Components in tobacco-free school policies-A coding tool for assessment

OBJECTIVE

To develop an instrument to examine tobacco-free campus policy components.

PARTICIPANTS

Missouri two- and four-year, specialized/technical, and religious colleges and universities (N = 76). Methods: The instrument was informed via literature review and expert interviews. Coder agreement was strong (κ = .80). Qualitative policy language examples were identified.

RESULTS

Model policy components including consideration for population, prohibited products, location restrictions, enforcement, consequences, promotions, communications, cessation, designated smoking areas and exemptions; comprehensive policies included all populations, for all tobacco products, and at all locations on the campus. Nineteen campuses had comprehensive tobacco-free policies, five had comprehensive smoke-free policies (cigarettes and e-cigarettes), and no policy included all model components. Fifty-two were non-comprehensive.

CONCLUSIONS

This instrument can allow campuses to identify components for comprehensive and model tobacco-free campus policies and assist officials in improving policy language. Future research can use this instrument to examine the effectiveness of components and their impact on tobacco use outcomes.

Campus Smoking Policies and Smoking-Related Twitter Posts Originating From California Public Universities: Retrospective Study

Background

The number of colleges and universities with smoke- or tobacco-free campus policies has been increasing. The effects of campus smoking policies on overall sentiment, particularly among young adult populations, are more difficult to assess owing to the changing tobacco and e-cigarette product landscape and differential attitudes toward policy implementation and enforcement.

Objective

The goal of the study was to retrospectively assess the campus climate toward tobacco use by comparing tweets from California universities with and those without smoke- or tobacco-free campus policies.

Methods

Geolocated Twitter posts from 2015 were collected using the Twitter public application programming interface in combination with cloud computing services on Amazon Web Services. Posts were filtered for tobacco products and behavior-related keywords. A total of 42,877,339 posts were collected from 2015, with 2837 originating from a University of California or California State University system campus, and 758 of these manually verified as being about smoking. Chi-square tests were conducted to determine if there were significant differences in tweet user sentiments between campuses that were smoke- or tobacco-free (all University of California campuses and California State University, Fullerton) compared to those that were not. A separate content analysis of tweets included in chi-square tests was conducted to identify major themes by campus smoking policy status.

Results

The percentage of positive sentiment tweets toward tobacco use was higher on campuses without a smoke- or tobacco-free campus policy than on campuses with a smoke- or tobacco-free campus policy (76.7% vs 66.4%, P=.03). Higher positive sentiment on campuses without a smoke- or tobacco-free campus policy may have been driven by general comments about one’s own smoking behavior and comments about smoking as a general behavior. Positive sentiment tweets originating from campuses without a smoke- or tobacco-free policy had greater variation in tweet type, which may have also contributed to differences in sentiment among universities.

Conclusions

Our study introduces preliminary data suggesting that campus smoke- and tobacco-free policies are associated with a reduction in positive sentiment toward smoking. However, continued expressions and intentions to smoke and reports of one’s own smoking among Twitter users suggest a need for more research to better understand the dynamics between implementation of smoke- and tobacco-free policies and resulting tobacco behavioral sentiment.

Assessing how a tobacco-free campus leads to attitude change and support among students, faculty, and staff

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.

The attitudes and behaviors of students, staff and faculty towards smoke-free and tobacco-free campus policies in North American universities: A narrative review

INTRODUCTION

In Canada, a series of recent public health policies and interventions have successfully led to a decline in national tobacco use rates. However, tobacco use among young adults remains high and the tobacco industry continues to place a strong marketing emphasis towards young adults on university campuses. In response, many universities across Canada are beginning to adopt smoke-free or tobacco-free campus policies. While the effectiveness of smoke-free and tobaccofree campus policies has been demonstrated in several countries, little is known about the attitudinal responses of university students, faculty and staff towards these policies. As such, we conducted a review of the literature to summarize the findings of studies conducted in North America regarding the attitudes and beliefs of campus community members towards smoke-free or tobacco-free campus policies.

METHODS

Using a pre-defined search strategy and Boolean string, we searched three databases for published articles pertaining to the research question. Only primary and peer-reviewed articles of studies conducted on North American university campuses were eligible for inclusion. Studies included for review were those published in English within the last five years. All studies included in the review contained outcome measurements related to the attitudes and behaviors of faculty, staff and students towards smoke-free and/or tobacco-free campus policies.

RESULTS

A total of 11 articles were included for analysis and result synthesis. Recent research indicates that individuals' attitudes and beliefs towards smoke-free or tobacco-free campus policies are influenced by social norms, smoking status, secondhand smoke exposure, and sociodemographics.

CONCLUSIONS

This literature review provides timely information for universities in the process of developing or implementing a smoke-free campus policy. The attitudes and beliefs of university students, faculty and staff can determine success and compliance to newly implemented smoke-free campus policies.

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

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.

Building capacity to implement tobacco-free policies in college and university settings with underserved populations

INTRODUCTION

This study aimed to facilitate the process of policy adoption and implementation across community colleges and Historically Black Colleges and Universities (HBCUs) to develop, adopt, and implement a 100% smoke- or tobacco-free policy.

