separate multiple linear and logistic regression models for students and faculty/staff. RESULTS Attitudes towards tobacco-free campus policies did not improve for students, but did for faculty/staff. Support for bans of cigarettes and e-cigarettes on campus increased following the policy change among both students and faculty/staff. Students were more willing to ask their friends to stop vaping post-policy, but did not differ in their willingness to ask friends to stop smoking. Among the individual factors considered, gender and use of cigarettes and e-cigarettes were predictive of attitudes among both students and faculty/staff. Women were more likely to support and have more positive attitudes towards bans, while current tobacco product users were less likely to support tobacco product bans and have less positive attitudes towards tobacco policies. CONCLUSIONS Attitudes towards tobacco-free campus policies changed pre- to postpolicy among faculty/staff, but not among students. However, both students and faculty/staff were more supportive of tobacco product bans following the policy change. Individual factors associated with support and attitudes were identified.
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Affiliation(s)
- Trevin E Glasgow
- Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, United States.,Department of Epidemiology, Milken Institute School of Public Health, George Washington University, Washington, United States
| | - Carrie A Miller
- Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, United States
| | - D Jeremy Barsell
- Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, United States
| | - Elizabeth K Do
- Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, United States.,Department of Epidemiology, Milken Institute School of Public Health, George Washington University, Washington, United States
| | - Bernard F Fuemmeler
- Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, United States
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Arslan HN, Oruc MA, Terzi O, Bilir N. Evaluation of the Opinions of Family Physicians on Some Tobacco Products. J Community Health 2020; 45:1132-1138. [PMID: 32613534 DOI: 10.1007/s10900-020-00872-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
This study aimed to evaluate the opinions of family physicians, who have an important place in preventive health services, on some tobacco products. The sample of the descriptive study was composed of family physicians working in 408 family health centers serving Samsun, Turkey. The data were obtained by distributing a questionnaire prepared by the researchers to volunteer family physicians during in-service trainings organized by the Samsun Provincial Directorate of Health in February and March 2019. In all, 322 (79%) family physicians who participated in the trainings were included in the study. The average age of the participating physicians was 45.0 ± 7.6 years; 61.5% of them were male. More than one third (36.0%) of family physicians said that they had never smoked, while 23.6% of them were current smokers. Most (85.0%) said that they knew what an electronic cigarette was, 94.7% of them were familiar with hookahs, and 9.0% knew about I Quit Ordinary Smoking (IQOS). It is important to inform all healthcare professionals, and especially family physicians, about those products marketed by the tobacco industry as "less harmful" than cigarettes. It is thought that providing appropriate counseling services to these professionals will contribute to the fight against tobacco use.
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Affiliation(s)
- Hatice Nilden Arslan
- Department of Public Health, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey.
| | | | - Ozlem Terzi
- Department of Public Health, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey
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