METHODS

In total, 135 community colleges and HBCUs took part in the program. This multiple-site case study analyzed each institution's online self-reported surveys every 6 months to record progress on each of five core project elements. Data were analyzed in June 2017.

RESULTS

Overall, 77 of 135 institutions adopted a smoke- or tobacco-free policy during the college initiative program that led to a broader public health impact of more than 717000 students and employees protected from the harms of smoking and secondhand smoke. A regression analysis also found that ongoing/completed policy activities and perceived importance of having a 100% smoke- or tobacco-free policy presented greater odds of an institution passing or adopting a policy.

CONCLUSIONS

Population-level impact and total number of people reached by this initiative is notable, though moving smoking off campus can have unintended impacts. This suggests policy change should include cessation efforts, policy compliance and policies into the broader community when possible through community partnerships.

Modelling the implications of reducing smoking prevalence: the public health and economic benefits of achieving a 'tobacco-free' UK

INTRODUCTION

Smoking is still the most preventable cause of cancer, and a leading cause of premature mortality and health inequalities in the UK. This study modelled the health and economic impacts of achieving a 'tobacco-free' ambition (TFA) where, by 2035, less than 5% of the population smoke tobacco across all socioeconomic groups.

METHODS

A non-linear multivariate regression model was fitted to cross-sectional smoking data to create projections to 2035. These projections were used to predict the future incidence and costs of 17 smoking-related diseases using a microsimulation approach. The health and economic impacts of achieving a TFA were evaluated against a predicted baseline scenario, where current smoking trends continue.

RESULTS

If trends continue, the prevalence of smoking in the UK was projected to be 10% by 2035-well above a TFA. If this ambition were achieved by 2035, it could mean 97 300 +/- 5 300 new cases of smoking-related diseases are avoided by 2035 (tobacco-related cancers: 35 900+/- 4 100; chronic obstructive pulmonary disease: 29 000 +/- 2 700; stroke: 24 900 +/- 2 700; coronary heart disease: 7600 +/- 2 700), including around 12 350 diseases avoided in 2035 alone. The consequence of this health improvement is predicted to avoid £67 +/- 8 million in direct National Health Service and social care costs, and £548 million in non-health costs, in 2035 alone.

CONCLUSION

These findings strengthen the case to set bold targets on long-term declines in smoking prevalence to achieve a tobacco 'endgame'. Results demonstrate the health and economic benefits that meeting a TFA can achieve over just 20 years. Effective ambitions and policy interventions are needed to reduce the disease and economic burden of smoking.

A tobacco-free campus ambassador program and policy compliance

OBJECTIVE

Assess impact and feasibility of a Tobacco-Free Ambassador Program on campus policy compliance.

PARTICIPANTS

Trained Ambassadors made 253 visits to campus sites over 15 months to observe and/or approach violators.

METHODS

Policy violators were observed at 23 locations during Wave 1 (April-June 2012) and/or Wave 2 (April-June 2013). For locations with at least 5 visits, average violators per visit were compared between the 2 waves using a paired t test. Attributes of violators were summarized. Cigarette butts were collected over 3-day periods in 4 campus hotspots during each wave. Personnel time and cost to implement the program were determined.

RESULTS

There were declines in observed violators per Ambassador visit and number of cigarette butts over time. Rate of violators per visit declined from 5.47 to 1.93, a 65% decrease. Personnel time was equal to 1.5 full-time equivalents annually.

CONCLUSIONS

The Ambassador Program was a feasible and potentially effective strategy to increase policy compliance.

Tobacco-free Take Action!: Increasing Policy Adherence on a College Campus

INTRODUCTION

One in five college students report tobacco use, thus universities are making strides to reduce tobacco use by adopting smoke- or tobacco-free policies.

PURPOSE

Describe an innovative ambassador program to increase adherence with a tobacco-free campus policy.

METHODS

The Tobacco-Free Take Action! (TFTA!) Ambassador program was created to form an environment of compliance. Hot spots were targeted by Ambassadors, who were trained to use scripted messages. Ambassadors completed an online documentation form to assess the number of violators observed and approached. The Tobacco-Free Compliance Assessment Tool (TF-CAT) was used to collect pre- and post-cigarette butt data at each hot spot.

RESULTS

During the 4-week intervention period, Ambassadors approached 332 violators (529 observed), of which 68% responded positively and complied with the policy. The number of cigarette butts declined by 25%.

DISCUSSION

Adherence with campus tobacco-free policies remains a challenge. Lessons learned from this innovative approach will benefit those currently implementing and planning tobacco-free campus policies.

State adoption of 100% smoke-free acute non federal hospital campus policies

To assess the number and percentage of acute care hospitals in the U.S. that have adopted smoke-free hospital campus (SFHC) policies, researchers conducted an assessment from January 2008 to May 2008 of available data on SFHC policy adoption in each state. Slightly more than one third (34.4%) of acute care, non-Federal hospitals had adopted such policies, with wide variation of policy adoption between states.